HIPAA Violation?

[Soccer990]

A doctor works at 2 different providers of which they are unaffiliated (A and B). The doctor sees a patient (at A) (not really sees them as they just go in for a diagnostic test/blood test performed by a nurse and is never actually seen by that doctor) and that has the results sent to the other provider (B) which is not affiliated. The doctor also works at B and the patient's PCP is a member of B. The doctor has no patient/doctor relationship at B, only one at A. The doctor does not forward the test results to the PCP but rather reads them and takes photos of their record with a cell phone, also reads the entire patient's medical history, then proceeds to question the patient through text messages about the history and asks why other tests were done. The doctor also reads mental health notes and other doctor's notes. The patient reports this but the provider says no violations have occurred. When the patient asks for copies of their medical records, the said tests from the picture and texts are no longer in the records. Is this a violation?

[psu_213, BSN, RN]

I must admit, I am a bit confused (shocking, I know!) by your wording...for me, it was difficult to read with "doctor," "other doctor's," "the PCP," and "providers."

Anyway, I don't see what the problem is with a doctor reading notes about the pt and asking the pt about test results. I'm not sure why the doctor communicated via text, but, if the pt had a problem with it, he/she should have told the doctor that he/she is not comfortable with communicating medical information via text.

[JKL33]

You are talking about and/or insinuating more than one problem has taken place (HIPAA and/or privacy violations, missing records). You will need to speak with the Patient Liaisons (or similar) at the respective facilities. There is not enough information in this instance for a group of strangers to make any intelligent comment on the situation or the appropriateness of someone's employment.

Good luck with getting to the bottom of this ~

[MunoRN, RN]

I've read your scenario a few times and I'm still not clear on the specifics. It's not unusual that patient's sign a HIPAA disclosure agreement as part of standard paperwork when you establish care at a clinic, go into an ER, are admitted to a hospital, etc which states that they will obtain necessary records to provide care and will share records as appropriate with other clinics, hospitals, etc where you seek care. There are some records where this kind of sharing can't be covered under this sort of blanket agreement, but for the most part any provider treating you should have access to all relevant history. There are also some types of information, such as prescribing scheduled medications, where no disclosure to the patient is required to share this with other providers and the patient cannot decline that this information be shared.

[Soccer990]

I guess it's not that straight forward. The biggest concerns were that the doctor used the fact that they had employment at another unaffiliated location to go an access medical records of a patient they were not responsible for the care of. The doctor also took pictures with a personal cell phone of the patient's medical records. The place of employment for the doctor said that there was no violation and that a text message can serve as legal written consent for a doctor to establish a client relationship. Also there is nothing wrong with taking pictures on a personal cell phone of patient records. Once reported, the tests in question never happened and there is now no record of anything.

My question is that if a patient is seen at an office by a doctor, can that doctor go to a different nonaffiliated office where the doctor also works and read the entire record of someone when it has no actual use to treatment (ie for curiosity sake) and then claim they had the right to do it because one paper was signed. If a patient signs a paper with one doctor to be treated at one facility, does that mean the doctor can then go anywhere and read all the notes of that patient without the patient's permission?

Hopefully that makes more sense. Sorry

[llg, PhD, RN]

Sounds like a legal question, not a nursing one. If you have concerns about the handling of your information, speak with an attorney who is very knowledgeable about HIPAA -- not a group of nurses with no (or minimal) legal education.

[sirI, MSN, APRN, NP]

As stated above, you will need to pose these questions/concerns to someone in the Legal Department and/or an Attorney. We cannot provide legal advice per the Terms of Service.