Online submission of case reports: an issue for patient confidentiality?

My medical school, like many others, uses an online portal for the submission of work and to auto-check for plagarised work. There are a a number of such resources, but I’ll refer to TurnItIn as that is what my medical school and many other use. One of the issues students sometimes have with TurnItIn is that by submitting your work it becomes their intellectual property. This is part of their terms and conditions and entirely up to the institution subscribing to the service to decide whether they are happy with or not. Some institutions now offer a reasonable alternative for submission of work without penalty for students who do not wish for their work to be handled in this way. For those unaware of how it works, TurnItIn automatically stores your work in a database to be compared with other documents forever more, but it has become their intellectual property. By submitting it you agree to this. Ethical issues over this do not lie with the company, rather the academic institution’s insistence on it’s use for submitting work without reasonable alternatives.

Whilst the use of TurnItIn for essays and other coursework can be ethically questioned by students, a separate question arises when it’s use is demanded for submission of clinical case reports. At Brighton this happens in the final year when students are placed at regional centres to ease submission for all involved. Reports are not assessed for plagarism, but TurnItIn is used as an efficient solution for report submission from students on regional placements who cannot make it to the medical school to give in a hard copy. Whilst all efforts are made to annonymise patients in case reports, and only one or two faculty staff read the reports, the case report still becomes the property of TurnItIn and is stored in their database. Whilst writing my psychiatry case report, I realised that even though I had changed the name of my patient, I was still required to include an admission date and hospital location within the report. This information coupled with detailed descriptions of the patient’s history (including very specific and easily identifiable delusions and hallucinations for this patient) provides a document with a great deal of patient information on that could easily be tracked back to a specific patient. And it’s now the intellectual property of TurnItIn. With 200 reported alleged breaches of security over the past few years, this is rather worrying, and begs the question whether such online submission techniques should be used for case reports. Other medical students and health care students (such as pharmacists) from all over the country have reported that they also are required to use TurnItIn (or equivalent) for case reports. Even if TurnItIn’s security is top notch and there haven’t been any real breaches, there is, as with any system, always a risk. It is one of the reasons the NHS hasn’t moved to digital records that can be transferred easily between healthcare settings.

Should medical schools use other methods to collect case reports? Is this an issue? What do faculty staff think about this? Comment please!


One comment

  1. fakethom · December 1, 2012

    I should add, this isn’t an attack on TurnItIn or any similar software resources. It’s questioning medical schools over specifically using such resources for reports containing potentially identifiable patient information.

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