Author Beware: The Law– HIPAA (Part 1/3)

Several months ago, I was watching a local TV news station when a nurse manager was being interviewed about the fact that you could look up ER wait times on the Internet before checking in. That’s a whole other can of worms I won’t get into today but the problem with her interview was that the camera shot included her standing next to their patient tracking board in which you could clearly see the last name of the patient, their age, and their medical complaint.

I almost fell out of my chair. This was a clear HIPAA violation and that ER manager should have known better than to be standing anywhere near that board.

Each time you visit the doctor’s office or sign into the urgent care or emergency department for treatment, you should be given a paper that outlines your rights under HIPAA which stands for the Health Insurance Portability and Accountability Act. It basically outlines rules on how to deal with a patient’s “protected health information” or PHI.

What this boils down to for the bedside clinical worker falls into a couple of areas and I’ll give some examples below.

1. I should be providing direct care to a patient or should have provided recent care in order to look up their chart. Some of you may remember the healthcare workers that were fired for accessing Brittney Spears medical information. They were likely fired under this provision.

2. I can’t share any specific information (name–never, age, and complaint) listed together in areas where other’s could become aware of the patient’s visit. This would include areas like social media (a big no-no). When cases are presented at medical conferences, generally all patient information is blacked out (say on x-rays). And the patient is only spoken of in general terms. Such as: 16y/o presented to the ER for evaluation of neck pain. Now, across the USA for one day, probably several patients presented with this complaint so how do you know which one it was?

3. I shouldn’t be sharing patient information with my spouse unless he has provided direct care to the patient as well. Therefore, since my husband is an accountant, I can’t say— “Oh, by the way our neighbor’s daughter was seen for a broken arm today in the ER.” Unless I’ve asked the mother specifically if it’s all right that I mention this to my husband, I have violated that patient’s rights by sharing that information with my spouse. Working in pediatrics, I’ve been in the situation often and don’t mention the visit at all when home.

4. Requests for information about a patient from the media generally go through the public relation’s office. This tends to happen more off hours, a reporter will get through to the ER desk and begin to ask questions. Most, if not all hospitals, are very firm that all media inquiries go through public relations. This allows them to control the message.

5. Patient information cannot be given over the phone unless specified by permission. This is why, when you fill out those HIPAA forms at your doctor’s office, they generally ask who they can talk to and what kind of information they can share. Perhaps you don’t want your husband to know why you were at the OB’s office. A caveat to this is giving information to your personal physician who is following up on your ER complaint. We will generally give specifics for this because they are providing your follow-up care.

Next post I’ll talk specifically about HIPAA and minors.

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