Patient Confidentiality and Phone Calls

[UrbanHealthRN, BSN, RN]

I currently don't have a lot of guidance on this topic at my job, I'm hoping to change that (create a protocol, etc.), and I'd appreciate any input I can get!

I work for a program that's funded by the Department of Health in my area. The name of the program includes the name of a disease that isn't exactly the most desirable of diseases people might choose to have, if they could choose. For example, I'd probably prefer to say that I'm being treated for GERD than anal cancer (my program name doesn't include either of these diseases). Also, speaking of choosing, my program's disease is affected by life choices such as illicit drug use and certain sexual practices. Not exactly the stuff you share around the kitchen table!

When folks are referred to my program, they're not usually aware of the referral- it's usually through something like mandated reporting of lab results- so they're not expecting me to call them. This is where the problem lies: I need to outreach these folks, tell them about my program, and offer services. Outreach is currently done through phone calls, and because many of the people I call are immigrant women, I often get people on the other end of the line who are husbands, or boyfriends, or a family member with English interpreting skills. Or, I get some other scenario, like an unidentified voicemail message.

I really don't like to state the name of my program to someone besides my call's intended recipient because of confidentiality reasons. For example, imagine a woman's partner hearing the name of this disease and then thinking "Could I have it too? Why hasn't she told me yet?" However, if I introduce my phone call with something more generic, like "visiting nurse" or "Department of Health", then I feel like I'm not taken seriously to the level I should be.

What do you do (or have you done) in situations like this? Any ideas you can share from your own areas of work? In previous jobs, this issue has been a lot more workable for me, but I'm new-ish to this job and it's creating challenges. Thanks in advance for your help!

[mmc51264, BSN, MSN, RN]

I haven't had experience with that, but I will be following. Interesting dilemma. I am always careful when I am giving HIV meds because many times family may not know, but may recognize the name of the medications so it becomes tricky to go through what meds I am giving.

[Sour Lemon]

I agree that it's an interesting question, but I don't have the answer. I know I won't personally call back anyone who leaves a vague message.

[ruby_jane, BSN, RN]

My first job was an epidemiology specialist at the "Ryan White Services Center" back in the 90s. Anyone with HIV knew who Ryan White was but the genpop did not. So yes, renaming something might make it more palatable to the people you serve.

Be careful what information you leave on a voice mail. You're in a less than advantageous place if you don't have your own translator for you. AT&T Language Line is not cheap but it avoids the issue of using a child or spouse to translate. What does your policy dictate that you can do/say over the phone? Back in the day I could say that the person I was calling was identified as having contact with someone whom I'd tested and they (the person I tested) must care about the person I'm calling a lot to make sure s/he is safe and well.....

[UrbanHealthRN, BSN, RN]

I agree that it's an interesting question, but I don't have the answer. I know I won't personally call back anyone who leaves a vague message.

It's good to actually hear someone say this. I agree, too- I feel like if I can leave a message that has a purpose to it, it might encourage someone to give me a call back.

[mmc51264, BSN, MSN, RN]

I have had issues where the health care systems, billing department, will cold call me and the phone number is either "unavailable" or not the HCS. Then they start asking me all these personal questions. I tell them that I am not giving them that information. How do I know who they are? I tell them I will call the hospital myself.

I would be scared having to make phone calls.