So news today that 27 hospital workers including nurses and doctors, were suspended from their jobs because they accessed or gave out information about George Clooney when he was in the hospital about his recent motorcycle accident. Got me to thinking...
Often when I have a critical patient, the next day I come back I will check on them on the computer to see how they are doing in ICU. Does that violate HIPAA? Probably it does. I don't do it out of malice or to invade their privacy. I guess I just want to know if we made a difference, if they are going to make it. Simple human curiosity and concern.
Its interesting because we have this line available for both doctors and medics who have either brought in a patient or transferred one. They leave a message about a patient they brought in, wanting to know what happened with them and we go into their record in the hospital and fax back what happened. Now, mind you the patient doesn't approve this, we just do it as a courtesy to our fellow medical professionals. I always thought it was a stupid waste of our time. Does this violate HIPPA? Probably does. It seems like once a patient goes to another part of the hospital they are no longer your business.
Our hospital has been hinting that employee access to any patients medical record that does not personally involve them is going to probably be cut off in the future. They warn that they are monitoring people, WATCH OUT!!!
The HIPAA thing is really getting to the point of ridiculousness and seems to be applied for the hospitals convenience and advantage and profit at times (i.e. out state docs and medic follow ups).
Is it realistic in an ER, to think that we won't access records? Things come up. Where do you draw the line? Darned if I know. Just one more thing for all of us to deal with.
9 comments:
"Its interesting because we have this line available for both doctors and medics who have either brought in a patient or transferred one. They leave a message about a patient they brought in, wanting to know what happened with them and we go into their record in the hospital and fax back what happened. Now, mind you the patient doesn't approve this, we just do it as a courtesy to our fellow medical professionals. I always thought it was a stupid waste of our time. Does this violate HIPPA? Probably does."
No, it doesn't. I could give you a long spiel about HIPAA (two a's, one p, by the way), but it could better be explained a by a lawyer well versed in health care law.
I'm not trying to bash nurses, but the nursing profession is responsible for a great deal of HIPAA hysteria and misinformation, and it all came about very innocently.
When HIPAA was first proposed, the original guidelines were far more stringent that the final version that was enacted during the Bush administration.
The nursing profession was the most proactive about educating their peers about HIPAA. Admirably, they led the way among all the health care professions.
However, the education most nurses got was far outdated when compared to the document that was finally enacted. A great deal of that misinformation continues today.
There's too much information here for a blog comment, but suffice it to say that much of what you were taught about HIPAA may be false.
I'm going to do a blog post on it, and ask a lawyer friend of mine to guest post on the subject.
Do you mind if I link your post?
I wonder if they would have been disciplined for accessing information about any other patient - or if the hospital would even have monitored that.
Special treatment for special patients...
The more I read of the blogs of those who are still hospital-based nurses, the happier I am to have left it. As I read you and ER Nursey in particular, I see more and more of the humanity of the profession being stripped away by administrations. One of the most precious parts of anyone's job is to be able to step back occasionally and see what has been accomplished. Nursing has always been one of the noblest of professions because of the self-sacrifice involved, not the least of which is the daily sacrifice of that very thing - knowing that you've made a difference, that what you've poured your whole self into for however long it was required...matters. To somebody. Such instances are too few and, as such, very precious. Those are the things that help us to keep on keepin' on. For them to take away any chance of your ever having that is not only completely unnecessary, it smacks of a complete lack of understanding of people and of the special circumstance of working with people, and it is truly cruel and inhumane.
ambulance driver - thats fine.
AD I hope you address the whole blog thing. I have always thought that it was strange that if you talked about someone and didn't say their name that was violating HIPAA. I think we are all paranoid about this subject.
I think I'll look into a little more, maybe even read the regulations...
I follow charts after patients have left my care all the time, sometimes starting from triage. Actually, especially if I'm in triage. It's how I QC my decision making and it's part of my continuing education.
Clooney's public statements have been very gracious. He seems to be one if the few in Hollywood who is trying to cultivate an image of an okay type of guy.
They showed a picture of the offending hospital on the news and said that up to 24 people will be suspended. It looked like a pretty small place and, assuming that access to charts is mostly limited to caregivers, I wonder how they can absorb that kind of hit to their staffing for the suspension period.
We had a similar thing happen where I used to work. A local politician came in, there was a bad outcome, and a lot of people were reprimanded for opening up the records. The risk at that place was that logging onto a computer was such a pain in the ass that we often just left it open and any coworker could come by and do what they wanted under someone else's log-in.
I think that looking up to see how one of your patients is doing elsewhere is no big whoop. But in Clooney's case it seems people got freaky.
I suspect that there was some true HIPAA violation with Hunky George - hell, I'd be curious too. And, ya' gotta' know there was some whispering and discussion about him so people started looking.
Further, how much do you trust confidentiality for yourself if you went to your hospital - say for what turned out to be a pelvic infection (read STD). It is very hard for people not to inquire of their co-workers health if they see them there as a patient. I already know I would drive to the hospital at the other end of the county if I wanted confidentiality promised.
I like follow up, as it helps me to hone my meager skills. Was I right? Was I wrong? Did I screw up somehow? This information is very valuable!
My only comment about wanting to know about how your patient did. Go thru the correct way, check to see if they are still in the hospital. If you know the patient's name, that means calling the hospital operator & finding out what room they are in. Then go visit them. What more compassion you could show that patient by introducing yourself to them or their family, as they may not remember you if they saw you first in the ER or ambulance. Grant it, that takes time and not everybody has time, but if I'm that interested in my patients follow-up, I make it a point to go see how they are doing.
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