HIPPA violations

[Doxie]

What do schools do if a student commits a hippa violation. Anyone know?

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[ADeadLois]

If a school has an honor code, then it's in violation of that and you receive the delineated punishment.

 

[avery2007]

HIPAA. sorry--pet peeve.

 

[Doctor Bagel]

HIPAA. sorry--pet peeve.

Thanks -- everybody at my school spells it wrong.

To the op, my guess would be that it depends on what you did and what type of training you received. Violating HIPAA can accidentally happen, especially if you're new or didn't receive the proper training. So more details are needed.

 

[PeepshowJohnny]

Thanks -- everybody at my school spells it wrong.

To the op, my guess would be that it depends on what you did and what type of training you received. Violating HIPAA can accidentally happen, especially if you're new or didn't receive the proper training. So more details are needed.

Agreed.

If your attending catches you talking about a patient in an elevator, that's probably an honest mistake and you'll probably get a gentle reminder or a stern lecture, but won't affect you in the long run.

If they catch you xeroxing Lindsey Lohan's medical record to sell to "US Weekly"....yeah you're probably getting booted.

 

[Non-TradTulsa]

Agreed.

If your attending catches you talking about a patient in an elevator, that's probably an honest mistake and you'll probably get a gentle reminder or a stern lecture, but won't affect you in the long run.

If they catch you xeroxing Lindsey Lohan's medical record to sell to "US Weekly"....yeah you're probably getting booted.

Absolutely. Intent matters a lot. HIPAA is so restrictive that I probably inadvertently violated it every day my last few years working in hospital administration. You'll make HIPAA mistakes without thinking about it and you'll get an appropriate slap on the wrist. But, discussing a celebrity case or commenting on a patient with malice - you could be in big trouble.

 

[MossPoh]

As everyone else said..most likely depends on the situation. HIPAA is not some small little thing with specific rules. It spans pretty much every piece of information in the hospital. It could range from a verbal "please don't do that" to some serious time. (That part being unlikely) I know that there were entire books on compliance when implementing new IT stuff....Just avoid it and be weary of personal information.

 

[EM_Rebuilder]

HIPAA seems to get violated endlessly everywhere I have been so far.

I see/here (past) fellow students, now fellow residents, etc talking to spouses/family on the phones about patients. Nurses and other staff doing the same.

HIPAA is good, but sucks also. We are supposed to consume our life with medicine, but never speak about it. If I meet an interesting person, why should I not be allowed to tell my family at home about it?

Unless you do something plain crazy/unethical/exploitable then I do not think you have any worries. You will see students, attendings, etc all violating HIPAA all over the place. Just dont make copies of medical records and sale them to the newspaper...

 

[ZagDoc]

If I meet an interesting person, why should I not be allowed to tell my family at home about it?

It's my understanding that discussing patients to others is allowed as long as there is an absence of personally identifying information such as name, etc. Then again, if the person has a rare/unique condition, simply discussing in this context may be considered "identifying information."

The problem with HIPAA is that is tries to turn greys into black and whites.

 

[dilated]

A more interesting scenario is research data. Almost all of it is supposed to be allegedly deidentified but nobody ever does because then you can't go back if there's missing info. It's interesting because it would be the hospitals problem if you got busted with 500 pts on your flash drive but only the med school can punish you.

 

[Doxie]

Absolutely. Intent matters a lot. HIPAA is so restrictive that I probably inadvertently violated it every day my last few years working in hospital administration. You'll make HIPAA mistakes without thinking about it and you'll get an appropriate slap on the wrist. But, discussing a celebrity case or commenting on a patient with malice - you could be in big trouble.

It just seems to accidentally happen a lot...random docs/other students stealing my computer and using it when I'm logged in, looking up things for patients i'm not seeing etc. I guess I'm wondering if they actually do check up on what you've been accessing electronically and if a student could get into trouble for something like that.

 

[Ephesus]

I wouldn't worry too much. Practicing docs that work in private offices were just signed off by the administration and went on with their life. They were just told "don't say anything about a pt unless required to by law."

As a med student, they may crack down on you. Be vague then.

 

[mudphudwannabe]

Electronic access to medical records is monitored, and you need to get into the habit of logging out anytime you leave your computer station - even if it is just for a minute. You are responsible for what other people look at while they are logged into your account, so be careful. I'm not sure what the punishment would be - as above it would probably depend on what the exact situation was.

 

[alwaysaangel]

It's my understanding that discussing patients to others is allowed as long as there is an absence of personally identifying information such as name, etc. Then again, if the person has a rare/unique condition, simply discussing in this context may be considered "identifying information."

The problem with HIPAA is that is tries to turn greys into black and whites.

This is my understanding too. This is how they trained the MAs at the free clinic I worked in. Basically if the info you give out could identify the patient in any way: eg. name, address, MR #, first name + birthday, date seen + condition, etc. etc. then its a violation.

