Office Horror Stories?

Nurses General Nursing

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Hello everyone. I am working in a very fast paced office, with several doctors. I feel it is very chaotic and without enough help. The medical records are a mess, and trying to find charts has always been a big issue. While I'm on the subject of medical records, is it a HIPAA violation to remove charts from the facility? This is one concern I have. We don't have electronic charts. Please share with me any related horrors that you might be experiencing, and/or answer my question. I just want some joy, but there is very little in this place due to the workload. Just putting out fires! Thanks.

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While I'm on the subject of medical records, is it a HIPAA violation to remove charts from the facility?

Absolutely, totally, yes - this is a HIPPA violation. Can you imagine the car being broken into, or a wreck, or anyone at the house seeing the records. YIKES and more YIKES!

In the old pre HIPPA days, doctors used to take records home, and some probably still do; but I wouldn't want any part of that.

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Specializes in Med/Surg, Ortho, ASC.

"Absolutely, totally, yes - this is a HIPPA violation."

Technically, it's a HIPAA violation.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

The only time charts should be taken outside your facility is if they are being transferred to secure storage somewhere. Your chaotic office is preventing your doctors from doing as good a job as they can, as well -- or maybe they don't mind waiting around for the staff to hunt down a chart? Maybe it's just fine with them to have the patient cool their heels in a room while they are trying to find a lab result they need? You'd think between four docs they could spring for an assistant to help organize the place - gosh - some people are penny-wise and pound foolish!

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Oh, yeah and it's H I P A A !

Oops - sometimes I type faster than I read.

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Shoot. I lost my entire post. Thanks for responding. We have more than four doctors, and most dictate after every patient, but there are charts being removed for dictation purposes. Can I lose my license by not reporting if it is a HIPAA violation? I really need this job right now, and am afraid of reporting and/or losing my job. Or, they could make it miserable for me to stay? We have several support staff, but not enough, esp in medical records. Loose papers not being filed and/or charts misfiled. Also, we frequently have to get down on our knees and/or climb up on stools to retrieve charts. How do your offices operate compared to this? I have nothing to compare to. Thanks everyone.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Where are they taking them to dictate? If it's within the building itself I don't think it's a HIPAA violation.

Doctors are included in the HIPAA regulations, just as you are. They are responsible for their own behavior.

Doesn't the office have a manager? Are any of the doctors aware of the haphazard way paper charts are being handled? If you are the manager, you need to have a meeting with them to discuss ways to keep control of the patient's medical records. Climbing and bending isn't unusual, but loose papers flying about and lost charts are a danger to the patient, ultimately.

Normally people are lucky to have a job in an office, but this one manages to sound really chaotic and stressful. If they aren't interested in improving things, start looking for another job right away. I couldn't function in an office/clinic job without being organized.

I sympathize about the lost post. >:-( I hate that!!

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The manager doesn't really think it's a HIPAA violation, but another doc there does. Also, how do all of you deal with the stacks of call backs with lab/xray results, constant faxes back and forth to pharmacy and nursing homes, sched appts for tests and with specialists, and all the while rooming patients? Just seems like an impossible load to me :(

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Does anyone have a link re specific HIPAA regulations and chart removal? Thanks.

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Specializes in Clinical Research, Outpt Women's Health.

This is all typical office nursing. I always came in before office hours to make calls. Then addressed them at lunch time also and at the end of the day. Urgent stuff as needed. Long days sometime to get everything done, but as long as they paid me for it that was ok. Searching for charts, over, and over, and over again.

I always stocked the rooms at the end of the day as I was cleaning up after the last patient so they were ready to go in the am.

Good luck!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
The manager doesn't really think it's a HIPAA violation, but another doc there does. Also, how do all of you deal with the stacks of call backs with lab/xray results, constant faxes back and forth to pharmacy and nursing homes, sched appts for tests and with specialists, and all the while rooming patients? Just seems like an impossible load to me :(

What a mess! You have to be the "front office" person and the "back office" person? I don't think I would want to set myself up for a nervous breakdown because a practice of 4+ doctors is too cheap to hire someone to handle the faxes, the calls and the appointments for specialists and tests.

The nutsiest office job I had was in a clinic where I was the nurse for the dermatolgist and the allergist who both worked part time but I had to handle the work of both all the time plus schedule and do allergy testing. The only way I was able to manage it was to have a block of time to do things when the patients were not being seen. Just three hours of peace is a real godsend!

Think through everything you do and determine what you can do ahead of time to make whatever you're doing go as smoothly as possible (as someone mentioned) stock up your rooms ahead of time. Some appointment paperwork can be partially filled out ahead of time. Non-urgent test and consult appointments you may have to tell the patient you'll call them back to set up.

Your stacks of call backs- if they're normal just "FYI" they can wait. Prioritize the rest. I always made sure to let people know if I didn't get an OK on a refill or the doctor said they would call back and didn't - as we know what it's like to be anxious and waiting for a call back.

Those are just some ideas bearing in mind that sometimes too much work is just that and the most speedy and efficient human being on earth wouldn't be able to handle it. Hope it gets better for you! :up:

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Specializes in Health Information Management.

Yikes. Sounds like the practice needs to hire some experienced HIM people to get the records/organization issues under control. I hope your facility takes advantage of the money that will soon be available to practices in order to assist them in transitioning to an EHR system. If properly implemented, a good EHR system could really help tame those beastly organizational problems!

Here's a link for you that explains how removing charts from a facility is a HIPAA violation. Slide 16 in particular refers to taking charts home. I'm waiting on payday to renew my AHIMA membership, so I can probably get you some more authoritative links tomorrow if you'd like. :)

http://www.scribd.com/doc/6437370/HIPAA-Basics

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