HIPAA and one's own spouse/partner

[pmabraham]

Is it against HIPAA for a healthcare professional (doctor, nurse, etc.) to discuss any identifying details about a patient they cared for with their spouse?

I did find http://www.utoledo.edu/offices/compliance/Privacy_FAQs.html where it appears the answer is "no," but I cannot find any on Health Information Privacy | HHS.gov that would actually cite the portion of the law the utoledo.edu is basing their answer on.

Where can I find something more specific as to whether or not a healthcare worker can mention (or not) anything to their spouse?

Thank you.

[pmabraham, BSN, RN]

Been there,done that said:

I am assuming you are giving up PHI to your spouse or writing a paper. If you are yakking to the spouse, knock it off, if you are writing a paper.. do your own research.

Let me break it down for you. Assume = *** out of you and me. I don't share any identifying patient information with my spouse, friends, classmates, etc. Before I leave clinical, any paper containing any PHI (which was required for the clinical on patients under my care) go to the shredder; and, I'm usually the one passing on HIPAA do's and don'ts to classmates.

In terms of research, read my opening post; I am doing my own research.

Now, unless you want to be a bully and continue to assume negative thing about people you don't even know whatsoever, how about you knock it off!

[pmabraham, BSN, RN]

Thank you so much, elkpark, for showing patience, and providing this level of detail. Thank you!

[elkpark]

pmabraham said:

Let me break it down for you. Assume = *** out of you and me. I don't share any identifying patient information with my spouse, friends, classmates, etc. Before I leave clinical, any paper containing any PHI (which was required for the clinical on patients under my care) go to the shredder; and, I'm usually the one passing on HIPAA do's and don'ts to classmates.

Which, again, raises the question; then why are you making a big deal about this? Why isn't it obvious to you that the answer is, no, people can't disclose protected info to their spouses? Why the repeated harping on whether someone can provide a citation of someone getting sued for this?

[Esme12, ASN, BSN, RN]

Okay...first. As per the Terms of Service...AN promotes the idea of a lively debate.

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Our call is to be supportive

Now....I am not sure what the information is for because it seems that you need it for research or you know someone who has talked to family.

HIPAA is very clear. The use of PHI (Protected Health Information) is only as a "need to know" basis. The spouse, family, neighbor, pastor, teacher (non nursing of course) is not involved in the care of that patient therefore has no "need to know". So, YES it is a HIPAA violation. You can find this information on the HHS.gov site. There may NOT be actual case law...HIPAA is "relatively new" but I do know that HIPAA is up for interpretation and facilities provide the details of what is acceptable and unacceptable according to HIPAA. You are much more likely to be fired for not following the facilities Confidentiality policy than be legally sued by a patient or the government.

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[Definition of Breach A breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information. An impermissible use or disclosure of protected health information is presumed to be a breach unless the covered entity or business associate, as applicable, demonstrates that there is a low probability that the protected health information has been compromised based on a risk assessment of at least the following factors:

1. The nature and extent of the protected health information involved, including the types of identifiers and the likelihood of re-identification;
2. The unauthorized person who used the protected health information or to whom the disclosure was made;
3. Whether the protected health information was actually acquired or viewed; and
4. The extent to which the risk to the protected health information has been mitigated.

Breach Notification Rule | HHS.gov

[WKShadowNP, DNP, APRN]

pmabraham said:

Let me break it down for you. Assume = *** out of you and me. I don't share any identifying patient information with my spouse, friends, classmates, etc. Before I leave clinical, any paper containing any PHI (which was required for the clinical on patients under my care) go to the shredder; and, I'm usually the one passing on HIPAA do's and don'ts to classmates.

In terms of research, read my opening post; I am doing my own research.

Now, unless you want to be a bully and continue to assume negative thing about people you don't even know whatsoever, how about you knock it off!

WOW!, I filled up a whole row in Bingo with this post!

[AlabamaBelle]

No, just no. The spouse is does not need to know. I have not ever, in my years of nursing disclosed PHI. My family has never, except in cases of prayer requests or social media posts, know anything about who is in our unit. I care for some the child of some local celebrities in my former state, my family would have love to have known I saw those people, but to this day, they have no clue.

I can say that prior to HIPPA, my youngest daughter's case was discussed at church. One of the CV residents in the OR for her first surgery attending church with us. He did not know at the beginning of the case who she was. The church gossip cornered him and some things were said (like her prognosis, which has been totally blown out of the water 27 years later) that I feel to this day that breached the more informal doctor/patient privilege. I personally felt very violated and that has shaped my protection of PHI to this day.

[JadedCPN, BSN, RN]

pmabraham said:

Yes, the University of Toledo referenced it, but I cannot find any legal case (aka legal precedent) or actual verbiage in HIPAA to support the interpretation.

Please keep in mind I'm not for or against the situation; I'm just trying to find an actual source document that either comes from HHS or is a legal precedent. So far I just have people telling me no, and citing anything but HHS or a legal case were it was proven to be a HIPAA violation.

You mentioned in two posts I believe that you are "not for or against" it. And based on your other posts, I am under the assumption (correct me if I'm wrong) that you are in school. Just some indirectly related friendly advice - you should firmly be against this now, so that it doesn't cause an issue with your actual license later.

[pmabraham, BSN, RN]

elkpark said:

Which, again, raises the question; then why are you making a big deal about this?

This after I just thanked you for the information you provided. Now, who is making a big deal of it?

[Rose_Queen, BSN, MSN, RN]

pmabraham said:

Is it against HIPAA for a healthcare professional (doctor, nurse, etc.) to discuss any identifying details about a patient they cared for with their spouse?

Yes. They are not in the need to know category.

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Where can I find something more specific as to whether or not a healthcare worker can mention (or not) anything to their spouse?

Thank you.

Why do you need anything more specific? The spouse is clearly not in the need to know category. If legislators and those writing regulations had to spell out every single possible person that isn't in the need to know category, nothing would ever get passed because they'd never be able to finish writing it.

[William2]

Not allowed. But who cares tell them they aren't to repeat any info you say as you risk termination if you feel the need to vent/talk about your day to unwind.I'm sure this happening anyway *some spouses are smart enough to keep it within the household/bedroom etc. So leave it at that.

[vanilla bean]

William2 said:

Not allowed. But who cares tell them they aren't to repeat any info you say as you risk termination if you feel the need to vent/talk about your day to unwind.I'm sure this happening anyway *some spouses are smart enough to keep it within the household/bedroom etc. So leave it at that.

Ugh. Let's hope the person you feel compelled to share PHI with is smarter than you are. *You* are the one that knows you're risking termination.

[pmabraham, BSN, RN]

To put this in context of why I asked the questions (devil's advocate)...

I responded to the professor's question, **prior** to posting my questions here, that a HIPAA violation took place. Then, based on spousal privilege questions that came up along with fellow classmates discussing questions about venting, thought to ask questions here looking to see if there were any legal cases that actually came out of a doctor, nurse, etc. disclosing information to their partner/spouse or if there was specific language concerning the issue as for some people their partner/spouse is "one flesh" or "one soul."

I appreciate Elpark for the detailed response at https://allnurses.com/hipaa-nursing-challenges/hipaa-and-ones-1077878-page2.html#post9259680 Now, coming from a student (hopefully to be new nurse in January) some of the tones of the responses make me wonder if anyone's learning to avoid eating their young ones.

For those that responded thoughtfully, thank you; and, thank you Elpark for that post #19.