HIPAA are there loop holes?

[pilotpn]

i just need some help understanding how things play out with hipaa. i'm a new grad and new hire. how do the hipaa policies differ or do they from urgent care walk ins, er, main campus hospitals?

main campus hospitals, usually the patient will stay long enough for a shift change/report so they are handed over to another nurse, i guess giving them the legal right to their information. er and walk ins, are they different when it comes to hipaa? a walk in visit is about an hour's stay, but you could have pending labs that won't result for 2-3 days requiring some one else to clear/note them. i have been in the er half a dozen times with my kids before i went into nursing and experienced this, triage nurse then md or pa and then another nurse doing the discharge.

discharging patients you did not treat. you see their medical information when putting together their discharge papers. does this fall under "policy and procedure of the hospital" giving you the right to see this info? when you are doing the discharge does that make you part of treatment by answering questions about meds or their diagnosis.

nurse notes on patients you did not treat. notes on labs mds have reviewed. the md didn't verbally tell me it was ok to look up that patient i didn't treat, but by dropping the signed final lab on the nurse's station desk, i'm suppose to add a note stating the labs have been reviewed. now legally if that patient found out i saw their medical and personal information without treating them would i be in violation? how would they find out? that's not the point.

change of plan of care that requires you to look up patient personal and medical history before contacting that patient. say you get a lab result back that states the patient is pos for beta strep and the md wants a new rx called in for them.

is this the way it is done everywhere and i'm just too green to have a clue? basically if all the aforementioned is not done it would take days for the right nurse to do everything for only the patients they treated.

i'm sure i'm gonna get a "welcome to nursing" from someone, but i would still like to have some feed back.

thanks

[jeckrn, BSN, RN]

One issue I ran into when doing EMS was facilities not wanting to us what issues the patient had which we needed to know to treat the patient. One classic example was we went to a PT center for a women with hip pain. When speaking with the nurse there asked if women and any issues with her hip and is that why she was recieving PT. She said she could not tell me because of HIPAA. Tried to explain to her that I needed to know so I could properly treat her & let the ED know, finally she said that the women was being seen for a hip problem. Also, frequently nurses at LTC facilities do not feel that EMS needs to know the history of a patient. Knowing pt hx is needed for proper care, just like I would obtain when I worked in the ED as a RN. Privacy rules were out long before HIPAA and we were doing the same things back then as today, only it has been more diffucult then it needs to be by the pucker factor of administration.

[morte, LPN, LVN]

You come to get anyone where i am working you will get ALL the info you need !

One issue I ran into when doing EMS was facilities not wanting to us what issues the patient had which we needed to know to treat the patient. One classic example was we went to a PT center for a women with hip pain. When speaking with the nurse there asked if women and any issues with her hip and is that why she was recieving PT. She said she could not tell me because of HIPAA. Tried to explain to her that I needed to know so I could properly treat her & let the ED know, finally she said that the women was being seen for a hip problem. Also, frequently nurses at LTC facilities do not feel that EMS needs to know the history of a patient. Knowing pt hx is needed for proper care, just like I would obtain when I worked in the ED as a RN. Privacy rules were out long before HIPAA and we were doing the same things back then as today, only it has been more diffucult then it needs to be by the pucker factor of administration.

[Esme12, ASN, BSN, RN]

One issue I ran into when doing EMS was facilities not wanting to us what issues the patient had which we needed to know to treat the patient. One classic example was we went to a PT center for a women with hip pain. When speaking with the nurse there asked if women and any issues with her hip and is that why she was receiving PT. She said she could not tell me because of HIPAA. Tried to explain to her that I needed to know so I could properly treat her & let the ED know, finally she said that the women was being seen for a hip problem. Also, frequently nurses at LTC facilities do not feel that EMS needs to know the history of a patient. Knowing pt hx is needed for proper care, just like I would obtain when I worked in the ED as a RN. Privacy rules were out long before HIPAA and we were doing the same things back then as today, only it has been more difficult then it needs to be by the pucker factor of administration.

You are right, it's the pucker factor of the administration. There is NO legal reason for them to not give you report unless you are just a transport vehicle with no plans or capabilities of providing care. If, however, you are "just a chair car" and otherwise cannot provide emergency care....technically you don't need to know and are considered a "cab" for all intensive purposes. It stinks but that is what the law means. If you are a transporting and have no "EMS" equipment for care...you don't need to know diagnosis for if something would happen you would still call 911. But if you were transporting as EMS...for medical care or to medical care.....they are wrong.

[jeckrn, BSN, RN]

The FD I am in runs a NYS certified ALS ambulance and does not run "cab" calls and needed the info. Too bad thou ambulance's are over used and treated as cabs for rides to the ED which should be done with a POV; most of these calls don't even need the ED but their primary care provider.

[jeckrn, BSN, RN]

You come to get anyone where i am working you will get ALL the info you need !

Thanks, that is what we need, the team approach to care. On military leave from my FD so I have not run a EMS call for 2 years.