Tracking patients when they are not in our care

Nurses HIPAA

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Specializes in Human behavior.

Your opinions are needed and much appreciated.

I work in a very busy office. When a patient misses an appointment, the charge nurses or the HUC will go into that patient's chart and track them in the hospital to see what they are doing and how they are doing.

Example, a patient missed their appointment in our office but we knew through the verbal grapevine that they were down in the ER. The HUC opened up their chart and READ ALOUD to the rest of us standing there, what the patient was in the ER for and told us all that she was still in the ER.

My opinion is that this is a major violation of HIPAA. When a patient is not actively in our office, we have no right to open their chart and read what ever else they are doing.

WHAT SHOULD I DO NEXT?

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Speak with your office manager/upline.

If you are concerned about the ramifications of that approach, utilize the system's compliance hotline. "Staff at XYZ Practice regularly access patient hospital records out of curiosity. For example, if a patient is rumored to be in the ED, staff access the chart to see what the patient is doing in the ED though that is not part of the job duties."

Edit: You do not say what your role is but I would make very sure that you understand the situation and that this is pure curiosity and gossip. If there is truly no reason for them to be in the charts, they're going to be facing termination most likely.

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Specializes in Human behavior.
7 hours ago, JKL33 said:

Speak with your office manager/upline.

If you are concerned about the ramifications of that approach, utilize the system's compliance hotline. "Staff at XYZ Practice regularly access patient hospital records out of curiosity. For example, if a patient is rumored to be in the ED, staff access the chart to see what the patient is doing in the ED though that is not part of the job duties."

Edit: You do not say what your role is but I would make very sure that you understand the situation and that this is pure curiosity and gossip. If there is truly no reason for them to be in the charts, they're going to be facing termination most likely.

Thank you so much for responding. I wrote that I work in a very busy "Office" simply because I do not want to identify what department I work in. I am that afraid of posting anything online.

I have witnessed this myself and it is ongoing. They are doing this out of pure curiosity, wanting to know how to schedule or re-schedule the patients we currently have in-house.

Example: Pt. #1 called to say they were going to miss their appointment because of acute illness and they were going to the ER.

Conversation at the desk: "I wonder how long #1 is going to be in the ER? We need to schedule these other patients in #1's time slot and move on. You should check to see if #1 is in the ER downstairs."

(HUC actually opens #1's chart and checks to see if they are in the ER and what for). Then, turns and verbally announces what #1 is in the ER for.

At the time the HUC does this, Patient #1 is not under our care, not in our "office".

In my opinion, this is a blatant violation of HIPAA. Based on the "Need to know" and "Under your care".

This would be no different than if I was seeing a doctor somewhere else and the HUC had access via internet to my medical chart and took the time to look to see what I was doing that day. It is NONE of her business.

I think I will take your advice and bring it to the attention of HR who handles this type of thing, let them decide what to do with it.



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They should be following a general policy/office guidelines for how to amend the schedule when a patient cannot show up at the appointed time.

If this is the only general instance in which they are doing this, it might be better to bring that issue to the office manager. "Staff needs direction/clarification on how to handle the rest of the day's scheduling and believes it is necessary to check on patient whereabouts (for example by checking their chart when they are in the ED) in order to do that."

There's curiosity and gossip and inappropriateness in the face of established expectations, and then there are just loosely run operations in which people try to use their own ideas of what is right in order to accomplish something because of lack of general direction. I personally think the two are distinctly different and would want to use caution for that reason.

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On 4/14/2019 at 10:52 PM, HighHotandAlot said:

Your opinions are needed and much appreciated.

I work in a very busy office. When a patient misses an appointment, the charge nurses or the HUC will go into that patient's chart and track them in the hospital to see what they are doing and how they are doing.

Example, a patient missed their appointment in our office but we knew through the verbal grapevine that they were down in the ER. The HUC opened up their chart and READ ALOUD to the rest of us standing there, what the patient was in the ER for and told us all that she was still in the ER.

My opinion is that this is a major violation of HIPAA. When a patient is not actively in our office, we have no right to open their chart and read what ever else they are doing.

WHAT SHOULD I DO NEXT?

I agree, this is not the proper use of the chart.

You need to speak to your manager about this. This is a huge liability issue on the practice.

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That seems like a really bad way to do things. If you work at a clinic, and your scheduled patient misses their appointment, for the majority of cases, why they missed that appointment is absolutely none of your business and it certainly isn't the business of the entire crew. And I would think it for sure isn't the business of the HUC. The nurse or physician, maybe you can find a way to justify it in select patient groups. But only just to see that they are in the ER. If the information is meant for you, it will be given to you or the patient will tell you. I would ask for clarification of the rules at your place of employment either with your direct supervisor, or with someone on the Privacy Team or Health Information Department.

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Specializes in Primary Care, LTC, Private Duty.

The only was I could see this being anyone's business would be if the provider, nurse, or (where they are employed in lieu of nurses) MA was following up for a continuity/coordination of care role. It also comes down to facility policy on how soon they like to set patients up for ER/inpatient hospitalization followup appointments and what goes into chart prep for that.

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Specializes in NICU.
On ‎4‎/‎15‎/‎2019 at 9:45 AM, HighHotandAlot said:

Example: Pt. #1 called to say they were going to miss their appointment because of acute illness and they were going to the ER.

Take Pt #1 off schedule and wait for patient to call to reschedule. The patient stated that they were going to miss the appointment. There is no need to look at their chart to see if they are going to miss their appointment, they already cancelled.

If the patient called to cancel an appointment because of a mandatory meeting at work, would the HUC call the patient's boss to verify that the patient was going to miss their appointment?

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Specializes in ER.

As a patient, I'd be furious to find out that someone looked up my information. I'm not coming in, that's all they need to know. When I know more about follow up, I'll call them. Then announcing it to everyone present...good grief. What if the patient gets tested for STDs, is that announced too?

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