But just talking in general about a patient seen with no identifying info or info about when the patient was seen doesn't violate it.

If thats not the correct interpretation then I've made some boo-boos in my years...

 

[Tired]

A more interesting scenario is research data. Almost all of it is supposed to be allegedly deidentified but nobody ever does because then you can't go back if there's missing info. It's interesting because it would be the hospitals problem if you got busted with 500 pts on your flash drive but only the med school can punish you.

It doesn't have to be deidentified, it just has be secured if it's not (ie - password protected). That is the typical requirement for IRB approval as well. Anyone stupid enough to have an open file on a flash drive deserves everything they get.

Also, talking on the phone about a patient is not a HIPAA violation either. What gave anyone that idea?

 

[RockShox]

According to my knowledge to date there has not been a single fine, citation, criminal action, or otherwise against any person or hospital system for HIPPA violations. There have been something like 300,000 complaint reports. You do the math.....complaint system without fear of repercussions due to apathetic government, guess all the hype is not living up to much.

 

[logos]

According to my knowledge to date there has not been a single fine, citation, criminal action, or otherwise against any person or hospital system for HIPPA violations. There have been something like 300,000 complaint reports. You do the math.....complaint system without fear of repercussions due to apathetic government, guess all the hype is not living up to much.

Thats the reason why lots of small practices dont bother with all the effort to become compliant. I know of at least one private practice that just dosent worry about it specifically because they always kept private info private before HIPAA and the government will never actually punish them for not complying.

 

[45408]

Just avoid identifying information, and for the most part, you should be fine. The only situation I know about that actually resulted in punishment was when an EMT was telling people about a specific patient by name, and it got back to that patient.

 

[Gut Shot]

Hungry, hungry HIPAA...

 

[Prehealth001]

At a teaching hospital, is a patient required to let the medical student enter the exam room with the attending? What if he patient refuses, does the Patient have no say in this matter if he has already signed the admitting paperwork?

 

[TooMuchResearch]

At a teaching hospital, is a patient required to let the medical student enter the exam room with the attending? What if he patient refuses, does the Patient have no say in this matter if he has already signed the admitting paperwork?

The patient always has a choice.
This thread is 8 years old.

 

[Prehealth001]

The patient always has a choice.
This thread is 8 years old.

Let's say this is in a emergency room, and the patient is required to sign admitting paperwork to receive medical care.

Hospital staff claims that somewhere in the paperwork patient waives his hipaa right regarding medical students.

Is this legal? is it ethical?

Emergency rooms are required to provide care. Can they take away patient hipaa rights while delivering it?

 

[Prncssbuttercup]

I disagree that intent matters. I volunteered with a hospital, on my own free time, and the staff there told me about a nursing student who 1. cost herself her training, 2. cost the school their hospital access because of sweet picture she took of herself with a kid that happened to have a room number in it and posted it, with the family's permission, on FB. She thought it would be fine, except she used his first name, and that combined with the room number and hospital was determined to be a HIPAA violation. Her intentions didn't matter. She was summarily dismissed for the HIPAA violation. A story about a patient with no details that is vague is one thing, ANY identifying information enough to constitute a HIPAA violation can result in expulsion.

As for patients allowing students, no they do not have to allow the student. They can turn down a student at any time. If the attending doesn't ask and the patient seems uncomfortable with the student in the room, the student should OFFER to leave the room "sir/ma'am would you feel more comfortable if I left, it's okay to say yes, whatever makes you feel more comfortable"... or similar

 

[mvenus929]

Let's say this is in a emergency room, and the patient is required to sign admitting paperwork to receive medical care.

Hospital staff claims that somewhere in the paperwork patient waives his hipaa right regarding medical students.

Is this legal? is it ethical?

Emergency rooms are required to provide care. Can they take away patient hipaa rights while delivering it?

I'm not sure you're discussing HIPAA rights. The admission paperwork probably included a line about allowing medical students and residents to take part in the care of the patient, but the patient is not waiving HIPAA rights by signing such a document. The student is also permitted to access the medical record to provide care and for educational purposes.

Yes, the patient can refuse to have medical students involved in his care. He would probably be talked into it, or the staff would try anyway, but he can still refuse.

 

[chipwhitley]

I'm not sure you're discussing HIPAA rights. The admission paperwork probably included a line about allowing medical students and residents to take part in the care of the patient, but the patient is not waiving HIPAA rights by signing such a document. The student is also permitted to access the medical record to provide care and for educational purposes.

Yes, the patient can refuse to have medical students involved in his care. He would probably be talked into it, or the staff would try anyway, but he can still refuse.

I had an experience in OBGYN where the patient said she didn't want a med student at the c section but the attending said sorry you're not allowed to refuse students for procedures, and made me go anyway. I didn't even want to, lol.

