HIPAA question...

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So, I thought I'd ask here. There is someone in my clinical group who, for reasons best left unsaid, I am not fond of. I can tolerate him, but he's just not someone I would ever go share a beer with. Because of that, I always question my concerns regarding him...because I don't like him, it's easy to see him as wrong or bad or whatever, you know what I mean?

But something he has done twice concerns me. The first instance took place about half-way through the semester, and the other took place last week.

First instance: we were in post conference in a doctor's conference room. There was a computer there, and I don't know if it was on, or if someone from our group turned it on. Either way, when I walked in, and while waiting for our instructor to come, this guy proceeded to give the rest of us a slide show of his patient that week's serious tib/fib fx. The pt's name and number was on her xrays, and the xrays, in our system, are not kept at the same place as the chart...in other words, he went into a different department's records, put in his pt's name or MRUN number, and pulled up the info. There was no purpose to this demonstration; he is not an instructor, and to me, showing people who were not involved in her care was a violation of her privacy. But was it? My study group and I talked about it, and while we felt it was wrong, we weren't sure if it was a violation...but I know that if it were my sister, I'd not want a bunch of students without an instructor oogling her xrays just because.

The second, and perhaps more concerning, issue, took place last week. His patient was in a serious, serious accident. Broken bones all over. Lots of bruising and pain, and the patient was a difficult one because he was hurting in the extreme. My colleague came in with a photo taken from the 'net of the accident scene...showed everyone while we were scrubbing up and getting ready to go on the floor; made a point to show where the man's motorcycle ended up under the semi. No learning there, and no reason to show it to fellow students other than the 'ugh' factor. Bear in mind we live and work in a huge city, and that horrific accidents happen with sad frequency.

What bothered me about that instance is that the only way my colleague could've gotten the photo is by researching the accident on the 'net. Which means running a search for either the pt's name (which we take home to prepare for clinical worksheets; but we are only supposed to take initials...), or the accident itself, or whatever. Which means he used the patient's name in a manner that had nothing to do with creating a care plan, or using it to determine anything that had anything to do with patient care. At least, not as far as I can see. Again, to me, this is a violation of HIPAA, and it worries me.

My study group and I talked it over, and didn't come to a conclusion other than this guy is creepy. But I'm still pretty bothered by his actions...and wanted to run it past you all to see if that's a HIPAA violation, or if I'm simply letting personal opinion color my judgment. No matter what the issue, I just can't see myself running an internet search for a particular patient's information, let alone printing off a photo of the accident to show colleagues.

So, please be honest. Were these violations, or am I being judgmental because I don't like him? I am aware that opinions are often colored because of personal dislike, so be honest on that accord, too.

Thanks in advance...

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Lovin' Learning

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Specializes in ortho/neuro/medsurg/peds.

In our clinical groups we shared pt names when we gave our report to our group, and also very detailed health information. This is not in my opinion a HIPPA violation. All students are there to learn, and sharing health information on our patients for the day facilitates this. Not sure what to tell you about your personal feelings towards him. In nursing school there are the one's you love and the ones you hate. Sorry I can not be more help.

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Thanks, Jenn. Because I have personal negative feelings, I am not objective about this...which is why I'm asking for opinions. I appreciate yours!

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Lovin' Learning

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Specializes in critical care, PACU.

by definition they are violations because the peers are not included in plan of care and he did that internet search and he cannot argue that they were "learning" like we are when we give post conf report. If it was such a learning opportunity, why didnt he share it with the instructor? Definitely in poor taste. I would tell him how I felt rather than going to the instructor and then see the reaction before pursuing further action.

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by definition they are violations because the peers are not included in plan of care and he did that internet search and he cannot argue that they were "learning" like we are when we give post conf report. If it was such a learning opportunity, why didnt he share it with the instructor? Definitely in poor taste. I would tell him how I felt rather than going to the instructor and then see the reaction before pursuing further action.

His reaction, when I said something about HIPAA violations during the xray show and tell (without the instructor present), was "so what? It was my patient. What's the problem??" in a very defensive tone.

I did not say anything about the photo he showed-and-told.

I believe it to be in exceptionally poor taste, but I am also cautious, because of my personal feeling about him, to take this to the instructor simply because she is very aware of our issues (he dislikes me as much as I dislike him).

But I am uncomfortable with this whole thing, you know? Unsettled, I suppose, is a good word. I keep thinking, 'is this a violation, or am I letting personal feelings color my opinion?' I will mention that no one else has done this in our clinical group...which indicates to me that it's not something most students typically do.

