Re: HIPPA

January 2, 2003

The question stated below is with regard to a nurse's statement to a

transferring medic that the transfer papers were not available to him due to

HIPAA.

This is a misunderstanding of the rules.

HIPAA allows individually identifiable health information (IIHI) which is

protected health information (PHI) to be used without prior patient consent

for treatment, payment, healthcare operations, and when required by law.

Therefore, the hx and so forth that are contained in the transfer papers are

available to the transferring crew because the information may be necessary

for patient care, and also because transfers are a part of EMS operations.

Politely inform the nurse that her information is incorrect. I am finding

that many hospital and nursing home personnel are making this same error,

possibly because they are getting their information from people who provide

HIPAA training to hospitals and nursing homes. Those people were far ahead

of EMS in preparing for HIPAA, but because they were ahead of us much of the

information that they first disseminated has been rendered incorrect because

of the amendments in the rules that were published August 14, 2002. Prior to

those amendments the information stated by the nurse was probably correct.

But it is perfectly clear from the final rules that as long as information is

passed along the " chain of care " it is available for use by the medical

personnel providing treatment and care.

If a transferring nurse of physician persists in this interpretation, you

can always just load the patient and then open the envelope in the truck and

read it. You have the right and duty to do that. Or you can refuse the

transfer.

HIPAA is not intended to impede the care of the patient.

Gene Gandy, JD, LP

HIPAA Consultant

In a message dated 1/2/2003 5:39:55 PM US Mountain Standard Time,

ropermedic@... writes:

>

> I have a question regarding this HIPPA stuff and forgive me if its

> been posted prior. I was recently told by a nurse that i wasn't able

> to get pt info from the transfer paperwork in a envelope due to this

> HIPPA that was out now and that I could just take what i was told by

> her, nonetheless it didn't nowhere near match the Hx info what was

> inclosed in the paperwork . Where do medics stand with this? Do we

> just take their word for it or can we still look for pertinate Hx and

> info prior to taking over the pt care. Thanks, Jeff EMT-I

>

January 2, 2003

Jeff-

Since you are providing a continuation of care, you should have full access to

all of the data pertinent to the patients medical history, current conditions,

treatments and standing orders for care.

If you accept a patient without conducting a proper " hand-off " including a

briefing by the prior care-giver, and a physical exam, you are placing your

certifications as well as those of your Medical Director at risk should any

medical misadventure occur, due to conditions or problems not spelled out or

discovered during the " hand-off " .

If you cannot get co-operation from the care-giver, contact your medical

director.

Funny how the righteous wrath of an angry medical director can smooth over the

bumps of life.......

Seek out a HIPPA seminar........armed with knowledge, you cannot be taken

advantage of in the future.

I hear Gene Gandy teaches a good one. Several members of a service I ride for

really brought home the HIPPA bacon for the rest of us slackers from one of his

schpiels. Stayed awake the whole time, too.

Regards-

Terry Dinerman EMTP DM

HIPPA

I have a question regarding this HIPPA stuff and forgive me if its

been posted prior. I was recently told by a nurse that i wasn't able

to get pt info from the transfer paperwork in a envelope due to this

HIPPA that was out now and that I could just take what i was told by

her, nonetheless it didn't nowhere near match the Hx info what was

inclosed in the paperwork . Where do medics stand with this? Do we

just take their word for it or can we still look for pertinate Hx and

info prior to taking over the pt care. Thanks, Jeff EMT-I

January 3, 2003

Her information is wrong. You are allowed face sheets. I would speak with

hospital admin or the hospital compliance\privacy officer.

Henry

" statcaremedic " wrote:

> I have a question regarding this HIPPA stuff and forgive me if its

> been posted prior. I was recently told by a nurse that i wasn't able

> to get pt info from the transfer paperwork in a envelope due to this

> HIPPA that was out now and that I could just take what i was told by

> her, nonetheless it didn't nowhere near match the Hx info what was

> inclosed in the paperwork . Where do medics stand with this? Do we

> just take their word for it or can we still look for pertinate Hx and

> info prior to taking over the pt care. Thanks, Jeff EMT-I

>

January 3, 2003

Unfortunately, this nurse has misunderstood the HIPAA rule and Health and Safety

Ch 181. These rules in NO way preclude the sharing of the patient's health

history, treatment, care, and billing information as it is necessary for

continuance of care during the transfer. You, as the crew accepting

responsibility for the patient, have a legal right to know. This is part of the

exemption from the rules that comes under " operations " . This information is

clearly delineated in the CMS interpretations of their own rule.

If you were a taxi cab driver who was to drive this patient from the hospital to

his/her private residence, you would NOT have a legal right to this information

and these rules would definitely preclude the nurse from giving it to you. That

is because in that scenario it is not a necessary part of the taxi operations to

provide continuing patient care to the person until delivery. But you are NOT a

taxi driver, you are a fellow healthcare professional who is expected to provide

care and treatment for this patient until you safely deliver them to their

destination. So the rules clearly set you up as having a legal right to obtain

and use the health and billing information in that " envelope " .

This is clearly an educational issue for this nurse or this facility. And until

that education happens, just exit stage left with your patient and get what you

need out of the envelope anyway. You are within your legal rights as long as

you are caring for the patient.

Jane Hill