Primary Concern: Unauthorized Access to Confidential Information
The primary problem with sending cancer screening results to an elderly patient via personal email is that email may be accessed by unauthorized individuals, representing a fundamental breach of patient confidentiality (Answer A). This is the most critical concern from a patient safety and privacy perspective.
Security and Confidentiality Framework
The transmission of cancer-related identifiable data through unsecured electronic means violates established confidentiality principles. Identifiable data should not be transmitted by any means (post, telephone, electronic) without explicit authority and appropriate security measures 1. Personal email lacks the necessary safeguards to protect sensitive medical information from unauthorized access 1.
Why Unauthorized Access is the Primary Concern
Electronic transmission of confidential cancer data requires specific precautions to ensure that data cannot easily be read by unauthorized persons 1. Personal email accounts are vulnerable to:
- Access by family members, caregivers, or others who share devices or know passwords 1
- Hacking or unauthorized remote electronic access 1
- Lack of encryption and secure authentication measures 1
- No audit trail of who has accessed the information 1
The guidelines explicitly recognize that electronic communication methods, while convenient, may give rise to breaches of confidentiality 1.
Secondary Considerations
Patient Understanding (Answer B)
While patient comprehension is important, screening communications should use concise simple language (reading age of 9) and non-technical language 1. However, this is a content issue that can be addressed through better message design, not a fundamental security flaw like unauthorized access 1.
Research shows that older patients rank information about prognosis and treatment as most important, but there is significant heterogeneity in what information patients need 2. The solution is improved communication design, not avoiding electronic communication entirely.
Forgotten Passwords (Answer C)
This is the least concerning issue. Password problems are a technical inconvenience that prevents access but does not create a confidentiality breach 1. In fact, password protection is recommended as a security measure 1.
Best Practice for Cancer Results Communication
Confidential enquiries should be sent to a named individual at the source concerned, with appropriate security measures 1. For cancer screening results specifically:
- Use secure, encrypted patient portals rather than personal email 3, 4
- Maintain consistency across media and publish contact details so patients can verify legitimacy 1
- Consider that verbal communication methods (telephone and in-person) are generally preferred by patients for cancer results and facilitate greater understanding 5
- Recognize that the majority of patients who view results via portals before clinician contact still prefer face-to-face or telephone communication for sensitive results 3
Common Pitfalls
The critical error here is treating personal email as equivalent to secure health communication systems. Personal email lacks the controlled access, encryption, audit trails, and security measures required for transmitting identifiable cancer data 1. Healthcare providers must use secure, HIPAA-compliant communication channels that prevent unauthorized access while still meeting patients' needs for timely information 4.