Are patient relationships the driver for information governance

The confidential relationship between patients and their practitioners is the foundation of clinical practice and is predicated on trust. Both parties develop expectations about how information shared in the therapeutic setting will be used and protected. However, as contemporary clinical practice is rapidly evolving through the use of digital technologies, our understanding and assumptions around those expectations are being tested while their importance in protecting a trusting relationship is becoming paramount. We illustrate this in this editorial by exploring how the technology-driven evolution in practice increases the risks of information disclosure outside the confidential relationship by accident while directly enabling it with the support of legislation by design. In the direct care setting, doctors and nurses are finding the use of smartphones and the apps that run on them particularly useful for providing care to their patients. They are also realising that this emerging practice poses risks to patient privacy and raises their concerns about the accidental disclosure of confidential information if it is not carefully governed.1 But the extent to which any concerns around accidental disclosure are affecting patients’ trust in the confidential relationship is not clear. This issue becomes more pressing as we consider other digital (or eHealth) interventions, including electronic health record and advisory systems, which are also an important part of evolving practice and face their own governance challenges. Such interventions are targeted at practitioners as well as patients and the public to help them engage with managing their own care. They …