Presented by Tara Scrogin, JD, Interim Chief Compliance Officer and Debra Bishop, Campus Compliance Specialist
Breaking the Glass (BTG) is the term we use to describe the application pop-up in One Chart to alert users that they are accessing confidential patient information which is restricted to a “need to know” basis.
All patient records are to be accessed only to perform essential job functions but there are additional protected categories of which you need to be aware. Some patients are explicitly identified as confidential (employee, prisoner, etc.), all patients in some departments are also confidential (psychiatry), as are certain legal lockup charts. Accessing these records without adequate reason can lead to disciplinary action up to and including termination.
Prior to January 2016 many enterprise employees had exemptions and did not receive BTG pop-ups. This will be changing in the first quarter of 2016. The compliance office in concert with clinical leaders are developing policy across the enterprise to ensure patient privacy. The policy will include criteria for exemptions, implementation for department specific overrides, and more encompassing BTG reasons and how they are to be used.
One area that Coordinators may encounter that involve BTG is screening for patients to enroll in a particular study. It is important for Coordinators to ask themselves: are there other ways to obtain the necessary information? For example, is exclusion criteria readily available in the visible record? Is this information that can be asked during an interview process? i.e. Screening for a psych history is not an adequate reason to BTG, you can see if they are on medications for a psychiatric illness and you can ask the patient for that history. Once you have broken the glass and entered a restricted view area the compliance officer is notified and these instances are tracked. If confidentiality has been inappropriately breached the patient is notified and given explicit detail of the breach including your name, the date, and what information was accessed.
BTG is intended to protect users with access to One Chart. Training on confidentiality and Breaking the Glass will be provided annually, during employee orientation, and periodically as needed.