Is HIPPA really secure?

Antikigirl, ASN, RN · Oct 27, 2006

Okay this is just me but I feel that HIPAA is just a political deal such as many things in healthcare. If someone notices a probelm with anything in healthcare...things seem to swing like a pendulum to the total extreme! HIPAA is an extreme that I believe can not ever be fulfilled! In other words, I think it is a great idea, but the rules and regulations are comical!

How can you discuss medical information in a facility without someone hearing it? How can you have rooms with open doors and hide a patients face, condition (if visable), conversation??? Even with shut doors you can hear from the hall! How many times have I seen a visitor see a person in a room and say "Oh soinso..I didn't know you were sick...what happened?" and go in! How can you talk to an MD at the nurses station while you chart without someone hearing it (even with the lightest voice and not saying a pts first/last name..which can lead to confusion and potential errors in the first place!!!!).

How do things get done accurately if you are afraid to communicate to staff about a patient because it might tread on HIPAA? How do you fax or send electronic information to other staff/facilities needed for pt care if you aren't sure if it is legal or not? (I have run into this so many times! Calling faclities to ask about a pts norm or meds and get denied info...umm HELLO I am their nurse!!!!!!!!!!! I am allowed!).

I have always taken the fact I know things personal about my patients to heart..and never abuse it...I call it confidentiality and I swore an oath to protect it. I know not all people take it as seriously as I sadly...but I don't need some politics like a black cloud always looming over head with fines and threats to keep personal information personal. I find it is a joke for the most part...not realistic...not obtainable by the structure of it vs actual facilities...so I just go on with my business the way I always have...with confidentiality, only talking to people that need to know, being rational with the info, and appreciating my patients rights to keep things private!!!!

OH...and along the same lines as the semi rooms, how about those baby monitors in LTC/ALF? My old job had them in the hallways for people that were a fall risk so you can hear them and/or hear a ambu alarm! My gosh the person can't even pass gas or burp without having it heard by anyone in that hall!?!?! Is that a HIPAA violation? What if a resident is talking about where they stashed their money to a relative or how much is in their account (going off the stealing thread in general here too). That violates privacy, and not necessarily medical!!! I find those a huge violation, and big time HIPAA one...but nothing is done? No, I can get fined for accidentally saying too much to a family member about their loved ones condition if they don't have the proper paperwork and authority...but a facilty can't get fined for a blatant violation of privacy on the most basic level

(I know those baby monitors are for safety...but typically when you hear a fall..it has happened, I find ambu alarms/bed alarms/mat alarms are the best choice and frequents checking on patients with fall risks are enough if done right!).

TazziRN, RN · Oct 27, 2006

HIPAA is primarily to avoid health care providers talking about pts with people who have no business knowing about the pts. When I found out I was pregnant it was a Saturday. The only people that knew was the lab tech who did my HCG and the sono tech, and I know they didn't say anything. I was off for a few days and when I came back I asked for a meeting with my manager to tell her. She already knew, as did half the hospital. My husband and I had decided not to tell anyone because I was high risk; if the amnio/sono came out bad we were planning to terminate. We didn't want anyone to know because of that, until we had decided on the next step. Not long after that a phlebo was terminated for talking about pts' lab results.

Trauma Columnist · Oct 27, 2006

I work in dialysis (read: big room with 32 chairs right next to each other) and we discuss everything (and unfortunately I do mean everything) in front of everyone!

In our facilities, the patients sign an acknowledgement that if they want to talk privately they must verbalize that to the staff and then it will be provided. Otherwise, everything is fair game.

meownsmile, BSN, RN · Oct 27, 2006

You would be surprised to hear the roomates conversations with each other when nurses arent present. They usually will tell each other their life stories without batting an eye. So not saying someone needs to discuss someone else's dx with their roomate here. But its not like the roomate doesnt probly know as much or more than the nurses do about their condtion anyway.

Someone calls asking about a patient, or visitors start asking,, then thats a definate NONO,, i wont even give out the patients name to the Dr's answering service(which they do ask for sometimes)when i have to have him paged. Dont feel thats appropriate at all since the dr is taking his own call and there is really no reason for them to know.

allnurses Guide · Oct 27, 2006

This is an issue that came up many times at the hospital that I used to work at; the issue of patients in semi-private rooms being able to keep any information confidential from their roommate and their family/friends.

The possibility of actually doing away with semi-private rooms was batted around at my facility from time to time, but it's really not a feasible solution. I agree that sometimes HIPAA is taken to a ridiculous extreme. I believe that having HIPAA around teaches us all to be highly cautious and careful with patient information, but I don't believe that there can ever, EVER be total security. Take this for example... doctor's offices now refrain from keeping sign in sheets in places where all of the names can be seen by all of the patients... but your physical presence is still going to be seen there! People you know are still going to know that you went to the doctor!