HIPAA and Advocate for competent patient - page 3
I have been an RN for about a year and a half now and I have recently started on days on a cardiovascular step down unit. I had a 29y.o patient who was completely alert oriented and competent. A... Read More
0Nov 11, '13 by Susie2310Quote from aubgurlMy post above referred to information I am legally entitled to. The law is on my side. I'm sorry you don't like that.I think this is one reason people are so careful about giving out information to someone,especially over the phone, because there is always someone great ending to go to an attorney.
1Nov 12, '13 by ktwlpnBut unless the loved one is confused or critically ill and unable to speak why should anyone -POA or otherwise-be wasting anyone's time calling docs and the floor for a report when the patient is perfectly capable of giving them any info they wish? Just because they can,IMHO. It's a control thing,too. You will get a call if your loved one crumps ,no need to call three times a day to find out what color his urine is and how many times he voided,especially if you've been there all day.Get some rest,you will need to be available after discharge to help them in their home.
1Nov 12, '13 by MunoRNQuote from applewhiternYou're facility is actually making up it's own rules, which is pretty common, although not to this degree. In the case of a POA when the POA becomes the active decision maker, you're actually required to facilitate communication, not stifle it.If the POA cannot be there in person, no, we cannot discuss the patient over the phone ~if THEY call US~ because we have no way of knowing who is actually on the phone. WE can call THEM, however, if the doctor requests it and/or we need a phone consent for something. Usually if a patient is incapacitated, they have a POA who is nearby. We are simply following HIPPA, and not just making up our own rules.
As for what HIPAA requires:
" If a patient's family member, friend, or other person involved in the patient's care or payment for care calls a health care provider to ask about the patient's condition, does HIPAA require the health
care provider to obtain proof of who the person is before speaking with them?
No. If the caller states that he or she is a family member or friend of the patient, or is involved in the
patient's care or payment for care, then HIPAA doesn't require proof of identity in this case. However, a
health care provider may establish his or her own rules for verifying who is on the phone. In addition, when
someone other than a friend or family member is involved, the health care provider must be reasonably sure
that the patient asked the person to be involved in his or her care or payment for care. "
1Nov 12, '13 by MunoRNQuote from ktwlpnI think you hit the nail on the head, but maybe not in the way you meant. There is power in being the gatekeeper of information, that power is demonstrated far more through denying access than it is by providing access, which is maybe why family is sometimes told they can't be given information due to HIPAA, even though according to HIPAA they clearly can be given information.It's a control thing,too.
Patients, unfortunately, are often largely ignorant of their own condition, either by intention, lack of supporting knowledge base, or poor comprehension due to illness, stress, etc, which is why often the best way for the Nurse to help encourage a strong support system for the patient is to clearly and openly communicate.
HIPAA provides for communicating with friends and family in the case of a competent patient, just ask, although you don't even have to do that:
"If the patient is present and has the capacity to make health care decisions, when does HIPAA allow a health care provider to discuss the patient’s health information with the patient’s family, friends, or
others involved in the patient’s care or payment for care?
If the patient is present and has the capacity to make health care decisions, a health care provider may
discuss the patient’s health information with a family member, friend, or other person if the patient agrees
or, when given the opportunity, does not object. A health care provider also may share information with
these persons if, using professional judgment, he or she decides that the patient does not object. In either
case, the health care provider may share or discuss only the information that the person involved needs to
know about the patient’s care or payment for care. "
0Nov 13, '13 by LadyFree28, BSN, RNQuote from MunoRN****Pt in OP's post didn't want to discuss information; so OP still had a right to follow through as they did. Sounds like the pt makes his own health decisions. The fact remains per the OP, the pt didn't want to discuss it; in addition, there are instances where PP's gave excellent examples of why they do not give out information on the phone.***** "If the patient is present and has the capacity to make health care decisions, when does HIPAA allow a health care provider to discuss the patient’s health information with the patient’s family, friends, or others involved in the patient’s care or payment for care? If the patient is present and has the capacity to make health care decisions, a health care provider may discuss the patient’s health information with a family member, friend, or other person if the patient agrees or, when given the opportunity, does not object. *****A health care provider also may share information with these persons if, using professional judgment, he or she decides that the patient does not object. In either case, the health care provider may share or discuss only the information that the person involved needs to know about the patient’s care or payment for care. "
If facilities had the unfortunate issue where they've had issues discussing PHI, and they want to ensure that PHI is protected; then the facility has that right to do so in order to comply.
I've had pt's in situations that they had a list, and codes, etc.,and wasn't in the system for anyone to find; for pt safety, the understanding was for all information was to be shared with people present.
Where I currently work; we always involve the pt in deciding whether to share the information; if the pt declines if they are AAO x3 and say NO, they are the ones to tell the person seeking information.
0Nov 13, '13 by krisiepooQuote from applewhiternI know I'm just a student, but this seems ridiculously restrictive. I also see nurses speaking to family members on the phone in the hospitals often (calls in and calls out). I think I'll just verify this when I get my job as to policy at the specific hospital since it appears there is a wide range of responsesWe don't discuss the patient on the phone, period. They have to be there in person, unless they have a code to identify themselves with. Yes, if they want to see labs, physician progress notes, etc., they have to go thru medical records. Anyone can call and claim to be a relative or POA; how do you know who is really on the phone?
0Nov 13, '13 by Susie2310Quote from morteRead the link MunoRN provided on common questions about HIPAA, point #4 for information on sharing health information over the phone. Then read my first post where I said in my particular case I had the POA and another document authorizing me to advocate for my family member and receive any/all protected health information. I had been by my family member's bedside and had spoken with the nurse, and it would be reasonable to expect that when I telephoned the unit that same nurse would make a good faith effort to identify me, as the nurse did - he/she was able to remember my voice and details of the care he/she had just provided for my family member in my presence. Plus, it would be easy for me to confirm my identity - I could e-mail the documents (they had the POA on file already) plus my identification. The POA and the other document drawn up by a lawyer give me the authority to receive information regarding my family member over the phone, according to HIPAA, so yes, I am entitled to receive information over the phone as I can identify myself in multiple ways.I don't think you are entitled to anything over the phone, if they can not determine who you are.