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Health fax mistakes create a headache for pharmacies

Elizabeth McMillan and Paul Bickford
Northern News Services
Published Monday, July 12, 2010

SOMBA K'E/YELLOWKNIFE - The NWT health care system is back in the business of sending faxes, although under new conditions to tighten up security.

NNSL photo/graphic

Daryl Dolynny, president of the NWT Pharmaceutical Association, says the Department of Health and Social Services should have given pharmacists a heads up before putting a hold on faxing all health records, including prescriptions. - Elizabeth McMillan/NNSL photo

On July 6, the Department of Health and Social Services temporarily stopped the faxing of all health records after several instances of records being faxed to the wrong place.

However, the suspension gradually eased throughout the week, and was affirmed to be over during an internal conference call on July 9 between the department and CEOs of the regional health authorities throughout the NWT.

"We talked about when there is an urgent need to transmit information for patient care and that there are no other ways of obtaining secure access to that information, that we can actually go ahead and do a facsimile," said Sue Cullen, CEO of the Hay River Health and Social Services Authority. "There are a number of structures and protocols though that we've put in place to ensure that the client information continues to be safe."

Cullen mentioned logs of faxes, reviewing speed dial numbers on a quarterly basis and improved cover sheets.

"If we have urgent information that we wouldn't have a speed dial set up for, we've looked at actually having a two-person review in terms of ensuring that the number is correct," she said, noting telephone calls will also be made in advance and after a fax is sent to ensure it is received as intended.

"Prescriptions would be an example of some of the non-urgent situations where you would actually send a facsimile, but the same protocols need to be covered," she explained.

Earlier last week, Kay Lewis, CEO of Stanton Territorial Hospital, said there wasn't an all-out ban on faxing, though all faxing was shut down for a few hours on July 6 while the department decided what to do after a security breach.

Lewis confirmed yet another health record was faxed by someone at the department to the CBC station in Yellowknife. The CBC previously reported at least two other incidents where confidential information - including pap and blood test results - landed in its office.

Lewis said the breach was caused by human error - the last four digits were the same, but an employee entered an incorrect prefix of 669, which is typically the Stanton prefix.

On July 7, she said the department had resumed sending urgent faxes, including those related to medical travel and prescriptions.

However, the president of the NWT Pharmaceutical Association said the Department of Health and Social Services had jumped the gun by halting the faxing of health information.

Daryl Dolynny said the policy change on July 6 was a complete surprise and pharmacists weren't given advance warning or guidelines on how to obtain the prescriptions that were previously faxed from health centres, clinics and hospitals.

Dolynny said fax machines are a "lifeline" for pharmacies in many communities as they frequently rely on them to get clarifications from doctors' offices and health centres, authorization for refills and to transfer prescriptions between pharmacies. He estimated 30 to 40 per cent of business involves a fax machine.

"That's put a lot of duress in the system and could put patient health in jeopardy if we can't get these authorizations of refills on time," he said.

Dolynny said he learned of the change July 6 by speaking to other pharmacists, but received nothing in writing from the department and didn't know what the rationalization for it was.

Cullen said, while prescriptions can be sent at any time using the new guidelines, additional methods will be considered for other medical information, including Internet-based options, ExpressPost, internal mail, hand delivery and telephone.

"It's just causing us to look at every piece of information that we send through with regard to the client," she said. "Is there another way where we can send this securely?"

While policy doesn't allow health records to be e-mailed, Lewis said the department is considering it, along with other alternatives.

"We're really going through a diligent risk-management process here," Lewis said. "We're doing our best to get the system up and running and secure as absolutely possible."

At Stanton Hospital alone, about 1,000 faxes are sent per day.

Dolynny didn't dispute the need to protect patient confidentiality, but said pharmacists were put in the precarious situation of having to explain to patients why their medication didn't get faxed or transferred.

When faxing was suspended on July 6, he said pharmacies across the territory were "at a standstill trying to figure what we're going to do with patients."

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