 

[Psai]

Don't post things like that. It makes you look bad and our profession as well

 

[tantacles]

Don't post things like that. It makes you look bad and our profession as well

To be frank, our profession does things that sometimes makes us look bad. Rather than sweeping it under the rug, I think it's better to acknowledge it and allow others to be aware and try to preemptively fix their behavior.

 

[Psai]

Attempting to avoid things that every doctor should see and participate in is something to be ashamed of

 

[Morzh]

As for patients allowing students, no they do not have to allow the student. They can turn down a student at any time. If the attending doesn't ask and the patient seems uncomfortable with the student in the room, the student should OFFER to leave the room "sir/ma'am would you feel more comfortable if I left, it's okay to say yes, whatever makes you feel more comfortable"... or similar

Yes, the patient can refuse to have medical students involved in his care. He would probably be talked into it, or the staff would try anyway, but he can still refuse.

I had an experience in OBGYN where the patient said she didn't want a med student at the c section but the attending said sorry you're not allowed to refuse students for procedures, and made me go anyway. I didn't even want to, lol.

I'll add another anecdote. Yes patients may refuse to be seen by a student, but attendings also have a right to send those patients away (excluding emergencies).

Once on OB a lady needed an EMB. She was fine with me being there initially, but after she changed into a gown and we came back for the procedure she told my attending that she was uncomfortable with a student being present for that part. The attending, without skipping a beat, said, "I understand that, but I have a student working with me today. If you'd like to reschedule we can do the biopsy another time, but I can't guarantee that I won't have a different student with me then. If you'd like I will refer you to a colleague who doesn't work with medical students." He wouldn't change his position and the patient ended up just leaving. Afterwards the attending told me he knew I would have gladly stepped out, but thanked me for not interjecting/volunteering to do so because it would have put him in an awkward situation of essentially having no choice. His philosophy about students was very much "you are an extension of me today and will see and hear everything I do, no exceptions."

 

[swoopyswoop]

That's kind of ****ty though. I highly doubt the patient knew the doctor would have a student with him when she made the appointment. If he's going to kick patients out he should have his scheduling staff inform every single patient who makes an appointment that a student will be present.

 

[TooMuchResearch]

Let's say this is in a emergency room, and the patient is required to sign admitting paperwork to receive medical care.

Hospital staff claims that somewhere in the paperwork patient waives his hipaa right regarding medical students.

Is this legal? is it ethical?

1. You can refuse paperwork and get actual emergent medical care.
2. No, hospitals cannot make you "waive your right" to choose if medical students participate.
3. This has nothing to do with hipaa.

 

[Morzh]

That's kind of ****ty though. I highly doubt the patient knew the doctor would have a student with him when she made the appointment. If he's going to kick patients out he should have his scheduling staff inform every single patient who makes an appointment that a student will be present.

This was at the academic hospital's main outpatient facility, every patient whose been there knows residents and students are always present. She wasn't a new patient. Also, there's a little more backstory.. the patient had already been really demanding and rude to just about everyone that day and I think the attending, at least in part, was glad to have a reason to get her to just choose a different provider.

I'm not saying I'd have done the same, but I can't fault him.

I did have a family medicine attending (private practice) earlier in the year whose staff did exactly what you said - every new patient was informed that Dr. so-and-so always had a student with him and that we participated fully in seeing and discussing each patient. If patients weren't comfortable they were encouraged to look for a different PCP. I loved that attending, and his patients loved him too.

 

[Wordead]

That's kind of ****ty though. I highly doubt the patient knew the doctor would have a student with him when she made the appointment. If he's going to kick patients out he should have his scheduling staff inform every single patient who makes an appointment that a student will be present.

He didn't kick her out. He's essentially saying this is a teaching hospital, take it or leave it. Go to a private hospital without a residency/students if you so wish. I think it's a stance more attendings should have.

 

[Psai]

One of our attendings attracts a lot of VIP patients - often from out of town or out of the country even.

He therefore gets a lot of these requests, usually moreso pertaining to residents than students but still.

His response is something along the lines of: "I know how to get you off the operating room table alive. These guys know how to get you out of the hospital alive. We're a team. I can't do your operation without them."

it's awesome how your attendings stand up for you
doesn't always happen

 

[Kaustikos]

One of our attendings attracts a lot of VIP patients - often from out of town or out of the country even.

He therefore gets a lot of these requests, usually moreso pertaining to residents than students but still.

His response is something along the lines of: "I know how to get you off the operating room table alive. These guys know how to get you out of the hospital alive. We're a team. I can't do your operation without them."

I just am not a fan of VIP patients. Only because of how they abused it. Most of them wanted q15 minute checks with a resident/attending seeing them all the time regardless. God forbid a student went in there.
And the family members or visitors made it worse.
I'm hoping things aren't that bad elsewhere