Privacy DOs and one big DON’T
ER Doctor Brady Pregerson and Nurse Rebekah Child discuss navigating the sticky issues of Patient Privacy practices, with four tips for following HIPAA (and one Hollywood cliche that undermines privacy credibility).
MD: In our first article on patient privacy we defined HIPAA and gave the general golden rule: If sharing certain patient information with others benefits the patient it should be okay. If you’re unsure, don’t, or ask your supervisor. Below I give four “DOs” to help you navigate particular situations where HIPAA may come into play.
(1) DO discuss relevant health information ONLY with those who have a legitimate need to know, such as the doctors and nurses taking care of the patient.
(2) DO release only a one-word condition descriptor plus a general location to any other people who inquire about the patient. Condition may be described as good, fair, serious, critical, undetermined (not yet seen by MD) or deceased. Location may be described as hospitalized, or treated and released. If, however, the patient or family has otherwise requested that even this information remain confidential, you must honor that request.
(3) DO access patient medical records as needed for medical care; no one wants patient privacy to trump good health care. As long as what you do has the goal of better care, you should be fine. And finally, something that should be obvious, but is often forgotten:
(4) DO speak softly when discussing private issues. In fact, you should speak softly all the time at work. Patients always complain that doctors and nurses talk too loudly. A little peace and quiet, especially at night, is more therapeutic for your patients than you know.
RN: Unfortunately, I feel like many medical shows shoot us real RNs and MDs in the foot here. I remember one scandalous medical drama where they were shouting patient information across the hallway in front of a packed elevator. Another show had the doctor doing a pelvic exam in the elevator!
Geez, Hollywood! What are you doing to us??? Those kinds of shenanigans don’t really happen in real hospitals.
So it’s up to us to make sure we are extra careful with patient information! The only piece of advice I’d add to Dr. Pregerson’s four HIPAA “DOs” above is one big “DON’T.” Please, please, please DON’T give out the information that a patient has been admitted to a psychiatric unit! No one wants their boss to know that the voices they were hearing were not really coming from their Bluetooth headset.
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.
By Brady Pregerson, MD