Freedom of information act and concerns over medical confidentiality among healthcare providers in Nigeria

Abstract

Background: Freedom of Information Act tends to be misused especially in healthcare settings if limits are not well understood. It has long been established that patients have lost control over how their health information is obtained and used, and that responsibility for medical confidentiality is not clearly understood by healthcare providers. Therefore, assurances about medical confidentiality are essential to the efficient provision of safe, effective and quality healthcare to patients and the public especially, with the passage of the Freedom of Information (FOI) Act in May, 2011. Hence, this cross-sectional study was carried out to determine possible concerns over medical confidentially in the era of FOI among healthcare providers in two public tertiary hospitals in Nigeria. Methodology: A 23-item questionnaire was designed for data collection. The study deployed stratified random sampling method in the recruitment of participants. Results: Nearly three-quarter (223, 74.3%) of the participants were females in a sample with a Mean age of 40±9 years. Most (228, 76.8%) participants indicated that they know the reasons for keeping the patients’ health records which include, education (66, 22.0%), continuity of patients’ care (51, 17.0%) and research purposes (50, 16.7%). The vast majority of participants (275, 92.3%) have heard about medical confidentiality, mostly (196, 65.3%) from the hospitals, and nearly two-third (191, 64.3%) of them have not heard about Freedom of Information Act. A few (11, 3.7%) knew it was the responsibility of all health workers to maintain medical confidentiality in any hospital setting. Notable factors that influenced the perceptions of participants on medical confidentiality in the era of FOI include profession, age, sex and years of experience. About two-third (184, 62.0%) of participants shared concerns that healthcare consumers may lose trust in the healthcare providers; more than half (155, 52.2%) were concerned that patients may not want to reveal sensitive information for the fear of the unknown, and nearly a half of the participants (142, 47.8%) were apprehensive that FOI Act will constitute threats to medical confidentiality. Conclusion: Most healthcare professionals as well as other health workers in Nigeria hold much concern about the emerging FOI Act which is largely misconstrued as having the potentials to pose threats to medical confidentiality. Their concerns were largely due to inadequate information about FOI Act and poor understanding of the tenets of medical confidentiality. This trend has the tendency to pose threats to the management of health information especially when the society may likely assume that FOI Act means free world and free speech in the public. These identified challenges require training and retraining on the need and obligations to protect medical confidentiality especially, in this era of FOI.