HIPAA

File this under "Don't blame the ER nurse..."

Frequently, we receive phone calls from people requesting information about patients. Usually it is someone who knows the patient--family, friend, co-worker. Other times it is someone who only has a passing interest--the good samaritan who brought the patient in, law enforcement officers, reporters from the local newspaper.

If the patient is present, awake, and able to converse, we transfer the call to the patient so they can give any information they choose. However, if this is not the case, ER nurses are bound by law to protect the privacy of the patient.

Some people don't understand this.

Once, I received a call from a person who identified herself as a patient's mother. She wanted to know why her son was in the ER, how he was doing, and if he was going to be admitted or discharged. The patient in question was drunk and unconscious, and an adult. Legally I couldn't tell the woman anything.

"But I'm his mother!"

People always say things like this, as if parentage trumps federal law. Who am I more afraid of, this woman or the feds?

ER nurses and others in the health care industry are restricted in the amount and type of information we can release about patients. The federal law that stipulates this is called the Health Information Portability and Accountability Act (HIPAA). Like most legislature "acts," HIPAA is verbose, complicated, and confusing, and has a misleading monniker. A better name would be "HIPPA: the Health Information Privacy and Protection Act".

The act does allow us to reveal the following. For a patient who is identified by name, HIPAA allows me to tell a caller whether or not the patient is in the ER, discharged, admitted to the hospital or transferred to another facility, and give a one word description of the patient's condition (e.g., critical, serious, fair, stable, poor, etc.)

That's it! It does no good to ask for more. People do, but I don't tell them. My stubborn refusal to do so angers most callers.

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Probably the most bizarre incident of not being able to disclose information about a patient that I've experienced occurred when a patient's wife called about 2 hours after he had been discharged. She asked the typical questions: why had he been in the ER, what did we do, and what should he do now.

Me: "We did have a patient by that name. He was discharged in stable condition."

Her: "I know. He's right here, at home. Why was he in the ER?"

"I'm sorry, ma'am. By law, because the patient is an adult, I am not allowed to disclose any other information to you without his expressed consent."

"But I'm his wife!"

"I understand that, ma'am. Allow me to suggest that you ask your husband why he was here."

"I did."

"And...?"

"He won't tell me."

"Won't tell you? And I'm suppose to?"

"Yes. I'm his wife!"

"You've already said that, ma'am. But I'm sorry. If I tell you any other information, then I will have violated your husband's right to privacy...AND a federal law."

"But I'm his wife!"

"I understand that, ma'am. What I'm asking you to understand is that that doesn't matter. I can't tell you anything else about the patient."

There was a long pause.

"But I'm his wife!"

"Yes, ma'am. Is there anything else I can do for you, ma'am?"