In situation #1, the activity going on in the operating room is treatment,
being provided by the hospital under the terms of a HIPAA consent.  The
"non-hospital employee" must be either a member of the hospital's workforce
or a business associate before the hospital may permit access to the
patient's PHI.  In general, the hospital will contract with the vendor as a
BA, and require that any trainer employed by the vendor who will have access
to PHI in the possession of the hospital will receive privacy/security
training.  However, the hospital could also contract with the vendor in a
way that would give it sufficient control over the trainer that it could
claim the trainer as a member of its workforce.  The trainer would then
receive the same privacy/security training as other hospital workforce
members.

In situation #2, the students are not performing a function on behalf of the
hospital, so they will not be likely to fit the definition of business
associate.  The hospital will want to have an agreement with the students'
educational institution that specifies that they are under the hospital's
control as members of the workforce, and must receive the hospital's
security/privacy training before having access to any PHI.

In either case, observation of any patient care would best be considered as
access to PHI.

Bill

William A. MacBain
Principal
MacBain & MacBain, LLC
1108 Hector St.
Ithaca, NY  14850
607-256-1522


-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Monday, February 04, 2002 10:58 AM
To: [EMAIL PROTECTED]
Subject: Question on non-employees' access



Are the following scenarios covered by "consent...for treatment and
operations", or by "business associate agreement", or is a "signed
authorization" required???

Situation 1:  A "non-hospital employee" vendor representative assists in
the surgery room, to explain or train surgeon and/or staff on the equipment
used in the procedure.  Is this "operations"?  Does this require a patient
authorization?

Likewise Situation 2:  A surgery is "observed" by an individual or by a
class of students (the patient is not identified), is this covered by
"consent ...for operations",  or does it require a signed patient
authorization?  Or is this not covered by HIPAA, since the patient's
identifiable information is not disclosed, except for the possibility of
seeing the patient's face?

John L. Schwarz
I/S Director, Enterprise Applications
---------------------



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