ADVANCE Perspective: HIM : patient privacy

Movies and Medical Records

Lisa Algeo — Tue, 03 Nov 2009 17:47:00 GMT

(Editor's note: The following blog was written by Mark McGraw, an associate editor on staff at ADVANCE .) It's movie night, and you're not interested in subtitles or surrealism. Maybe next week you'll go for the one with the "Winner: Best Foreign Language...(read more)

PHRs Go Overseas

Cheryl McEvoy — Thu, 29 Oct 2009 13:26:00 GMT

If you've been following Jay's blog, " XY Files in and MT World ," recently, you know there have been some frightening reports of medical records being sold overseas. It's enough to make you hunker down in the States and demand your records stay local....(read more)

AHIMA 2009: The Health Information Bill of Rights

Cheryl McEvoy — Tue, 06 Oct 2009 12:41:00 GMT

At a news conference yesterday, the American Health Information Management Association (AHIMA) unveiled its Health Information Bill of Rights, a set of seven principles designed to protect and promote patient access to personal health information. Craig...(read more)

On the Record

Cheryl McEvoy — Wed, 30 Sep 2009 15:24:00 GMT

With all the prep for next week's American Health Information Management Association Convention and Exhibit and our HIM Team of the Year coverage (Yes, we have a winner!), I've been neglecting my Google Alerts. Well, I found some time this morning to...(read more)

Public Tweets, Private Matters

Cheryl McEvoy — Wed, 16 Sep 2009 15:33:00 GMT

I'm wrapping up an extensive print and online package about social media for our September issue (Look for it next week!), and with all the reading, interviewing and, yes, tweeting I did to research the phenomenon, I thought I'd heard everything. Well,...(read more)

Privacy Problem Causes Real-Life Drama

Cheryl McEvoy — Tue, 21 Jul 2009 13:14:00 GMT

There's been quite a buzz at ADVANCE headquarters about the television phenomena "Nurse Jackie" and "HawthoRNe." Staffers wonder: is it realistic , do nurses approve of the portrayal and--at least around the HIM desk--how many HIPAA violations can they...(read more)

HIPAA be damned?

Lynn Jusinski — Tue, 14 Jul 2009 12:05:00 GMT

[Editor's note: This is a guest blog by ADVANCE for Nurses editor Lyn A.E. McCafferty, who contributes to the "ADVANCE Perspective: Nurses " blog featured on the ADVANCE for Nurses Web site.] If you think the fictional Nurse Jackie and HawthoRNe are bad...(read more)

Suleman’s Records Accessed; 15 Employees Fired

Lynn Jusinski — Tue, 31 Mar 2009 15:18:00 GMT

I had a feeling when the Octomom story hit the wire and all the details spilled out that someone would be caught sneaking a peek at her medical records. Sure enough, 15 workers were fired for looking at the records of Nadya Suleman without permission....(read more)

Company Sells Health Info to Pharma Companies

Lynn Jusinski — Fri, 27 Mar 2009 13:36:00 GMT

Would you share your personal health information on the Internet, including intimate information like how sexually active you are or how heavy your menstrual cycles are? Well, more than 27 million people have, according to a New York Times article on...(read more)

A Dose of Reality

Cheryl McEvoy — Thu, 26 Mar 2009 13:58:00 GMT

Thanks to Obama's rah-rah health care reform, the general public is turning an ear to EHR. But what exactly are they hearing? At first mention of EHRs in the stimulus package, news outlets swooped in with the "revolutionizing health care" angle. A national...(read more)

Patient Consent Gets New Meaning

Cheryl McEvoy — Fri, 27 Feb 2009 15:37:00 GMT

It's Friday. The weekend is almost here. Friends are coming in from out of town. So of course, I'm gathering all the weird news I can to make for some interesting dinner conversation. And the great debate over patient privacy has turned up two gems:

First up, we have a story out of Omaha, NE, where Health and Human Services (HHS) is butting heads with a county historical society over patient consent. The historical society wants to release burial records from a local cemetery. Problem is, the cemetery is affiliated with a former psychiatric hospital, so anyone buried at the site was assumedly treated at the psych center.

