It seems to me that the act of issuing and filling a prescription is a treatment process therefore the minimum necessary standard would not apply. I don't think that the privacy rule prohibits such communications. The pharmacist is in a treatment relationship with the patient and the physician. Remember that the patient's action in presenting a prescription to a pharmacist implies a consent to communicate with the physician to insure that the prescription is filled in a way that is most beneficial to the patient.
Let me give you another scenario to illustrate my point.
A patient is being seen by an EENT for chronic sinus infections and by an internist for treatment of hypertension. One of the drugs the EENT prescribes has a serious interaction with the blood pressure medication the patient is on. The error occurs because the patient failed to note the fact that he was hypertensive on the history form he filled out at the EENT's office. Fortunately, the patient uses the same pharmacy for both prescriptions and the pharmacist runs and interaction check. Under these circumstances, the pharmacist would contact the EENT and make him aware that the patient was already taking the hypertension medicine so that the EENT could change the to a drug with more benign interactions.
None of this violates the privacy rule. By the same token, I think that once the pharmacist realized that a patient had accumulated an inordinate supply of a controlled substance, he would be within his rights to bring that fact to the attention of at least one, and most probably all of the prescribing physicians.
-----Original Message-----
From: Mimi Hart [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, January 15, 2003 3:17 PM
To: WEDI SNIP Privacy Workgroup List
Subject: Re: Here is a good Privacy Issue that will cause problems
My gut feeling tells me "huge issue"...I don't know if there is
something in public health law that would state that it is being done in
the best interests of the patient and is therefore okay.....hopefully
one of the lawyers on the group will weigh in. MIMI
Mimi Hart ӿ�*
Research Analyst, HIPAA
Iowa Health System
319-369-7767 (phone)
319-369-8365 (fax)
319-490-0637 (pager)
[EMAIL PROTECTED]
>>> "Rebekah Savoie" <[EMAIL PROTECTED]> 01/15/03 02:53PM >>>
Today, a clinic that I work with received a letter from a local
pharmacy
about a patient that was a "Drug Seeker" as we call them. Over the
course of 30 days he had been to several doctors and several
pharmacies
and received over 350 total pills all a controlled substance.
What happens to the pharmacy's ability to do these types of things
under Privacy?
Clearly, pharmacist were communicated information back and forth to
each other and to physicians on this person. They even sent letters
to
all physicians in the area.
Problem? yes or no
Rebekah Savoie, CCS-P
Healthcare Consultant
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