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How much about patients are you allowed to share?

Discussion in 'Pre-Medical Allopathic [ MD ]' started by Kochanie, 05.14.14.

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  1. Kochanie

    Kochanie

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    I recently started volunteering in a clinic and I love the direct patient volunteering, but other volunteers like to talk about the patients and their experiences.

    Doesn't this violate rules? Other doctors and workers don't seem to mind, but how much am I allowed to share about patients to fellow volunteers, on applications, etc?
     
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  3. mmmcdowe

    mmmcdowe Duke of minimal vowels Gold Donor SDN Moderator 7+ Year Member

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    No identifying information. It's okay for medical personal to discuss patient information in non public settings (meaning not in the elevator).
     
  4. J Senpai

    J Senpai Grab my arm. Other arm. MY other arm. 5+ Year Member

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    Volunteers can talk about patients all they want, in closed company. None of that leaves the clinic, though. Familiarizing yourself with HIPAA privacy rules will save you some trouble down the road.

    EDIT: I'll add that casually talking about patients, even in closed company with other workers, is not entirely appropriate.
     
    Last edited: 05.14.14
  5. IWTBAD

    IWTBAD

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    How is that okay? to talk to other people about a specific patient?
     
  6. CardiologyPrincess

    CardiologyPrincess

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    Example: at work we refer to them by their room numbers. And even then, spare details if someone else is around. Be mindful of HIPPA and you never know who else knows that person in room 212
     
  7. YamNMangos

    YamNMangos 2+ Year Member

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    As said above, as long as it's not identifiable information you are revealing, so people won't be able to tell which specific patient you are referring to.
     
  8. tantacles

    tantacles Lifetime Donor SDN Moderator 7+ Year Member

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    This is the correct answer. However, keep in mind that identifying information does not only apply to name, age, race, date of birth, etc. Anything that might possibly identify that patient to another person who is not responsible for caring for that patient is considered PHI, and you should be exceedingly careful. For example, the fact that a person came to the hospital with a certain condition on a certain day or a patient's room number might be PHI. You can not control how much information your colleagues disclose, but you can certainly control your own disclosures.
     
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  9. pDeluxe

    pDeluxe 2+ Year Member

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    At the hospital where I volunteered, the general rule was not to discuss any identifying patient information. The only exception was when a specific patient had signed a release, and even then you could only speak to those directly involved in that particular patient's treatment and care (i.e. you can speak with the floor nurses about a certain patient, but not nurses from other floors).

    Granted, I saw a lot of people breaking the rules when the department head or director was not present.
     
    Kochanie likes this.
  10. mvenus929

    mvenus929 10+ Year Member

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    "I once interacted with a very hostile patient. She was very adamant that nothing I was doing was right. I ultimately had to call for help."

    I use anecdotes to impress things on patients and families. For instance, when I was working in the ED, we had a young child come in after a car accident in which the adult driver died on the scene. I use this story to impress on mothers how important it is for them to teach their children names, phone numbers, addresses, etc, because that was the only way we were able to identify that child and contact the family.

    Stories are how we learn, and how we deal with difficult situations (talking out patient deaths, venting about situations in which we were not treated well). You may even end up using patient stories to explain a difficult situation come interview day. As long as the patient can't be identified, it's fine. The hard part is figuring out what information can identify the patient and being aware of who is around you when you talk. In my example, I could've seen the patient today or 5 years ago, but if you're talking about current patients in the hospital, or ones who have recently been discharged, it's a lot easier to connect the dots.
     
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  11. Kochanie

    Kochanie

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    My main concern is when I go into a room with a patient and come out and volunteers clearly see and know who it is. It might not violate HIPAA but it's sill kind of uncomfortable.
     
  12. tantacles

    tantacles Lifetime Donor SDN Moderator 7+ Year Member

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    That's not something you can control. Opening a door to leave a room will never and can never be a violation of HIPAA.
     
