The answer: Is this a HIPAA violation?

Identifiers

This lists the identifiers specifically appearing in the HIPAA privacy regulations. The presence of any one of these identifiers renders health information individually identifiable.

If none of these is a part of the information, it is not possible to identify the individual and no HIPAA violation occurs if the information is used

HIPAA De-identification requires removal of all such identifiers as specifically defined in the regulations.

The following identifiers of the individual or of relatives, employers, or household members of the individual the asterisk * indicates permitted in a limited data set §164.514(e)(2)):



Safeguarding PHI

The Privacy Rule requires you to "safeguard" PHI at your training site. Use the following practices to ensure Privacy Rule compliance.

If you see a medical record in public view where patients or others can see it, cover the file, turn it over, or find another way to protect it.

When you talk about patients as part of your training, try to prevent others from overhearing the conversation. Whenever possible, hold conversations about patients in private areas. Do not discuss patients while you are in elevators or other public areas.
When medical records are not in use, store them in offices, shelves or filing cabinets.
Remove patient documents from faxes and copiers as soon as you can.

When you throw away documents containing PHI, follow the facility procedures for disposal of documents with PHI.

Never remove the patient's official medical record from the training site.

Avoid removing copies of PHI from the training site; if you must remove copies of PHI from the training site, e.g., to complete homework, take appropriate steps to safeguard the PHI outside of the training site and properly dispose of the PHI when you are done with it. You should not leave PHI out where your family members or others may see it. All copies of PHI should be shredded or otherwise destroyed when they are no longer needed for your training purposes.

The U.S. Department of Health and Human Services has issued another set of HIPAA rules (the Security Rules) regarding safety and security of electronic data files and computer equipment, about electronic safeguards and how the HIPAA Security Rules may affect you at clinical training sites.

Use Only the Minimum Necessary Information

When you use PHI, you must follow the Privacy Rule's minimum necessary requirement by asking yourself the following question: "Am I using or accessing more PHI than I need to?" If you are unsure of the PHI you may use or access while providing health care for a patient at your training site, please contact your preceptor, supervisor or the HIPAA Privacy Officer at your training site

Disclosing PHI to a Patient's Family Members

Before you may discuss a patient's condition, treatment or other PHI with his or her family member, it must be determined if the patient would object to such a disclosure. You should confirm with your supervisor that the patient has agreed to allow or in some other way has expressed no objection to such disclosures before you may discuss a patient's condition, treatment, or other PHI with his/her family members.

Patients' Rights Under the Privacy Rule

Each training site covered by the HIPAA Privacy Rule will have policies and procedures for implementing the following patient rights under the Privacy Rule:

The right to request alternative communications.
Under the Privacy Rule, patients can ask to be contacted in a certain way. For example, a patient may ask a nurse if she/he can leave a message on the patient's home voicemail instead of contacting the patient at work. If a patient's request is reasonable, as is the previous example, the health care provider or facility must follow it.

The right to look at (and obtain copies of) records.
Patients can ask to read their medical and billing records, and have copies made.

The right to ask for changes to medical and billing records.
Each facility must review and consider all requests for changes to medical and billing records.

The right to receive a list of certain disclosures.
Your training site must make and keep a list of certain disclosures of PHI (excluding disclosures for treatment, payment, and health care operations) that are made without patient authorization. Patients have the right to see and receive a copy of this list.

The right to request restrictions on how PHI is used and disclosed.
Patients can ask health care providers and facilities to limit the ways they make use of and disclose the patient's PHI for treatment, payment, and health care operations. Providers and facilities are not required to agree to such requests. You, as a trainee, must never agree to such restrictions on behalf of the training site.

The right to receive a "Notice of Privacy Practices."
Each health care facility that provides direct patient care must give every patient/client a copy of their Notice of Privacy Practices. The notice describes their privacy practices and the Privacy Rule. The facility must make reasonable efforts to have each patient sign a form acknowledging he or she received the notice. We recommend that you obtain a copy of the Notice of Privacy Practices from your training site and become familiar with it.

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