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Do you know the patient identifiers HIPAA defines as off-limits?


Thinkstock | Wavebreakmedia Ltd.

Thinkstock | Wavebreakmedia Ltd.

Do you know what you can–and can’t–share about your patients online? If not, it’s time to brush up on your HIPAA knowledge!

As Brittney from The Nerdy Nurse notes, the possibility of a HIPAA violation is clear in the minds of all nurse writers–and even just those with Facebook accounts. As a nurse, you’ve got to be careful what you say and where you say it! Read on for her HIPAA advice:

Omit These Identifiers When Blogging About Patient Care

1. Names;
2. All geographical subdivisions smaller than a state, including street address, city, county, precinct, zip code, and their equivalent geocodes, except for the initial three digits of a zip code, if according to the current publicly available data from the Bureau of the Census: (1) The geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; and (2) The initial three digits of a zip code for all such geographic units containing 20,000 or fewer people is changed to 000.
3. All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death; and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older;
4. Phone numbers;
5. Fax numbers;
6. Electronic mail addresses;
7. Social Security numbers;
8. Medical record numbers;
9. Health plan beneficiary numbers (read the rest over on The Nerdy Nurse)

The dates and ages piece proved to be very informative. If your patient is over the age of 89, you need to refrain from referencing that. I guess that’s because people in their 90s are a small and more easily identified population. Also worth noting is that it would be wise to omit specific dates in your writing in most cases (admission and discharge dates in particular).

Can I Blog About My Patients?

You can absolutely blog about specific patient encounters, but you have a duty to be respectful of the patient’s privacy. They allowed you to participate in their care and they deserve the utmost respect from that. However, if telling a story can be educational and informative, you can write about your individual experiences in providing patient care. You can actually include quite a bit of detail in your nursing or healthcare narratives about patient encounters and experiences.

The key is to make sure that the details are never specific enough to tie back to any individual patient. It is also a good idea to change certain details of the story completely so that a patient is absolutely unidentifiable. You can have fun with this and make for a much more entertaining read. You aren’t writing research articles. In blogging, the details are not as important as telling the story, anyway.

So get your blog on. Share your stories of nursing and healthcare and include specific events and examples. Just be sure you respect the rights and privacy of your patients in the process.

Don’t fear HIPAA, just be aware and be respectful.

To see the rest of her advice on how to avoid breaking the rules, head on over to The Nerdy Nurse. Then, in the comments, tell us about your top advice and rules!

The Nerdy Nurse
Brittney Wilson, RN, BSN, also known as The Nerdy Nurse, is a Clinical Informatics Specialist practicing in Georgia. In her day job she gets to do what she loves every day: Combine technology and healthcare to improve patient outcomes. She can best be described as a patient, nurse and technology advocate, and has a passion for using technology to innovate, improve and simplify lives, especially in healthcare. Brittney blogs about nursing issues, technology, healthcare, parenting and various lifestyle topics at

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