Sigh.

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Lovin' Learning

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Just stay away. From him, and whether it's a violation.

As they say, keep your head down and your powder dry. If you bring it up even though you are right you will look petty and troublemaking.

Let it go.

The guy shouldn't be cruising around the facility's system but, if he has access, there should also be an audit trail in place and it will be discovered.

eta: Looking for something on the net isn't a violation. Finding it and showing to everyone is, as is sharing his records with them. If it isn't their patient they do not have the right to know.

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Specializes in NICU.

I think you are right about this being a HIPAA violation. I know if a family member or myself were one of the patients involved I would not be happy with a student showing off pictures of my accident or xray pictures unless it was for learning/care planning purposes with an instructor present.

I also have to wonder who else this student is showing off the accident picture to. It seems strange to print it off the internet.

However, I also have to agree with Suesquatch in that you may come off looking petty and troublemaking, especially if the instructor knows you two have issues with eachother. You have already approached your colleague about your concerns. Unless there is something serious going on to compromise the safety/care of the patients I would let it be.

I had a similar situation last year with a colleague, and the instructor was aware there was a problem before I brought anything up. I had a good relationship with this instructor and felt comfortable going to her with my concerns. I also felt I did not have a choice as I was partnered with him for a project. But my point in telling you this is that the instructor was much more aware of what was going on than I realized. Eventually he will get caught violating HIPAA if he keeps on like this.

Good for you for standing up for these patients though, you will make a great nurse :up:

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Suesquatch, I think you speak true to both counts...

I think I just wanted to know if this was a violation, or if my concerns were based in something other than fact, if that makes sense. I also think that saying something, especially at this point, would be counterproductive and appear petty.

Wannabe, thanks for that comment. I am hoping that the instructor is more aware than she appears...I'm not exactly confident on that point, but I can hope anyway.

Ah well. The semester's soon to be done, and I won't be in his group again. If he continues the behavior, then I suspect others will notice, and will properly comment to those who need to know...

And thanks for thinking I'll be a conscientious nurse. I most certainly hope I will be...so from your fingers to God's eyes, I hope.

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Lovin' Learning

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Oh, your instincts are right. This guy's tromping all over HIPAA. HIPPA? Well, either way, he's a jerk.

Not your problem.

:)

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Specializes in Maternal - Child Health.

I have a different opinion than some of the other posters.

I believe that the X-ray incident may be a HIPAA violation, since the student was essentially playing "show and tell" and not actually presenting an educational program to fellow students. HIPAA allows protected health information to be used for legitimate educational purposes, even for personnel not directly involved in the patient's care, but I doubt that this incident fits that description. HIPAA violation or not, it is easy enough for the IT department to track the student's access to the electronic medical record and determine whether he accessed it inappropriately.

The second incident, while strange, probably does not constitute a HIPPA violation. HIPAA addresses "protected health information". Details of an accident published in the popular press are not protected health information. Even if he took the patient's full name home and googled it, the information he obtained is not protected. And given the seriousness of the accident, it was probably not necessary to know the victim's name to find details on-line. Your classmate could have googled "motorcycle-truck crash" and gotten a full account, complete with pictures. I agree it shows a strange pre-occupation with gore to bring in pictures of the accident, but I don't think he violated the law or the patient's privacy.

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Specializes in NICU.
I have a different opinion than some of the other posters.

The second incident, while strange, probably does not constitute a HIPPA violation. HIPAA addresses "protected health information". Details of an accident published in the popular press are not protected health information. Even if he took the patient's full name home and googled it, the information he obtained is not protected. And given the seriousness of the accident, it was probably not necessary to know the victim's name to find details on-line. Your classmate could have googled "motorcycle-truck crash" and gotten a full account, complete with pictures. I agree it shows a strange pre-occupation with gore to bring in pictures of the accident, but I don't think he violated the law or the patient's privacy.

But I am wondering if he would be going and showing people he knows this picture- seems he is a "show and tell" kind of person. Is he then telling random friends and family this accident victim is his patient and giving out personal health details? I have seen that happen here with an MVA patient unfortunately. Sad how some people entertain themselves. :no:

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Specializes in Maternal - Child Health.
But I am wondering if he would be going and showing people he knows this picture- seems he is a "show and tell" kind of person. Is he then telling random friends and family this accident victim is his patient and giving out personal health details?

He may be, but you don't know that. Based on your description of events on the unit, I don't believe that he violated HIPAA by sharing the news article and pictures. If you hav evidence of similar behavior off the unit, identifying the victim as his patient, then that's a different story.

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