Nebraska HHS argues that opening the burial records without patient consent would violate privacy. Short of hiring a clairvoyant or tracking down kin for the OK, HHS can only hope to protect privacy by keeping the records locked up. But the historical society says burial records should be open. The case goes to the state Supreme Court next week.

If that doesn't get your friends gabbing, take a gander at this report. Ah yes, the limitless possibilities of Facebook has proven all too tempting for two Wisconsin nurses. Faced with the rather unusual case of a patient who had a sex toy lodged in his rectum, the nurses threw compassion to the wind and took photos of his X-rays. Said photos were promptly uploaded to Facebook for all to gawk.

Whether the post was to gripe or joke, the nurses have been slapped with serious consequences; in addition to losing their jobs, they may face charges if investigators decide they violated HIPAA or the patient's rights. The photos didn't include identifying information, but by snapping the shots the nurses copied a part of the patient's medical record without consent.

My suggestion? Next time you want to click and post, stick to a safer subject. I hear fluffy dogs in sweater vests are all the rage.

Abortion Records Go on Long, Strange Trip

Lynn Jusinski — Tue, 24 Feb 2009 21:05:00 GMT

When patient records of women receiving abortions made their way from the Sedgwick County, KS, court to the Johnson County, KS, district attorney's office and then probably on to somewhere in Virginia and then back to Johnson County, KS, that's an issue worth considering, according to a lawyer for Wichita abortion provider George Tiller.

Tiller faces 19 misdemeanor charges for violating the state's late-term abortion law. Phill Kline, former attorney general and anti-abortion Republican, started scrutinizing abortion clinics during his 2003-07 tenure as Kansas attorney general. After losing a re-election bid, Kline became Johnson County's district attorney, according to the Associated Press. After losing the Republican primary for that spot, he took a position as a visiting law professor in Lynchburg, VA.

Here's where the medical records come in (whew!). A box was sent from Sedgwick County to the Johnson County DA. It was then forwarded on without being opened to Kline's new address in Virginia, The Wichita Eagle reported.

But the address was insufficient. Kline never received the box, which included copies of the medical records of women who received abortions as well as state reports of abortions, notes about the investigation and prosecution of Tiller and an activist group document, according to the AP.

Instead, the box headed back to the Johnson County DA's office, where the records were locked away. Tiller's attorney used the traveling records as part of a plea to dismiss the charges against Tiller, who heads to trial in March. "Tiller's lawyers have argued that Kline's conduct in investigating the doctor was so outrageous that the resulting charges against him should be dismissed," The Wichita Eagle wrote.

In the end, the box of records mailed halfway across the United States shouldn't affect the case, the Kansas attorney general's office said Friday. The prosecutor said the mailing wouldn't harm the case against Tiller. "The mailing of this package is at its best an innocent act that means nothing," Prosecutor Barry Disney said in a pleading. "At its worst, it is the act of a private citizen whose conduct is not binding upon the office of the attorney general."

Surgery Goes Web 2.0

Lynn Jusinski — Tue, 17 Feb 2009 21:06:00 GMT

One of these things is not like the other: "Watching a good bootleg of The Wrestler." "Holy cannoli, unhappy baby. Early bedtime for you, kiddo." "Dr rogers (sic) has adequately sutured closed the urinary collecting system and any bleeding vessels."

The first two come directly from the people I'm following on Twitter. The last one is also from Twitter, the microblogging/short messaging service. While the first two are entertaining, or at least mildly informative, the last one is obviously a bit more serious.

