Q
• The patient asks to bring someone in the
exam room with you. Do you need to get
written authorization to talk to the patient in
front of that person?
A
• No – you can ask the patient if you can
speak freely in front of the person. If you
suspect abuse, you can ask the visitor to
step outside for a few minutes while you
examine the patient more thoroughly.
Q
• What about other friends and family who
accompany the patient into the hospital?
A
• Try to establish a single person who can
accompany the patient into the exam room,
with the patient’s permission, and follow the
above guideline. Document that this
person is present as you examine and talk
with the patient. Leave it to the patient or
this person to share information with others.
Q
• The patient is unconscious or mentally
incompetent. Can I call family or friends?
A
• Look for an Advance Directive for a contact
person. If there is none, look for the person to
notify listed on previous admissions. Lacking
these, you will have to talk to whoever contacted
police or ambulance for more information about
who is the caregiver or next of kin for the patient.
Act on the best information you can get, and
release medical information only to the person you
deem is the responsible party. Since you are
dealing with an emergency situation, you will not
be held liable for trying to act in the best interest
of the patient.
Q
• You call another facility for information,
and they refuse, based on HIPAA. What do
you say?
A
• HIPAA does not restrict the flow of information for
treatment purposes (reference 45 CFR section 164.512).
In addition, by virtue of the fact that you are working in an
emergency room, denial of the request would be cause for
a much bigger problem than release of information if the
patient is adversely affected. Let the person who refuses
know that you can report them to the Office for Civil
Rights if they do not comply, and refer them to the OCR
web page www.hhs.gov/ocr/hipaa. The only exception to
this is HIV status, for which you do need a written
authorization – form # 788.
Q
• Can you release information to another
facility? Under what circumstances?
A
• You can release information to another Emergency Room,
with the exception of HIV status. Call back and verify that
you are talking to another hospital or emergency room. If
it is not an emergency, refer it to the Health Information
Management Department, ext 5028. If it is after business
hours and is not an emergency, ask them to leave a
message with contact information at that number.
• If a less than acute care facility calls for a patient who was
recently there for continuing care and it is after hours, this
may be released once you verify the caller by using the call
back method.
Q
• Can you release information to a caller
asking if the patient is here, or why the
patient is here?
A
• Ask who you are talking to, and then you
can verify whether the patient is here and
the general condition. If it is the press, refer
to Michael O’Connell or Kelly McDade in
Community Relations.
Q
• Someone calls you saying he is the patient,
and asks about his bill, wanting you to
intercede for him. Can you talk to him?
A
• Ask the patient to send you something in
writing, with name and date of birth. Say
you cannot talk to him over the phone,
because you need to verify who you are
talking to, but will look at the issue once it
is documented and resolve the issue with
the appropriate department.
Q
• Can you call and leave a message at a
patient’s home to call you back?
A
• You may leave a message using “Mount
Auburn Hospital” as the caller, without
specifying the department. You may leave
a phone number. If you suspect the person
may not want others knowing of this visit,
ask the patient for how he or she wants to
be reached if follow-up is needed.
Q
• Can you release information to another
hospital Emergency Dept created by another
provider?
A
• Yes – you can release this information for
treatment purposes.
Q
• Can you release information to a law
enforcement official’s oral or written
request for the purpose of identifying or
locating a suspect?
A
• The hospital may disclose only name and address,
date and place of birth, social security number,
ABO blood type and Rh factor* , type of injury *,
date and time of treatment *, date and time of
death *, and a description of distinguishing
physical characteristics. Information noted by an
asterisk may be disclosed only it the hospital in
good faith believes the disclosure is necessary to
prevent or lessen a serious danger to the patient or
others.
If the information is about a victim of a
crime, the patient must authorize release.
Again, if the hospital fears that
disclosure is necessary to prevent or
lessen a serious danger to the patient or
others, the hospital may release the
minimum necessary information without
patient authorization.
Q
• Can you release psychiatric information to
another ER?
A
• You may release the minimum necessary
information to another Emergency Room in
order to treat and safeguard the patient.
Q
• You are on the run and want to use your
PDA to check on a patient; what
precautions should you take?
A
• Any wireless device, including PDAs and laptops,
is insecure when used in an insecure location,
possibly exposing PHI to surfers. Never store
passwords on your PDA, and consider encrypting
any PHI. Any PHI saved on a PDA must be
password protected. The MAH wireless system is
a secure system that only allows devices that have
an MAH issued wireless card access the network;
a wireless PDA or laptop of a person without this
card cannot jump on the system.
Q
• You want to do a study, which you have
received approval for by the Privacy Board
and IRB. Can you copy the data
electronically and bring it home to work on
it?
A
• No – HIPAA specifically forbids taking
Protected Health Information and storing it
off site. This also applies to patient
records; it is prohibited to take them out in
a car, off campus, or home.
Q
• What are the rules around HIV and
exposure of EMT personnel?
A
• Any time there is an exposure of body
fluids with a patient, the affected personnel
should take an HIV test.
• The patient cannot be forced to take an HIV
test, although there is legislation being
contemplated.