HIPAA and message boards

[Gompers, BSN, RN]

Hey everyone! There has been some chit-chat here over the past day or so regarding HIPAA compliance and message boards. I'm really nervous about this now and am wondering how exactly we can handle this? Someone posted that even though we don't use names, some people still consider this a breech of confidentiality. I don't really understand HOW. If no one knows what hospital you work at, and you don't use names...how can it be an offense?

This board has been such a wonderful place to come for support, answers, and new ideas. Part of the comfort is that it's anonymous. I mean, there are nurses posting from other level III units in my city, but I still don't know for sure were they work, and at least one person was sure they knew were I was working but she was wrong. So what is the problem?

The only thing I can think of is that a family member of a patient might search nursing message boards and find a case that sounds familiar. But even then, if the hospital and patient aren't identified, there is no proof that it's their family member. I can understand if you're in the cafeteria at your workplace talking about a patient, but this is the internet! It's a HUGE world out there! I mean, read any nursing magazine and you will find case studies reported from specific hospitals, often over specific periods of time, discussing patients in detail - how is that not a HIPAA offense but chatting on an anonymous message board is?

I'd just hate to lose this as a place where we NICU nurses can come to chat, because it's just such a wonderful (albeit ADDICTING) place!

[gwenith, BSN, RN]

It is difficult when people give away too much information and occasionally we have people who "recognise" each other. This is one of the reasons why I never post anything here that I would not like known at work. I am open about what I do and most of my colleagues know that. I keep in non-committal and I try not to post any current cases.

[traumaRUs, MSN, APRN]

Gwenith - me too! This is a public place - not somewhere you come with details!

[Ned the Red]

Seems to me that we have two distinct cases here.

First - Details are posted about me that would allow my neighbor do determine not only what the problem is but that I'm the one who has it. Like, "I have a pt who lives in Flower Mound Tx with ........ " This would be a clear violation.

Second - Details are posted in such a way that the only way my neighbor would know you're talking about me is if he already knew about my problem (and the fact that I have a problem).

So, if the details are specific enough that someone with periperal knowledge of the incident could indentify the pt you have just violated HIPAA. To discuss cases in general shouldn't be any problem.

Something related that I've seen that could cause trouble is when someone comes on the board and says "Something happened on my unit last night." and then goes to talk about how a Dr. or administration (or another nurse) really messed something up. In this case, anyone who knows that the problem happened might be able to figure out where it happened and suddenly gets more details. You've just "spilled the beans" and allowed for a potential lawsuit against your employer or another worker.

I'd be more concerned with someone else from, say, administration putting two and two together.

Make sense?

[BittyBabyGrower, MSN, RN]

Interesting thought! I guess any one of us could be in HIPPA violation just posting things on boards. You shouldn't be coming here and posting about certain things and saying things about co-workers....it may eventually come back and bite you in the butt, that is for sure!

[Havin' A Party!, ASN, RN]

... This is a public place - not somewhere you come with details!

Agree.

Let's keep things general. No prob with that HIPAA-wise.

Identification specifics aren't necessary to our discussion anyway.

[nurseiam]

I have thought about this also....When HIPPA first came out one of our house keepers was fired for saying something when a friend asked.....and she only knew it was there...

[prmenrs, RN]

Thanks, everyone, for this valuable and timely discussion.