Better And Better

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Monday, March 26, 2012

HIPAA

"HIPAA" is the dirtiest word I hear, some days. And given the profane things discussed in my day-to-day life, that's impressive.

The Health Insurance Portability and Accountability Act was an important piece of legislature, passed too late in a time when people had suffered from their healthcare information under one insurance agency not being properly shared with another.  Part of that improper information sharing was the OVER-sharing of patients' private information. This law had provisions to protect Grampaw from having the highlights of his colostomy broadcast throughout the parish, or news of his grandaughter Suzie's prescription for antibiotics for a social disease picked up on spring break making its way around campus from the quack shack.

As soon as it was passed in 1996, everyone began to focus on the privacy concerns in HIPAA. So much so, in fact, that I've seen more than one healthcare professional misquote it as "HIPPA," for "Health Information Privacy Protection Act."[sic] Which does not exist.

If they can't even get the NAME OR THE ACRONYMN right, how are they expected to get the content of that large document right? Answer? They don't. I've had more garbage told to me under the umbrella of "We can't tell you that. Sorry. HIPAA."

I once was on duty on a deep night shift in the early aughts, when Dave, a buddy of mine from one of my undergraduate Criminal Justice classes and a sergeant for another police department in our county, was given a rather difficult roadblock to deal with. See, Dave had to work a major multicar crash caused by a drunk driver going the wrong way on a major highway. Dave and his comrades blocked the highway, saw that the wounded were transported by EMS, and had the highway cleared by the wrecker agencies.  Part of Dave's duties was to create a landing zone (LZ) for a private helicopter ambulance to land to pick up the suspected drunk driver, who was badly injured in the wreck. After it was all cleared up, Dave sensibly enough radioed our county dispatcher and inquired as to which hospital he should go for the mandatory blood draw that he was going to perform on the driver, who was now a suspect for Intoxication Assault. The county dispatcher called the helicopter ambulance dispatcher, who then, unbelievably, informed the county dispatcher that she could not release that information because of "HIPAA." 

Dave was audibly frustrated over the radio. I went to the PD, printed out the exceptions when medical information could be released, circled the section of Law Enforcement Exceptions ("...to identify or locate a suspect, fugitive, material witness, or missing person..."), circled the pertinent portion twice with a black Magic Marker, and faxed it to Dave's PD, to the County Dispatcher, and to the office that I thought might be the dispatcher for Moronic Private Helo Medical Transport. Then I sat down and read the document. It wasn't that hard.

The other morning, while visiting my partner in the hospital, I saw his wife smile as he happily dug into the fruit and yogurt that I'd fetched him from the cafeteria, and I whipped out my camera phone to take a quick picture, mostly to send to both their phones. The ICU nurse jumped in, speedy-quick: "You can't take his picture without his explicit permission. It's against HIPAA."

Okay, now look: I appreciate her looking out for my buddy. I really do. More than I can express. I appreciate that my partner isn't quite as fully alert right this minute as he is when he's at his best. But she had stood right there when he had told the doc that I was his partner, like family, and was thus privy to the doctor's briefing him. She had heard me jokingly suggest that he really wanted a Foley catheter while there, and she had heard him laughing with it. I'm on his team.  I come in peace. I mean him no harm. His wife, who saw me taking the shot, had leaned in close to him and smiled for the picture.

But most importantly, I'm not subject to HIPAA. I'm not a medical professional. I wasn't handling his information. I'm in no way licensed, medically. It doesn't apply to me.

"Consent is not needed for photography done by the patient’s family members or friends..."

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12 Comments:

At Monday, March 26, 2012 6:53:00 AM, Anonymous Anonymous said...

Yup, in a nutshell. When I was working for [Other State Air Ambulance], we had a big furball over how we could alert our ambulance driver if he/she needed to glove up and gown up for certain patients, without letting everyone with a scanner know why. Apparently the old "the patient has liver involvement" was deemed as potentially revealing. I never did hear what code they worked out.

LittleRed1

 
At Monday, March 26, 2012 7:14:00 AM, Blogger Chip said...

