I really find many of these conversations entertaining (also frequently
enlightening and helpful). "Unworkable?" Hardly. Most of you appear to not
realize how lucky you are! Nor does it appear that you give yourselves much
credit for being creative and resourceful. I work for an alcohol and drug
abuse treatment provider. We in this field have successfully operated under
what is, generally, a more demanding set of patient privacy rules (42 C.F.R.
Part 2, not to mention state mental health statutes, which are also usually
very strict)than those found in HIPAA. E.g., unlike "regular" health care
providers, we have to have the patient's written authorization to talk to
another treatment provider, not to mention just about everyone else,
including payers. If we can successfully operate in our environment, you can
successfully operate in the HIPAA environment! Will you have to change some
of your current business practices? Yes. Will you frequently find the rules
to be a pain in the neck (not to mention other parts of your anatomy)?
Certainly. Is compliance an impossible task? No. Will it cost you some
money, not only to implement, but to abide by in the future? Probably. Are
all of these new rules, which are intended to benefit patients in terms of
protecting their privacy, going to be otherwise beneficial to them? No. Some
of the burden of complying with these rules is going to make it harder for
patients, too. These rules are not necessarily "customer friendly." The
patients are going to have to make some changes and part of our
responsibility will be to educate and help them. No doubt we will frequently
be blamed for the inconvenience, but what's new? As with any other set of
government statutes and regulations which I have ever read, there are
ambiguities, if not worse defects. It will take time, and perhaps additional
rule-making, to sort everything out (if we ever get to that point, which may
never happen in such a complex area with so many legitimate, competing
private and public interests). I suggest, however, that it would be more
productive to spend time looking for solutions to the challenges presented
rather than bemoaning our fate. Pin numbers? I think that may be a very
workable concept for some settings. I've been telephoning my bank for years
(mostly I do it on-line now) and putting in a pin number and my account code
to access my bank account. Let's get on with it!

Darrell Rishel, J.D. 
Director of Information Services 
Arapahoe House, Inc.

This message is not legal advice or a binding signature.

> -----Original Message-----
> From: fwdanby [mailto:[EMAIL PROTECTED]]
> Sent: Friday, January 17, 2003 5:01 PM
> To: WEDI SNIP Privacy Workgroup List
> Cc: WEDI SNIP Privacy Workgroup List
> Subject: Re: HIPAA privacy and people
> With the same due respect, and I, too, mean it sincerely, the word
> 'unworkable' is very tempting to apply to the whole HIPAA 
> scenario where
> there is an interface with patients.
> Take a look at what all you very bright and well-intentioned 
> folks have been
> posting over the past several months. This is a high level of 
> confusion
> among intelligent people. Now translate that to the 
> undeniable fact that
> half the people in the real world are below average 
> intelligence (IQ < 100)
> and the world we physicians live and work in is populated by 
> patients who,
> through no fault of their own, exhibit an even higher 
> percentage of room
> temperature IQs.
> Sure, we will get some of the people complying some of the 
> time, but all of
> the people all of the time is, in a word, unworkable.
> To have us exposed to legal liability in this situation is, 
> in another word,
> unfair.

> I believe we providers should demand an umbrella of some sort 
> to protect us
> from unwarranted, arbitrary, over-zealous enforcement of an 
> essentially
> unworkable set of regulations.
> I'd love to hear other opinions on this - here if you think 
> it warranted,
> privately if you think otherwise.
> ----- Original Message -----
> From: "Benjamin W. Tartaglia" <[EMAIL PROTECTED]>
> To: "WEDI SNIP Privacy Workgroup List" <[EMAIL PROTECTED]>
> Sent: Friday, January 17, 2003 12:17 PM
> Subject: RE: HIPAA privacy and telephone
> > With all due respect, and I mean it sincerely.....
> >
> > Good idea for privacy........ Based on my many years of management
> > engineering and the application of voice, data and image
> telecommunications
> > systems in healthcare as an employee and later as a 
> consultant I suggest
> it
> > is unworkable. (really long and ill structured sentence).
> >
> > The major premise is "When the patient calls back, someone 
> who can accept
> > the call and pin number is available".  The major premise, 
> although well
> > intentioned, is false.
> >
> > When I try to get to my Doctor's office, I get a call 
> management system
> 99%
> > of the time.  If I'm really lucky, I may get an answering 
> service.  People
> > who work for many answering services are part timers, sometimes from
> > temporary employment companies, working for minimum wage, 
> with little or
> no
> > healthcare background.  Try and get them HIPAA certified.
> > (I have also done consulting on Doctors' answering services.)
> >
> > I believe such a system would simply generate round after 
> round of call
> > backs which are unsuccessful.  If anyone thinks this would 
> actually work,
> > should get another opinion and only pay for that opinion 
> when the system
> is
> > proven effective.
> >
> > I really would like to talk to the people who have used 
> this successfully
> so
> > that I might add to my professional knowledge and moderate 
> my opinion on
> he
> > matter.... or... is this simply a "scenario" from a 
> brainstorming session?
> >
> > Additional comments are welcomed and desired.  I find I 
> learn more from
> > people who disagree.
> >
> > Ben Tartaglia
> > Benjamin W. Tartaglia, MBA, BSIM, CSP
> > Director, Client Services
> > BWT Associates, HealthCare Consultants
> >
> > HIPAA, JCAHO, Telemedicine, Contingency Planning, 
> Telecommunications,
> > Telephone Fraud & Abuse, Training Programs, Policy & Procedures,
> Management
> > Audits.
> >
> > PO# 4515, Shrewsbury, MA 01545
> > Phone: 508-845-6000
> >
> > -----Original Message-----
> > From: Ribelin, Donald [mailto:[EMAIL PROTECTED]]
> > Sent: Friday, January 17, 2003 10:09 AM
> > To: WEDI SNIP Privacy Workgroup List
> > Subject: RE: HIPAA privacy and telephone
> >
> >
> > So far, the best scenario I have seen is the phone call 
> that requests the
> > patient to call back to the office.  Part of the call back 
> involves a pin
> or
> > secret code that the patient was provided previously.
> >
> > Donald L. Ribelin
> > HIPAA Project Manager
> > Firsthealth of the Carolinas
> > (910) 215-2668

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