SINGAPORE — The Ministry of Health (MOH) on Wednesday (Oct 22) released a circular to medical practitioners that contains guidelines pertaining to the communication of medical information over the phone.

The circular comes days after the High Court overturned a psychiatrist’s conviction for failing to protect his patient’s confidential information.

Dr Soo Shuenn Chiang, a psychiatrist at the National University Hospital (NUH), was fined S$50,000 earlier this year by the Singapore Medical Council’s (SMC) tribunal for not verifying a caller’s identity and sharing confidential information about a patient’s condition with her brother, who had posed as her husband.

The medical watchdog eventually applied to the courts to quash the conviction.

WHAT ARE THESE GUIDELINES?

The MOH said in its circular that the guidelines were formed after a review that started in May this year, during which views from public healthcare institutions, private hospitals and polyclinics were sought.

Here are the seven "key guiding principles" that the MOH has come up with for communicating medical information over the phone:

• Balance the need to act in a patient’s best interest with the need to respect patient confidentiality when considering requests for medical information.

• Proper avenues and processes should be adhered to unless there is a “legitimate urgent need”.

• Reasonable effort should be made to verify the identity of an individual requesting information. For instance, healthcare institutions could ask for: Three patient identifiers, the caller’s relationship to the patient, or even return the call through the designated next-of-kin’s number as per the patient’s records.

• Only relevant information that is needed for urgent care should be shared.

• Healthcare providers should carefully choose the appropriate method to disclose the information to ensure that the intended person receives it.

• Proper documentation must be made by both the caller (if he is a healthcare professional) and the receiver of the call. The documentation should include: The reasons for the urgent need for medical information, the type of information requested and released, as well as the identities of those involved in the call.

• Healthcare institutions should regularly monitor the workflows for the requests and release of medical information such that the telecommunication process can be validated when necessary.

WHAT DOES THE LAW SAY?

According to SMC’s ethical code and guidelines, patients have a right to expect that any information provided to them in the context of clinical care will be kept confidential.

An exception can only be made if a patient gives his consent for specific disclosure to other parties.

Furthermore, under the Private Hospitals and Medical Clinics Regulations, adequate safeguards must be made by medical institutions to protect medical records against accidental or unlawful loss, modification or destruction, or unauthorised access, disclosure, copying, use or modification.

WHAT DR SOO’S CASE WAS ABOUT

Dr Soo’s patient was admitted to NUH in January 2015 after a drug overdose.

In March that year, the patient’s brother — posing as her husband — contacted Dr Soo, telling him that she was suicidal and needed to be taken to the Institute of Mental Health.

The caller was able to provide the patient’s name, medical history and identification number.

Dr Soo noted that she had a history of depression and was at risk of harming herself.

The doctor then issued a memo to refer the patient to IMH.

The brother later used that memo to successfully get a personal protection order against the patient. He had earlier applied to the Family Court on behalf of the patient’s son for the order.

The patient then filed a complaint with the SMC. It is not known if the patient was eventually referred to IMH.

WHAT HAPPENED NEXT

In March this year, Dr Soo was fined S$50,000 by the SMC’s tribunal. This sparked an outcry among doctors and two petitions emerged, one in support of the psychiatrist and the other urging the SMC to consider the ruling’s impact on medical practice.

The MOH, in response to TODAY’s queries, subsequently said it was looking into the ruling.

On March 14 this year, the SMC said it would be appealing for a reduction of the fine.

Two months later, the council said it would seek to overturn the conviction, citing the emergence of new information which it said raised doubt on the “circumstances surrounding the incident”.

On Oct 18, the High Court quashed Dr Soo’s conviction.