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If MDT members are unable to share identifiable, confidential information about specific cases with each other, one alternative option is for members to present “de-identified” cases to each other, in which all identifying characteristics and information about the vulnerable adult have been removed and key details about the case have been changed to protect the adult’s anonymity. This option may help an MDT member to get advice and strategies from other MDT members on how to handle challenging issues in a specific case, without having to disclose any confidential information about the vulnerable adult they are serving.
Practically speaking, MDT members may find it challenging to truly “de-identify” a case presentation in a way that abides by applicable confidentiality laws while still allowing for meaningful case review discussions.
For example:
- Other MDT members in the room may be working with the same vulnerable adult and may be able to identify the individual based on some of the facts presented.
- If a case has received public attention, other MDT members may be able to identify the individual described through pieces of information they have learned in news reports or through community chatter.
- If the MDT member presenting the case changes key details of the case in an effort to protect the vulnerable adult’s identity, those key details may be relevant to providing advice on how to handle the case. In other words, if an individual’s case is truly de-identified and anonymized when it is presented, MDT members may provide less helpful or relevant recommendations about the case, because they do not know full or accurate information about the case.
If an MDT wants to try a de-identified case review approach, each MDT member that is subject to any confidentiality laws should discuss best practices and legal requirements for de-identification of case information with their agency or organization’s legal counsel. For example, any member whose organization is subject to HIPAA must follow a specific method described in the law for de-identification of protected health information (see 45 CFR § 164.514(b)).