In a supposed desire to uphold the 1996 law protecting the confidentiality of patient medical records, health care workers -- principally nurses and office workers -- refuse to disclose medical information to family members, public safety officials (investigating police officers or social service workers) and even in same cases other medical professionals not directly assigned to the patient at the time of 'official' treatment.
As well meaning as the legislation is -- there's a clear need to ensure that the medical records of a person remain private -- it's fraught with unintended consequences largely the result of poorly trained providers. Workers in the medical facilities refusing to disclose necessary medical information to next of kin or other appropriate bodies and an enforcement system (Health and Human Services) oblivious to the need for ensuring intelligent ("common sense") design and implementation.
The situation of its implementation has gotten so bad that someone related that "A lab technician once refused to give me a copy of MY OWN lab results at a lab. where I had a lipid profile, on the grounds that it was prohibited by Hipaa."
In an interview with Susan McAndrew, deputy director for health information privacy in the Office of Civil Rights at the Department of Health and Human Services one quote jumped out at me:
Q. I also could not figure out, either from the website, actually reading the law or interviewing both providers and privacy experts, whether your department took or investigated complaints about unnecessary or inappropriate withholding of information.
A. Failure to exercise discretion is not a violation. If we receive a complaint or inquiry about non-disclosure to family or friends, or non-disclosure to another health care provider, we don’t investigate those cases because they’re not subject to enforcement action. We deal with those situations on an education level. [emphasis added]
It's that kind of attitude that generated the stack of letters the NYT published in response to their original article.
A number of letters came from children or other family members who had sought information about about their family member, only to be denied because of hippa laws, including this situation:
My father in Florida was in a hospice and I was in California. I called to check on his condition and was told they could not inform me because of hipaa laws. I yelled and screamed at them. I became very distraught. Later I found out that he was already dead at the time of that conversation and they wouldn't even tell me that.
Another letter related how even with the "patient" beside him, he was asked to leave the room when they discussed her medical condition:
In 2004 when my wife and I had an insurance coverage issue, we met with the Human Resources manager at my wife's employer. The HR director said that she couldn't discuss that matter with me because it would be a violation of Hipaa. Even though I was sitting right beside my wife!
Then there are these two stories:
1. I have a hard time remembering the names of my prescriptions, but Kaiser Permanente pharmacists refused to let me look at my very own screen on their computers, to ask for what has been prescribed to me. (Now I keep a list in my purse for this purpose.) 2. When my aunt's caregiver (Auntie is an alcoholic with dementia) went to the hospital and I was trying to decide what to do about her care I wasn't able to find out WHICH hospital or her prognosis until after her death, some five days later. I had no clue as to seriousness of the problem, and I was trying to cope from 3000 miles away, since I make medical decisions for my aunt.
One writer suggested that patient care is compromised as other care givers are denied previous medical information.
As a radiologist, I have found the legislation to be nothing but a headache that
detracts from my ability to provide the best possible care [for] my patients, ...
[particularly] as a patient moves from provider to provider.
It can be very difficult for a radiologist to get clinical data and follow-up information about a patient. Examples: 1) Patient is having a M.R.I. at our imaging center. I call for a report on a prior M.R.I., done at another institution. Staff will refuse to fax it over ... 2) Patient is having a MRI of the knee at our imaging center. The patient has had arthroscopic surgery on that knee. I call for an operative report. Staff will refuse to fax it over. 3) Patient has a shoulder M.R.I. at our center, and has some unusual findings. The patient has surgery on the shoulder, and I call over for the operative
report. By knowing what the intraoperative findings are, I improve as a radiologist, and the next time I see these findings, I will recognize them for what they are. This is one important way doctors improve over time - getting feedback on their performance. Even though I am a consultant to the referring physician, the office staff will refuse to fax me the operative report. [emphasis added]
The absurdity of how the law is being managed is illustrated best by how the article ended
A hospital spokeswoman, Elena Mesa, was asked if nurses were following Hipaa protocol when they denied adult children information about their parents. She could not answer the question, Ms. Mesa said, because Hipaa prevented her from such discussions with the press.
