HIPAA Scenario???

suzanne4, RN · Dec 10, 2005

What would you do in this situation:
You are taking care of a patient and a lady claiming to be his daughter calls on the phone to see how the patient is and what is going on with him. What do you say? BTW the patient in this scenario is asleep.
Do you answer her questions, what do you do? Would it go against HIPAA if you do??
Help!! Any help would be great!!

How do you know that it really is the daughter? That is why it is so important to establish some type of code that a family member, or the person who can get infor per the patient, has. You have no idea who that person is, and on a true technical point, you do not even have to admit that the patient is there. By admiting that they are even there, you are actually giving out information.

It is definitely in violation of HIPAA, unless that patient listed that family member as approved to receive medical information about them.

TweetiePieRN · Dec 10, 2005

Thanx Suzanne!! I did not give out ANY info. Since it was 11pm and the pt was sleeping, I could not even get an ok from him to talk to her. Naturally, the daughter got mad at me and I had to sound like a broken record repeating myself. I have never met the daughter...so I was not about to give her any info!!

The reason I posted this today is because there were 3 other nurses around me and they thought I was being unreasonable! I had a very pleasant tone of voice and I even apologized to the "daughter". I am glad I did the right thing. Our management is so big on "customer service" that I actually expect to get called into the office sometime soon regarding this.

BGgirl · Dec 10, 2005

We have a place on our kardex where we list the people who can recieve info about the pt. Some nurses even ask the caller to tell them the pts birthdate to really verify if they know the pt or not.

suzanne4, RN · Dec 11, 2005

You were quite correct in what you did. Federal laws are above what ever your facility or the other nurses say to you. You were following the law, and to do otherwise could put you in a legal mess actually.

I have this issue all of the time at work, fortunately, everyone that I work with follows the same rules. You first concern is with the patient, they come first. And if they haven't said earleir who they wanted information given to, then it is not given out. Simple as that.

RazorbackRN, BSN, RN · Dec 11, 2005

I have seen many places require the use of a password or security question that is established by the patient.

veegeern, BSN, RN · Dec 11, 2005

Our facility issues each patient at "PIN" number on admission. The patient can then give that number his/her family member, SO, friend...If someone calls or comes to the desk to ask about a patient, then they must produce the pin number. Without it, we cannot speak to them about the patient.

I have actually had family memebers threaten to sue me personally and the hospital over this when they have called the floor. I very calmly and politely explain that they are welcome to do that, but that by federal law I am not allowed to speak with them.

Havin' A Party!, ASN, RN · Dec 11, 2005

How do you know that it really is the daughter? That is why it is so important to establish some type of code that a family member, or the person who can get infor per the patient, has. You have no idea who that person is, and on a true technical point, you do not even have to admit that the patient is there. By admiting that they are even there, you are actually giving out information.
It is definitely in violation of HIPAA, unless that patient listed that family member as approved to receive medical information about them.

I pretty much agree with the tenor of this.

But can anyone cite a U.S. court case or an official statement from an authorized regulatory body upholding the use of a password?

suzanne4, RN · Dec 11, 2005

It doesn't have to be a password, but somehow you are going to need to take responsibilitiy for knowing who you are giving information to, and that could go to court if the wrong person was given information. The best way to cover everyone is to have a list of approved people, or one person that can receive information. And either a mutual code decided opon, or par tof the patient's medical record number of even account number that staff knows about, or can verifiy.

rnmom3153 · Dec 12, 2005

I absolutely suggest the use of a password and do not give out any info over the phone. I don't even acknowledge that the person is even there. It's hard to believe anyone would even question your actions, Tweety. You're right on! Especially with HIPPA!

Daytonite, BSN, RN · Dec 12, 2005

I hate to have a relative get upset with me, so I hear where you are coming from. What I've done in situations like yours is to engage the caller in some conversation. I'll ask them to give me their full name and then ask, "well, how was he when you saw him last?" and try to find out just how much they know. I'll get them to talk about their last visit with the patient and how he was doing then, have they talked with the doctor and what did he say. It's more difficult for a person who is lying about their identity to lie proficiently, especially when you ask open ended questions that you know the answer to already (like what the patient was just doing a few hours ago). A lot of times I feel comfortable enought to decide that I am really talking to who the person is saying they are. Then, I will give information like, "well, he's sleeping now, but he's been comfortable, was there something specific you were worried about". Doing this, I sometimes didn't have to give out anything at all, the person just needed some reassurance that the patient wasn't suffering. I've had people telling me they were a patient's wife saying they were so worried because papa had a terrible day yesterday and they just wanted to know if the diarrhea had cleared up yet. How can you refuse to answer that? Then, the next time I'm in with the patient I would tell them that so-and-so called them while they were sleeping. The patient will let you know if you've goofed up or not. In my 30 years as a nurse I've only run across a couple of people who were calling for information on a patient that weren't entitled to it. The fact that they were drunk or had slurred speech as well as calling at 3am in the morning and getting nasty or belligerent was usually a dead give away that they were up to no good. In general, it's not likely a stranger is going to be calling for intimate details of a patient's hospitalization, but it's still good to be wary. Another way to handle this is to tell the caller that you are in the middle of something very important and could you call them back? Get their number, compare it with what is in the chart and then call back in a few minutes. I also interact with visitors as much as I can and let them know my name and if they are going to call to please ask for me by my name. It kind of sets things up for calls you might get at a later time. Those admission interviews we do with patients and file in the back of the chart and never look at again. . .sometimes they contain information as to who the patient is expecting to be checking up on them. I guess what I'm saying is that there are slick ways to determine just who is on the phone and not tick them off. Sometimes you have to be practical and just use common sense.

Havin' A Party!, ASN, RN · Dec 12, 2005

... somehow you are going to need to take responsibilitiy for knowing who you are giving information to...

That's dead on. And my implied point.

Does anyone know of any official pronouncement specifically indicating an approved method for handling inquiries?