A HIPAA Dilemma
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is designed to protect a patient’s healthcare information from unauthorized disclosure among other things. Laboratories, for example, may do so “for treatment purposes without patient authorization, as long as they use reasonable safeguards,” by fax, email, telephone, etc. But what if the disclosure is unintentional?
As a department manager, I frequently review results, charts, and history for quality and workflow purposes. For example, I might review a history and physical of a person admitted from the ED who has had blood cultures drawn. It’s easy to run across test results and healthcare information for people I know personally in the community. It’s part of the job but falls within “treatment purposes.” We can’t help but see this kind of stuff in our professions, unless we work a city away.
I don’t have access to all information. I can’t look at results just because I know the patient. If it is within the course of my duties or work, that’s fine. I might, for example, review a urine culture on a close relative that I didn’t know had been collected as part of quality assurance. Like everyone else working at the hospital, I have to put a patient’s personal information aside and be discreet.
This can be difficult.
What if, for example, a tech delivers a result to the emergency room and discovers her husband has just arrived with chest pain? She sees the chart, sees his name on a computer screen, or hears a nurse or doctor mention the name. It’s impossible in these situations to remain objective. There’s no way the tech can return to the lab and work, obviously.
This is an interesting dilemma, since it is understood in normal circumstances that the wife would be at her husband’s side during this ordeal. HIPAA allows disclosure to a family member if the information is directly related to patient care or payment. But in this case the spouse learns of the event because of unintentional access to information that was impossible to ignore.
Has this happened to anyone? And how was it handled?
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