HIPPA questions

[VAC]

Am I the only one who thinks the new HIPPA regs are going to clash horribly with the kiss-but customer service and open visitation policies in place in most hospitals?

I understand the new regs to mean that no info can be given out to anyone without the signed permission of the patient. We have many patients in the trauma unit who come into us intubated, unconcious, unable to sign anything. You have to get consents from someone, which you certainly can't get if you can't give out info about the patients condition. If my husband were in a accident, came to the hospital unconcious, they couldn't tell me anything?

Don't forget all the nosy visitors who ask questions which we'll have to refuse to answer. Anyone can go in a room, read the labels on the IV bags, go home look up the names on the internet, and learn about a patients condition.

I've had patients with visitors who claim to be the wife, then the next day another woman claims to be the wife.

Do any of your hospitals ask for ID or proof of power of atty, etc from famililes before giving out any info? Do you screen visitors? Except for peds and newborn we don't.

The other night while we were withdrawing a brain dead patient from the vent. The family wasn't found for a couple days, when they were, they decided they didn't want him to suffer. Any Joe schmo on the street could come in, claim to be the patients family and ask to have them withdrawn. Farfetched, maybe. Ya'll let me know if I'm crazy. You always do:)

[sunnygirl272]

I'm sorry ma'am...you cannot go into the exam room with your 18 month old dtr to have her examined for otitis media...that would be a violationof her privacy.......

[Q.]

I don't think HIPAA is responsible for not allowing a parent in an exam room. It's not about that - it's about protecting the SHARING of info (like name, address, SS#, etc) with third party health care providors or billers, etc. A parent is the owner/originator of such info, therefore, protecting them from their own information is not reasonable.

The sharing of this info with third parties is still accomplished by a patient signing an authorization. More paperwork for us, is really all it means.

HIPAA doesn't go into effect until April, and even after that, there will be a 3 year period in which providers can adjust to the new regulations without fear of penalty.

[CraigB-RN, MSN, RN]

Most of the problems with HIPAA are of people getting carried away. 80+% of the rules are things we should have been doing all along. It's the 20% increase in paperwork that is the killer. One more reason to push for a GOOD electronic Medical Record.

I'm responsible for the nursing side of HIPAA inplimentation and no were have I found were it says the parent can't go in with their kid to be seen. THe rules about preg girls having privacy have been on the books for years, that isn't anything new.

As to patient follow-up's it's nice to know about your patients, but it really isn't pertinent to their care. If you want to know about the patient, ask the patient themselves.

[SandyB]

Who knows someone who can draft a paper (legal kind) that gives friends and family named in the paper the right to all my info? I WANT some of my friends and family to know this stuff if I get sick!!!!

We need to make the form and get it accepted by whoever "accepts" those kinds of things...ASAP!

[emily_mom]

Originally posted by BelindaLPN

Get this!! I took my 10 y o daughter to the doctor Friday and was told that I could not go into the exam room with her. Excuse me, but I made a bit of a scene. Seems HIPPA says it would be a violation of my daughter's privacy! She's 10! No way in HELL I'm letting her go back there w/o me! Looking for a new doctor now....

I took my daughter in on Friday and had no problem like you did. Also discussed a medical problem of spouses' with PA and something about me. Should my daughter have been asked to leave because she was in violation? Should my doc not be able to talk to me about my hubby? Guess I am fortunate to live in a small town with a wonderful clinic. :)

This breaks it all down by subject. http://www.hipaacomply.com/

They also have an email address with questions.

[deespoohbear]

Our administrator is complaining because he is receiving calls from people who are telling him that the nurses are being rude. Why? Because we won't release any information over the phone to anyone. His reply is that we need to use some common sense. HELLO? How on earth am I suppose to ID somebody over the phone? Someone can call in and tell you I am the daughter of so and so, and I live 3 states away and can't come to visit. Can you tell me how she is doing? How do I know that is really the daughter and is she entitled to any info? What if the patient is unconscious, confused, sedated and can't speak for herself? Then what? Do I take a chance to violate HIPAA or do I just tell her I can't release any info? Damned if I do, and damned if I don't. (to quote Heather from another thread!) Yeah, patients rights need to be protected but will the pendulum swing too far the other way in the name of patient's rights?

Our government hasn't been to concern with citizens' rights since 9/11. Our constitutional rights can be violated with no repercussions for those guilty. But now healthcare workers can be fined big bucks if they even inadvertently release protected information. Seems kind of screwed up doesn't it?

