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How to avoid patient privacy pitfalls

clooneyThere are many ways you can get into trouble at work or even lose your job: missing shifts, sexual harassment, pissing everybody off… you get the picture (and you’ve known the culprits!).

Brady Pregerson, MD, and Rebekah Child, RN, may disagree about a lot of things, but they do agree about this: One way to lose your job is to violate patient privacy.

However tempting it was for hospital workers to sneak peeks at the Octomom’s charts, it was considered just as much a violation of privacy as sharing Farrah Fawcett’s cancer diagnosis with the tabloids or accessing the records of A-list stars. And all of those snoopers? Fired.

In part one of a two-part series on patient privacy, Dr. Pregerson and Nurse Child expound on HIPAA and what it means in your daily work life.

MD: We’ve all heard of HIPAA, the Health Insurance Portability & Accountability Act. This federal law, passed in 1996, became fully effective in 2003.

The portability part of the HIPAA moniker acknowledges the importance for relevant health information to be available to those with a “need to know” both for patient care and for billing purposes.

The accountability part of the title means that if you violate patient privacy without a legitimate reason or your patient’s consent, you’ll be in hot water with the federal government.

To stay on the straight and narrow path that HIPAA provides, ask yourself, “What patient health information can and should I share with others?” The golden rule here is that if it benefits the patient , then it should be okay. If you’re unsure, keep your mouth (and the patient’s chart) shut, or ask your supervisor.

RN: Everyone thinks this is “no duh” stuff, but remember, there was a time when an employer could refuse to hire you if you had a diagnosis of HIV, and your nosy mother-in-law could theoretically call up and get your latest pregnancy test results from your doctor’s office.

Disaster!

Keep in mind that the need for HIPAA (which sometimes can feel like a fiasco, I agree) was brought about by a couple of privacy-violating people who ruined it for everyone…just like those few drivers who got into accidents while talking on their cell phones.

So here’s what I recommend: Let’s say I get a phone call inquiry and I don’t know if information is “sensitive” or appropriate for sharing. My favorite cop-out is to say “The patient is still being evaluated. I could certainly have the patient or designated family member phone you back.”

No one (so far) has pinned me against the wall for anything more specific (maybe I should run for political office!). Let’s face it: If the patient is in the hospital or emergency department, he’s always still being evaluated until he’s discharged home. Until that point, his nosy family becomes someone else’s problem!

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Brady Pregerson, MD

Brady Pregerson, MD, a returned Peace Corps volunteer and winner of the 1995 Wise Preventive Medicine Scholarship, completed his medical school at the University of California, San Diego, and his residency at Los Angeles County General Hospital. He has authored three medical pocket books for nurses and doctors, as well as the educational web sites erpocketbooks.com and gotsafety.org. Dr. Pregerson currently works as an emergency physician in Southern California. He writes, "Although the ED environment may be quite different from working on the hospital floor or in an office setting, I am hopeful that you can take these tips and apply them to your own specific work situation." You can buy his books on lessons from the ER, including Don't Try This At Home: Lessons from the Emergency Department and Think Twice: More Lessons from the ER, at amazon.com.
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3 Responses to How to avoid patient privacy pitfalls

  1. Sherry

    How do we keep the privacy when we have family members and patients who are insistant upon standing at the nurses’ station: where we give report, make calls to the Doc, give report to the Docs and they dictate?

  2. mandkhoag RN

    We just started doing bedside report, giving report in front of patient. We get in trouble if we don’t do it however none of us like to do it. We think it’s a privacy issue because the patient’s roommate can hear everything. Plus sometimes there are just something’s you don’t want your patient to hear.

    Any thoughts on this?

  3. Anonymous

    While I understand the need for HIPAA laws to protect privacy it is getting ridiculous and hard to do our jobs when we can’t even write patient’s names on the main white board at our nurse’s station any more. It makes it harder to keep track of who’s who!

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