HIPPA Question

[kmchugh]

OK, for any of you all who know the new HIPPA regulations pretty well, I have a question.

We recently had a patient brought to our ER with a closed head injury. I am a CRNA at a small rural hospital, and we (anesthesia) were called in for intubation and stabilization while awaiting air evac to a level 1 trauma center. Having worked as a trauma nurse at a Level 1 center before, I am pretty familiar with care of the head injured patient, and did quite a lot beyond just intubation as far as stabilization went. I am quite comfortable that I gave the patient the best possible care, but nonetheless, would like to get feedback on what improvements could be made.

I've been told that under the new HIPPA regulations, this feedback to outlying facilities (which used to be routine) is now forbidden. It would appear that in the name of patient privacy, we can no longer evaluate our procedures for improvement. Is this true?

Kevin McHugh, CRNA

[imenid37]

I share your frustration. I am a nurse in a Level Ob unit. We can't get updates on our babies and moms that get transported to NICU/tertiary care. I agree, we'd often like feedback on what we did to stabalize the pt's we send out esp. babies. I attended a conference at Children's Hospital in Columbus in the summer and they briefly mentioned letters they send to referring facilities about NICU babies. This was not the focus of the conference, so I am not sure what exactly they do. You could check w/ them to see if they still send out these letters (the purpose of which is to help streamline care from referring to to tertiary facility) and how that fits in w/ HIPPA. I know the have a website.

[CoffeeRTC, BSN, RN]

I too have had problems like this..I work in a LTC facility and when we send a resident to the ER, we rarely get any info on them.. now I don't need all the details, but some of them won't even tell me that they were admitted. Once I sent a resident to one ER for eval and tried to find some info out for family... no one would tell me if they had the resident.. later different hospital called and wanted some background info on said res. (the EMS took them to a different ER secondary to a divertion of ER res) Now I think this is a little crazy..once my resident leaves our facility sometimes I have no idea where they go..

[jenac]

The problem with the new guidelines is that it leaves most of us in the dark as far as follow-up goes. The problems I've encountered have been due to the fact that noone can verify who you really are by phone. Hence no gaurantee that they are not violating the Hippa standards.

[dianah, ASN]

Seems there should be some way -- a code, a signal, a form, a ??? -- to identify the inquiring facility, so that facility can obtain F/U info important to QI/PI, etc. Ideas???

[jenac]

Some sort of international code word- like "safe", or "no lawsuit".

[WashYaHands]

My understanding is that patient information shared between two covered entities (health care facilities) is okay as long as it pertains to the continued care of the patient. I think you acted within HIPAA guidelines in this case, Kevin.

Linda

[Hellllllo Nurse, BSN, RN]

Originally posted by WashYaHands

My understanding is that patient information shared between two covered entities (health care facilities) is okay as long as it pertains to the continued care of the patient........

Linda

This is my understanding, as well.

[Big Bab's]

This is what I was told also.....you can release info for conituity (sp?) of care, I especially think the LTC issue mentioned earlier would fall under this, after all, if the ER Dr. changes anything on your patient..ie. meds, PT or what ever, how are you supposed to know unless they tell you??....I've actually run into other offices that won't send us ANYTHING on patients that WE referred to THEM!!!....How ridiculous is that?!?!....It's soooo agravating!!

Originally posted by WashYaHands

My understanding is that patient information shared between two covered entities (health care facilities) is okay as long as it pertains to the continued care of the patient. I think you acted within HIPAA guidelines in this case, Kevin.

Linda