By Vuledzani Munzhelele, Claims Specialist at iTOO Special Risks
Technology has significantly transformed the healthcare landscape, particularly in the wake of COVID-19. Before the pandemic, Telehealth was not widely discussed or utilised, but the necessity for remote medical access reshaped how healthcare services are delivered.
Virtual consultations in mental health have become standard, facilitating online therapy and follow-ups. While this shift has improved convenience and accessibility, it also poses new ethical and legal challenges for healthcare professionals, particularly Social Workers, Psychiatrists and Psychologists.
Confidentiality is crucial in healthcare, whether consultations are in person or online. The Health Professions Council of South Africa (HPCSA) mandates that patient information must be private and protected, regardless of the consultation medium. This is in line with the National Health Act (Act 61 of 2003) which protects patients’ rights to confidentiality, in line with the South Africa’s constitutional right to privacy. Healthcare professionals cannot disclose patient information unless specific exceptions in the Act apply.
Despite protections, unintentional confidentiality breaches can occur, emphasising the need for practitioners to secure patient information and follow regulations. Telehealth platforms like Microsoft Teams, and Zoom enhance accessibility, especially in areas where in-person visits are challenging. They also assist those with limited time for in-person appointments.
However, the transition to virtual care brings critical questions: Who else can hear or see these conversations? Where are these sessions stored? Are practitioners inadvertently compromising patient trust, which is central to the doctor-patient relationship?
The HPCSA Telehealth ethical guidelines, Booklet 10emphasise that virtual consultations must meet the same standards of confidentiality, consent and professionalism as in-person therapy. These standards should not be compromised simply because healthcare services have moved online.
Additionally, the Protection of Personal Information Act (POPIA) governs the lawful processing of personal and healthcare data, addressing how consultations are recorded, noted, stored and shared.
A critical concern is the informal use of messaging apps such as WhatsApp and SMS for professional therapy-related communication. These platforms are not secure for handling sensitive patient information and pose a risk of breaching confidentiality.
Regulatory bodies like the HPCSA and the South African Council for Social Work strictly prohibit healthcare professionals from posting patient-related information online or using unsecured communication channels. If a practitioner is found to have violated these ethical guidelines, they may be formally requested to remove such content and may be exposed to possible complaints by the affected patients.
A key aspect of maintaining ethical Telehealth services is ensuring that all staff members within a healthcare practice are adequately trained in information protection protocols. Administrative personnel responsible for handling patient records or communications must understand confidentiality principles and adhere to strict safeguards. Practitioners remain accountable for any breach of confidentiality, whether intentional or accidental, and must take proactive measures to mitigate these risks.
While online therapy offers convenience, practitioners must recognise that adapting to digital platforms also requires strict adherence to ethical and legal responsibilities. The principles of patient confidentiality, informed consent and data security remain paramount, regardless of whether therapy takes place in person or virtually. Practitioners must navigate these evolving dynamics with caution, ensuring technology enhances healthcare services rather than compromising patient safety.
By fostering a secure digital environment, practitioners can continue to support patients while upholding ethical standards and regulatory compliance.