I spent 33 years as a Firefighter/EMT. The number 1 most frustrating thing was HIPPA and its mis-application. My 18 year old son was injured and at the ER the admitting person said I couldn't have information about him. I looked at her and said just who do you think is paying this bill? Him? Good luck with that. The privacy part was written after the bill was passed by Congress with the first proposal in 1999 and finalized in December of 2000 by a committee of bureaucrats. ( information from Department of HHS)
Anyone who thinks that currently proposed Health Care Law won't be modified along the way to include all kinds of scary things better think again.

 
At Monday, March 26, 2012 7:19:00 AM, Anonymous Anonymous said...

It's becoming endemic in many businesses; if it's not specifically authorized, it's not allowed. A corollary to what bureaucrats love to do: say no. it's easier to say no than to actually read the document or rule and correctly apply it. Much easier to say it's against the rules, since 90 percent of people will never challenge you on it.

Matt
St Paul

 
At Monday, March 26, 2012 9:01:00 AM, Blogger David said...

My daughter's HIPAA "joke".

Knock Knock.
Who's there?
HIPAA.
HIPAA who?
I can't tell you that.

 
At Monday, March 26, 2012 9:47:00 AM, Blogger Diane said...

At a routine doctor visit last year, the nurse took me to a room, took my BP and left. Two minutes later she was back in a fluster, grabbing my patient file from the desk and saying she could be in a lot of trouble for leaving it.

It's MY file, on ME. I'm the only one in the room. WTF?

 
At Monday, March 26, 2012 6:42:00 PM, Blogger TOTWTYTR said...

A lawyer/paramedic friend of mine points out that the initial HIPAA training was extremely flawed. As were the original regulations. Much of that was fixed in 2003, but the word that of the fixes never got out because there is no ongoing training requirement.

Add to that some very risk averse risk managers and many medical providers are operating with bad information.

Look at the LAFD fire chief. He's using (or tried to) HIPAA as an excuse to hide poor response time data. With luck, that will cost him his job. Not the using HIPAA part, but the lying to the city council part.

While the law may have been necessary (I'm skeptical), it's application has been horrible.

 
At Monday, March 26, 2012 6:59:00 PM, Anonymous Anonymous said...

Work in a hospital at reception desk. We often get discharges, which we handle by writing down pt's last name on a tiny piece of white paper before updating computer. Example: "Smith." We have HIPPA police coming around and scolding us for RIPPING UP the paper and tossing it in the trash, even though it is completely illegible. Must go in shredder down the hall.

 
At Monday, March 26, 2012 8:35:00 PM, Blogger Old NFO said...

Yep, Cluster F... period... Had the same issue with my daughter, who is a paramedic AND has my medical power of attorney on file with my Dr's office being told that SHE as my legal POA, had no right to know what was going on... sigh...

 
At Tuesday, March 27, 2012 10:34:00 AM, Blogger Library-Gryffon said...

We never did find out why they converted my sister-in-law's gamma knife procedure to open surgery. She had a stroke on the table, and was in a persistent vegetative state for over six months. The hospital (UVaCharlotte) refused to release her records to her daughter who was her medical proxy claiming HIPAA. For that matter the doctors wouldn't tell her either. They told us they could only release them to a medical professional. They seemed to think that a non-MD wouldn't be able to understand anything without an MD to interpret. Though why they refused to do it for my niece themselves....

If we'd had the money to pay for the copies, I'd have had them sent to my father, the Dr. (PhD). I doubt they would have bothered to check for an out-of-state license.

Part of me wonders if there was malpractice, but the odds are that it was just massive misinterpretation of HIPAA.

 
At Saturday, March 31, 2012 7:40:00 AM, Anonymous RN_ReFlux said...

Hate to tell ya, good chance it was malpractice and they are trying to cover it up.

 
At Sunday, April 01, 2012 1:10:00 PM, Blogger phlegmfatale said...

HIPAA is a great example of bureaucracy run amok. I could launch into an hour-long spittle-flecked rage about it. Instead, I'll go to yoga and find my happy place.

 
At Wednesday, April 04, 2012 3:37:00 PM, Blogger Justthisguy said...

Oh, I hate that HIPAA thing with a violent passion. I have read the fine print on it. It allows the Feds, and other badge-bearers, access to all of yer medical records, but throws up barricades against your friends and family even finding out that you are in the hospital.

 

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