On the morning of Feb. 9 at Henry Ford Hospital, the chief resident sat by on a computer tweeting about the live tumor removal being performed by lead surgeon Dr. Craig Rogers at the same time, in the same room. The resident managed to capture the surgery blow-by-blow in 140-character "tweets" as it happened. Here's the stream of the surgery on Twitter.

According to CNN, "Dr. Craig Rogers, the lead surgeon in the Henry Ford surgery, said the impetus for his Twittering was to let people know that a tumor can be removed without taking the entire kidney. ‘We're trying to use this as a way to get the word out,' Rogers said."

With social networking sites abounding, there's likely to be more of this happening. Are there limits to what should be shared on the Internet? Just this morning, I was contemplating updating my Facebook friends on the status of a broken sewer pipe in my apartment. No, that's not pretty information at all, and yes, I just told the Internet via this blog. Is "tweeting" the surgery as it happens progress, or just pushing the limits of privacy?

I personally think the idea is pretty cool, as long as the patient consents to being tweeted about. If the information is helpful to others performing or curious about the surgery, then it might be worth it for more than just a novel Internet trick.

I look at it from two angles. If I was getting ready to go through a robotic partial nephrectomy, as the patient did in the Tweetstream above, I would probably be scouring the Web for information beforehand, and coming across the tweets would either calm my fears or seriously wig me out. And if I was getting ready to go under the knife and was asked if I would mind being tweeted about during surgery, well, I might hesitate a bit on that one. What are your thoughts?

Privacy Violation in NY

Cheryl McEvoy — Fri, 06 Feb 2009 14:20:00 GMT

A few months ago, reports of hospital employees snooping through celebrities medical records brought patient privacy issues to the foreground. But it's not just the rich and famous at risk.

A medical records employee at the Catskill Regional Medical Center in Harris, NY, was fired in November for inappropriately accessing records of acquiantances and co-workers. According to the Mid-Hudson News, the violation was discovered during a routine audit. Since then, the hospital has been closely monitoring all records and who accesses them. Patients who were affected by the violation were notified by letters, which were sent out Wednesday.

The former employee has not been charged.

A Twist on Patient Privacy

Cheryl McEvoy — Thu, 04 Dec 2008 14:26:00 GMT

Still recovering from Thanksgiving (and 2 nights of reenacting the feast, thanks to Tupperware and a microwave), I spent last Sunday morning lounging on the couch and watching the news. I usually zone out during the sports segment, but a story about Giants wide receiver Plaxico Burress caught my attention. No game-saving play, no philanthropic Thanksgiving deed; instead, the man shot himself in the thigh-at a nightclub-on accident.

I shook my head and chalked the incident up as a (highly illegal) social faux pax that will likely be recounted on SportsNight and E!'s stupid celebrity moments. Why Burress had a gun and why the safety was off, I'll leave for the police to untangle.

But scan the news sites today and viola! The plot thickens. Investigators are looking into some questionable practices at the hospital where Burress was treated; namely, why the incident wasn't reported. Hospitals are required by law to report gun shot wounds to authorities, but this time, no notification was issued.

With UCLA Medical Center still embroiled in controversy surrounding patient privacy breaches-most recently, an employee pleaded guilty to selling Britney Spears' medical information to the National Enquirer-it's not surprising that a facility would want to tip-toe around Burress' celeb status. But by keeping tight-lipped, doctors violated their legal obligation to report a gunshot wound. Countless hospitals have kept their mouths shut to protect celebrities in their care, but a hospital that actually breaks a law when doing so? That's newsworthy.

Perhaps it was a no-win situation; alert the police (and, inevitably, every media outlet in the metro area) or keep Burress' treatment under wraps and hope authorities don't catch wind. No matter the facility's intentions, you have to give employees some credit for not blabbing as soon as Burress hopped on the examination table. But by failing to alert police, the facility still broke the law-and to protect someone who allegedly had a loaded gun in a public place, nonetheless.

Burress may be nursing his thigh for a while, but his doctors just shot themselves in the foot.