Question about nursing, law enforcement, and HIPAA

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Specializes in ED.

We have become aware over the weekend that our facility does not have a police in regards to how to handle police requests for PHI when a patient is going to be arrested for DUI. From what I understand, there are certain circumstances that allow for the release of PHI to law enforcement under HIPAA. Is there anyone familiar with this? And is there anyone that has a sample of a policy they use at their healthcare facility in regards to this?

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Specializes in Adult and pediatric emergency and critical care.

They would need a warrant signed by a judge, if so I would send them to medical records. I would have your risk management and legal departments draft your policy.

Laboratory results in the hospital are not valid in court unless they have a chain of custody, with the exception of SANE exams there aren't many times in which lab samples have a chain of custody much less documentation of it.

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Yep. Warrant.

And they present all requests/warrants to Health Information/Medical Records personnel or Supervisor/Administrator on duty.

Yikes. Does this not come up very often or something?

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Specializes in Pedi.

Your hospital presumably has a legal department that has someone on call. Direct any inquiries to them if you are unsure.

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Specializes in ER.

Be aware that it may be illegal for you to answer a question, but it's not illegal for police to ask any question. And if you let them stand in the room, or just outside the curtain, they are allowed to use any information they overhear. I started my career believing that officers would never ask me a question I'd get in trouble for answering....wrong.

You can ask the police to leave the room or the unit for privacy reasons, or just because they are lurking. I've never had an officer obey, but once they've been asked to leave and don't, the information they get can be questioned in court. Document your request, and you've documented that you tried to protect your patient. I was threatened with arrest once when I did this, and in the investigation afterwards I was vindicated by hospital and the police supervisor.

Our hospital policy is that police don't get to come in the ER unless specifically invited...well, that's not what actually happens, and they have been a huge help to us. You have to protect your own livelihood though.

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Specializes in Complex pedi to LTC/SA & now a manager.

A gunshot wound is not subject to HIPAA protection. Lab results in absence of a subpoena or warrant in the absence of patient consent is protected by HIPAA.

Quick cheat sheet from the entity charged with enforcing HIPAA:

https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/special/emergency/final_hipaa_guide_law_enforcement.pdf

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We had alot of police on our unit d/t the nature of the unit. We just always told them we could not give out info AND if they were requesting info they needed to contact our SECURITY/hospital police who would guide them. They weren't even allowed on a unit without one of our officers escorting them.

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Specializes in ED.
We had alot of police on our unit d/t the nature of the unit. We just always told them we could not give out info AND if they were requesting info they needed to contact our SECURITY/hospital police who would guide them. They weren't even allowed on a unit without one of our officers escorting them.

Unfortunately this is a VA hospital, and our "security" are armed federal police officers. I was hoping to be able to draft a new policy regarding this because we should know better, and I think many of us do, but we have no formal policy on this issue.

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