[K O'Malley]

I am ambivalent about HIPAA but I feel that pts privacy rights are violated far to often. I have had co-workers look up my test results in the computer before my doctor had a chance to talk to me. Once we had a pt with HIV and his mother wanted it to be kept strictly confidential. A distant relative with medical knowledge came to visit and simply looked at the IV antibiotics hanging and figured out the diagnosis. Never mind everything that is overheard by the other pt and visitors in the room. Hospitals are really going to have to get over their 24/7 open house mentality for HIPAA to work.

[bergren]

I went to a HHS WEDI conference on HIPAA this weekend. The mother with the 10 yr old most certainly can go in treatment room unless child is being seen for something that, according to your state law, makes her an emancipated minor. Usually with preteens we ask the mothers and children if they still want the Mom in the room for the entire exam. Ten is still a little young for that.

The HHS people stated that a lot of the guidance is to be reasonable and flexible. If a patient is unconcious, the spouse or next of kin should be kept in the loop. I do think that designating a health care proxy at any age and even if in excellent health is a good idea as most ICUs are now asking the family to designate ONE person to give and receive information. It is just to labor intensive to deal with multiple family members calling.

Calling another floor and asking about patient's family that is officially no longer under your care would be considered inappropriate. In hospitals with electronic records, logging into a chart for this reason is grounds for dismissal. To be reasonable though, the other nurse should have offered to give that person your message and the mother herself could come down and talk to you.

I also agree that this law was needed. I, as I am sure all of us have, have seen some pretty bad judgement used in giving out information. The feds are trying to make it more user friendly and stated over and over, "we are not trying to get in the way of delivering care".

[sjoe]

Sandy B writes: "Who knows someone who can draft a paper (legal kind) that gives friends and family named in the paper the right to all my info? I WANT some of my friends and family to know this stuff if I get sick!!!!

We need to make the form and get it accepted by whoever "accepts" those kinds of things..."

Talk with the social worker at the relevant hospital. If that person can't give you the forms, get a referral to an appropriately-trained attorney, who definitely can assist you.

[maureeno]

Last week my husband was called to evaluate a patient for involuntary mental health commitment. he gets to the hospital and the admissions people would not tell him what room the patient was in. Later he is making arrangements to transfer the patient to another facility and the staff was worried about sending records. people are going absolutely and wrongly nuts about HIPPA.

I took the training last week and found nothing approaching many of the fears I've seen posted in this and a previous thread.

[SandyB]

At the moment I don't need an attny...I just made up a simple wavier and named who I wanted to see/participate in my care and the docs are happy with it...gets them off the hook for talking about me with my hubby and friends and lets me know all about hubby.....

Thanks sjoe, but I would hate to have to spend the $$ on a LAWYER unless I have no other choice.

[pay4lawschool]

I was looking for an answer to the issue raised in this thread, and Google directed me here...but looking further I found the meat and potatoes answer on the US Dept of Health & Human Services site, so I thought I'd share it here to save everyone else a further step in the future. :)

Question:

Does the HIPAA Privacy Rule allow parents the right to see their children's medical records?

Answer

Yes, the Privacy Rule generally allows a parent to have access to the medical records about his or her child, as his or her minor child's personal representative when such access is not inconsistent with State or other law.

There are three situations when the parent would not be the minor's personal representative under the Privacy Rule. These exceptions are: (1) when the minor is the one who consents to care and the consent of the parent is not required under State or other applicable law; (2) when the minor obtains care at the direction of a court or a person appointed by the court; and (3) when, and to the extent that, the parent agrees that the minor and the health care provider may have a confidential relationship. However, even in these exceptional situations, the parent may have access to the medical records of the minor related to this treatment when State or other applicable law requires or permits such parental access. Parental access would be denied when State or other law prohibits such access. If State or other applicable law is silent on a parent's right of access in these cases, the licensed health care provider may exercise his or her professional judgment to the extent allowed by law to grant or deny parental access to the minor's medical information.

Finally, as is the case with respect to all personal representatives under the Privacy Rule, a provider may choose not to treat a parent as a personal representative when the provider reasonably believes, in his or her professional judgment, that the child has been or may be subjected to domestic violence, abuse or neglect, or that treating the parent as the child's personal representative could endanger the child.