Re: is this practice O.K.?
Sounds like some undue stress on a question that probably cannot be answered out of court. The regulatory language provides for no end of possible interpretations and we can only guess at what the courts will decide -- and they get the advantage of a specific set of circumstances (and, I think dice or chicken bones to aid in the decision). If the situation is viewed as a balance between the harm done and the benefit gained, it may be possible to make an educated guess. For example, searches are, by definition, an invasion of privacy. To search without prior approval from a judge, you need some urgent factor to outweigh the violation -- immediate risk to life, etc. There is a long list of court cases weighing the harm against the claimed urgency. That has not cleared up things much, but there are some useful clues. Would it make sense to look at why the release of PHI is happening? What weighs against infringing on the patient's rights? If it is simply a matter of gaining identification, that would not seem terribly urgent. If the harm (release of information without permission) was to prevent the spread of some life threatening virus that would seem to justify doing things that simply identifying a suitable payer would not. In short, if the patient is comatose (which sounds stable to the nonmedical folk), why wouldn't you ask a judge? They have the power to make decisions on behalf of people not able to decide for themselves. It is also much harder to get in serious hot water if you can claim you did it "because the judge said it was OK." I have broken similar rules when I believed the circumstances warranted it and would do so again, but I can't claim it was wise -- simply a strong wish to see the person upright again -- even if in court. Dale K. Howe, PhD Grand Rapids, MI, USA --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
Re: psych notes
There may be reason to look at this again. More stringent as in greater restriction on the patient or the staff? If HIPAA explicitly gives the patient right to access their own record, which regs prempt? Dale K Howe Grand Rapids, MI In a message dated 3/24/2003 1:30:53 PM Eastern Standard Time, [EMAIL PROTECTED] writes: Paulette, as I'm reading Colorado statute as it is being currently modified: http://www.leg.state.co.us/2003a/inetcbill.nsf/fsbillcont/12872ADAA2C72AF087256C5A00624B00?Openfile=051_ren.pdf I think Colorado law may be more stringent. It reads to me that all 'mental health records' are restricted from access by the patient -- at least while therapy is occurring. --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
Re: If patient refuses to sign receipt of NOPP
I believe you will find that the newest version of the privacy regs require that you have a Notice, but only that you make a "good faith" effort to get the patient to acknowledge receipt of the Notice. There is no longer a specific requirement for a Consent as required in earlier versions of the regs. They don't have to sign a Consent form agreeing to the terms and conditions spelled out in the Notice. A fair number of HIPAA experts are interpreting this to mean that the Consent is not required. This is legally, probably true. From a business and medical records standpoint, it is probably a really bad option. I suspect your legal advisors will tell you and I know my business experience would tell me to use a written/signed consent form. It is almost certainly the best way to document receipt of the Notice. The variation is that anyone could sign this consent form for a patient. It is really only documentation of the "good faith effort" to make the Notice available. If a staff member signed and dated this consent form with a one line description as to why the patient didn't sign, you have documentation to support your claim that the Notice was distributed. Doesn't it really make sense to try to get the patient's agreement to the information presented in the Notice? If they are refusing to sign, because they really disagree with something found there -- there is a reason to discuss things a bit more. I recently had a trip to a hospital for some repairs and it was rather alarming to find that the staff I ran into were largely clueless about patient's rights. There was no Notice available (OK, they have a few days before it is required - no planning ahead here!). When directed to get some follow up tests, I requested a copy of what exactly they wanted me to do. The nurse said "Oh no, we can't do that hip, hipit, something like that won't let us give you anything from your chart." When I indicated that this made no sense, she checked with a supervisor who said I had to wait until it got to medical records and could then request, in writing, a copy, which would be available within 30 days. For a rather important test to be done ASAP. -- but I can't get documentation as to what, exactly they wanted done in the next day or two. They went on to schedule the wrong test. Think of the fun we can have in court. Why wouldn't you tell patients what you plan to do with their information and seek their agreement to do those things? Hospitals are not manufacturing facilities dealing with inanimate objects and not all situations make such discussions impossible. The situation was not emergent, I believe I am capable of understanding the paperwork, and had my wife, an RN, with me. I met some caring medical professionals in the business of processing "bed 21 West" in whatever way they felt best -- without any interference from patients. Dale K Howe, PhD --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
Re: Facility Directory
Yes, it would come under the "right to object" clause. The patient has a right to not have their name listed, but there are no specific documentation requirements and no specific standard as to how or when the option must be offered. However, if you don't document the agreement to be listed, how would you show they were given a choice and chose to be listed? You may be able to show that the option was listed in the NPP, but why would you not make it a part of the entrance paperwork? It is supposed to be all about patient's right to choose. Dale K Howe, PhD Michigan In a message dated 3/12/2003 7:56:35 PM Eastern Standard Time, [EMAIL PROTECTED] writes: For some reason I have been under the assumption that when a patient registers we, an acute care hospital, need to explain the right to opt-out of the facility directory. Is this something we need to explain verbally or is the fact that explanation in the NPP is sufficient? I really appreciate any feedback Cindy --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
