[caromck823]

I have really been thinking about HIPAA and all of its rules and regulations lately and am wondering if they are all necessary. I am a firm believer in the need for patient privacy, but wonder if some of the regulations go a little overboard. I would just like to get some feedback on what others think.

-Caroline
1st year BSN student

[Chaya]

IMO, it just generates a blizzard of ineffectual paperwork. I don't see that it accomplishes any of the goals it's supposed to achieve, at best. At the worst, I think it can create situations that actually endanger patients because it can favor confidentiality above safety.Yeah, we receive enough brochures about it at every appointment to wallpaper a room. Meanwhile, at my facility we have to conduct admission interviews in 2-4 person rooms with curtains separating the beds and every word is perfectly audible to all. We are no longer allowed to post the patients' names outside their room or have a board displaying which patient is in which room. Sure, we all know to check the wristband on every patient every time. But we know people do slip up occasionally. It's just a matter of time before a situation arises where someone forgets to check a wristband and doesn't realize that the patient who was there before switched beds and is not the one there now-or you get a confused patient who has worked his wristband off and that was the only physical identifier you had. The situation that makes me most crazy b/c it is so unnecessary is when the ambulance drops off a new admission, you open the info packet and find crucial info has been omitted, then when you call to get it they tell you "Oh, we need faxed permission from that patient to send that info because of HIPPA" I've had to remind them (threaten?) that this person has not BEEN admitted to our facility yet, pending said info from that facility, without which we might have to send him back...
OK, I've raving now and I don't need any more dental bills from gnashing my teeth!

Oh yeah- and I somehow doubt if it really can prevent your entire medical history from falling into the wrong hands (if really determined and technologically advanced).

[NRSKarenRN]

Firm believer that HIPAA is protecting us in to important ways.


1. Our medical information cannot be shared or sold like it was in the past between unrealted busineess, pharmacies and drug companies etc without our notification.

2. Push to electronically communicate makes it easier to do conduct healthcare business.
a.Since charts are electronic, I can look up meds patient is taking currently or 3 months ago for physician covering for PCP on wekeneds/evenings instead of having to pull paper chart from medical ecords.
b. Electronic connections between inurance companies and healthcare providers allow instant verification of eligibility and online authoriztions--saving great deal of time hanging on phone

3. Electonic access protected: those without approved authorizations from security officer, can't get into system. Automatic password changes q 2-3 months helps minimize prior employees from getting access to info after leaving. Time out limits on computer screens limits prying eyes too.


See these pre HIPAA stories:

Examples of recent privacy breaches include:
• A Michigan-based health system accidentally posted the medical records of thousands of patients on the Internet (The Ann Arbor News, February 10, 1999).
• A Utah-based pharmaceutical benefits management firm used patient data to solicit business for its owner, a drug store (Kiplingers, February 2000).
• An employee of the Tampa, Florida, health department took a computer disk containing the names of 4,000 people who had tested positive for HIV, the virus that causes AIDS (USA Today, October 10, 1996).
• The health insurance claims forms of thousands of patients blew out of a truck on its way to a recycling center in East Hartford, Connecticut (The Hartford Courant, May 14, 1999).
• A patient in a Boston-area hospital discovered that her medical record had been read by more than 200 of the hospital's employees (The Boston Globe, August 1, 2000).
• A Nevada woman who purchased a used computer discovered that the computer still contained the prescription records of the customers of the pharmacy that had previously owned the computer. The pharmacy data base included names, addresses, social security numbers, and a list of all the medicines the customers had purchased. (The New York Times, April 4, 1997 and April 12, 1997).
• A speculator bid $4000 for the patient records of a family practice in South Carolina. Among the businessman's uses of the purchased records was selling them back to the former patients. (New York Times, August 14, 1991).
• In 1993, the Boston Globe reported that Johnson and Johnson marketed a list of 5 million names and addresses of elderly incontinent women. (ACLU Legislative Update, April 1998).
• A few weeks after an Orlando woman had her doctor perform some routine tests, she received a letter from a drug company promoting a treatment for her high cholesterol. (Orlando Sentinel, November 30, 1997).
No matter how or why a disclosure of personal information is made, the harm to the individual is the same. In the face of industry evolution, the potential benefits of our changing health care system, and the real risks and occurrences of harm, protection of privacy must be built into the routine operations of our health care system.

Privacy breaches info from Part 1 of law:
http://www.hhs.gov/ocr/part1.html

[fergus51]

I think the rationale behind it is good. I do think sometimes it goes overboard.

[elkpark]

I agree with NRSKarenRN. The law was passed precisely because of the many flagrant abuses and violations of client confidentiality, large and small, in the past. If you don't like the law, we have only ourselves (the healthcare community at large, that is, not any particular individual) to blame ...

I also find that, often, healthcare people are perfectly comfortable doing things to clients that they would never find acceptable if it were done to them. Don't you feel strongly that the confidentiality of your own medical history/record should be protected? Then why don't our clients deserve the same?

[Turd.Ferguson]

Not trying to be a wisenheimer, but it’s actually HIPAA, not HIPPA. It’s an acronym for Health Insurance Portability and Accountability Act .

Before entering Nursing school, I worked as a Privacy Officer in a medium-sized hospital. Some interesting violations I found were:

A woman who looked up the medical history of men she dated, just to make sure they were healthy.

A unit secretary who looked up medical records to see if an acquaintance had a breast augmentation.

A local political VIP came into our emergency room. A respiratory tech walked out into the ER waiting room, pulled out her cell phone and called a friend to inform her that the VIP was in the ER with *** infection. Many of the waiting patients in the ER waiting area heard the information. Can you imagine what they thought?

A patient was going to have a surgery that she preferred to keep private. A nurse looked up her information and told her pastor about it. The pastor then told the church congregation about the patient and her surgery. The nurse’s explanation was that the church needed to pray for her and how would they know what to pray for if they didn’t know what the patient’s illness was? I guess she didn’t think that God would know what was wrong either unless some church member told Him.

I could go on and on, but the point is, we healthcare workers have a million and one reasons to think that someone else’s business should also be our own. After intensely studying the privacy regulations under HIPAA, I found that I agreed with 99% of it.

[suebird3]

It can be used another way:
My boss got transfered to a sister facilty. Her replacement/predesessor (new DON) was to work any open shifts. Hey, "conveniently" his wife...also a nurse....would end up at the hospital with an "out of contol" anaphylactic shock type problem. Once...no problem. But on several occasions?

To put it mildly, and without going into more detail at present, he used HIPAA, but it caught up with him.

[Hellllllo Nurse]

By the way, it's HIPAA, not HIPPA!

That drives me crazy!

Many people misinterpret HIPAA. There are no problems with exchange of pt info between one health care provider to another, as required to provide for the pt. People think there are because they are over-interpreting HIPAA and do not understand it.