HIPAA Violation- Chances of new employment

[mandanel22]

So here's the situation...

I was formally employed by a pretty large healthcare system and worked my way up from an LPN to a clinical services supervisor after 6 years in a neurosurgical specialty. I worked from home on Fridays, and while working from home one day, a co-worker initiated a group text with the entire front office staff which included a screenshot of an unfavorable review written on healthgrades. The patient had surgery 4 years prior, and I found it strange that he was just writing the review. I thought it best to investigate to see if there were any recent encounters that would have prompted him to write this review so many years after receiving care from our practice. We typically have exceptional reviews. In doing so, I came across some extremely unusual encounters with multiple consecutive ED visits. I decided to share screenshots of the notes but did not include the patients name or date of birth in the screenshots in order to prevent a breach of privacy. It did not occur to me that because his name was included in the original text sent by my coworker, that this was a HIPAA violation. I was terminated on these grounds. I was also told that because I accessed a patients records without needing to directly care for the patient, this was also a compliance violation. The text was presented to the compliance department by an extremely unprofessional employee with very low productivity right after her evaluation by me with my superior... I know sending the text was very poor judgement, but I honestly didn't think I was violating HIPAA by not including his information, and I did not think that accessing a patient's chart to look into a bad review was a violation either. We send screenshots of records to physicians all the time without including patient info. The entire office, including the neurosurgeons in the practice, tried to defend me, but I was still let go and my actions were reported to the board. This is still under investigation. I'm currently trying to apply for a position in utilization review. My question is, should I put all of this information in my application and just be honest and upfront straight off the bat? Do you think I should wait until I'm called for an interview? What are my chances of even finding a job in nursing? Should I just make a career change? I'm so distraught over this entire situation. Any advice would be appreciated.

[JKL33]

Even if investigating complaints/poor reviews is within your assigned role/duties, it's a very hard case to make that it was appropriate to access recent ED visit charts and screenshot notes 4 years after the encounter in question, and very possibly inappropriate to open up his record at all just to peruse it for anything interesting that might help you make a judgment about the review left by the patient. On the face of it I would say this is an unauthorized use of the patient's records.

The practice should have a policy for how negative public reviews will be handled and by whom. Even if that person was you, I doubt the entire front office staff is to be involved in the investigation.

On 5/11/2020 at 4:38 PM, mandanel22 said:

I did not think that accessing a patient's chart to look into a bad review was a violation either.

It isn't...as long as it is your role/duty within the organization to do so, and in this case your investigation would have involved the episode of care in question (the one 4 years ago), not random unusual encounters that looked interesting. And even then it wouldn't have been the business of a bunch of officemates.

On 5/11/2020 at 4:38 PM, mandanel22 said:

We send screenshots of records to physicians all the time without including patient info.

Gotta have good judgment no matter what others are doing. There's no way I would do this. No one gets to be lazy; if someone has an authorized need to look at a record they look it up under their own sign-on. Those neurosurgeons who are getting others to send them screenshots aren't the ones holding the bag when TPTB find out what's been going on. Also, as you now know, bad practices lead to general loosening of "good judgment" and those same bad practices then serve as a poor/wrong rationale for something even more careless.

This stuff needs to be by.the.book. Period.

It sounds like that whole place needs to tighten things up immensely. Honestly this whole group text doesn't even sound like a conversation that should have been happening.

I don't know how I would handle future interviews. TBH I would consider whether or not you need legal representation. I know nothing about that part of it but I would at least consider it. On the surface of this, it sounds like a legit violation.

I hope you get things worked out. This is a very hard lesson. ?

[Been there,done that, ASN, RN]

The board has not even looked at this mess yet. Do not offer any information in the hiring/ interview process. You only need to state a reason for the being let go. Get creative with that. Hopefully... you will get the position and move on.

Best wishes.