  13. Kochanie

    Kochanie

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    And then talking about their history, issues, etc to others is the uncomfortable part.
     
  14. tantacles

    tantacles Lifetime Donor SDN Moderator 7+ Year Member

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    Again, that's the part you have control over. If you feel you might compromise HIPAA, don't disclose.
     
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  15. LizzyM

    LizzyM the evil queen of numbers SDN Advisor 10+ Year Member

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    If it is necessary for patient care, then you can discuss it. You might have to say, "The patient in Rm 212 needs some help understanding how to do a clean catch... does someone here speak Serbian?"
     
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  16. Goro

    Goro 5+ Year Member

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    My clinical colleagues do this all the time in this manner: "I had a patient who had a spinal abscess after playing touch football"...or, "I was the attending for a 97 year old guy with an esophageal bleed, and ..."

    Just be generic. VERY generic.



     
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  17. Lifeman

    Lifeman 7+ Year Member

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    In my personal statement, can I write something about the medical condition of one of my old teachers if they were a patient at my hospital while I was volunteering? Like "I was shocked that my old English teacher had high blood pressure".
     
  18. tantacles

    tantacles Lifetime Donor SDN Moderator 7+ Year Member

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    If you want to relate a story about someone you knew that you treated in the hospital, referring to them as a friend or acquaintance might be the safer option. "Old English teacher" is pretty specific.
     
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  19. WillburCobb

    WillburCobb I am the pull out king Banned Account on Hold 5+ Year Member

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    They have Old English teachers:confused:???
    [​IMG]
     
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  20. mehc012

    mehc012 Big Damn Hero 2+ Year Member

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    To me, this is the sort of thing that HIPAA was made to prevent. It was out of your teacher's control that you, someone they knew, happened to work in the hospital they needed to go to. Because of that, you are now able to identify them and discuss their medical information.
     
  21. pkwraith

    pkwraith 5+ Year Member

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    Your fellow volunteers are covered entities at the same organization. Covered entities can obviously talk about their patients, as well as use as much PHI as much they need to for their job. Even if they accidentally reveal PHI to a non-covered entity, it's not a HIPAA breach if it's for example unintentional (if the breech is limited and they were acting in good faith) or unretainable (non-covered entity overhears something they would not comprehend or retain). Obviously, those explicit exclusions don't apply to written applications (anything written is pretty easily retainable). But, volunteers talking about a patient while using common sense has a pretty reasonable buffer zone.
     
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  22. Kochanie

    Kochanie

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    Got it! Thanks guys. :)
     
  23. LizzyM

    LizzyM the evil queen of numbers SDN Advisor 10+ Year Member

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    Don't refer to anyone as "old". It might be better to say, "my former teacher" -- fewer characters and less specific than describing a subject taught by the teacher. (As an aside, why would you be shocked that someone has high blood pressure-- it is one of the most common medical conditions in America.)
    On the issue of naming names:
    I knew of an applicant who gave the first name of a disabled child he'd interacted with as a school volunteer. The school's name was in the experience section. The adcom member reading the application immediately recognized the child -- it was her son who had died earlier that month!
    It's a small world, you never know who will read your essay and recognize someone they know. I once had someone write a secondary essay naming and describing my brother as the embodiment of the ideal physician -- we don't have the same last name and we aren't at the same school so it wasn't a suck up move... actually we found it rather touching -- and hilarious. I recommended the applicant for interview so we could see if Dr. D's' suturing skills were as good as his bedside manner. ;)
     
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  24. masaraksh

    masaraksh 5+ Year Member

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    That must have been horrible, I can't believe that happened. Oh and way to end that sentence with an exclamation mark...
     
  25. LizzyM

    LizzyM the evil queen of numbers SDN Advisor 10+ Year Member

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    It knew the mom. Of course, it was tragic to lose her child to a sudden illness. She was comforted to know that someone had been inspired by her child and was pursuing a career in medicine to take care of kids like that. Nonetheless, she handed back the file and asked that someone else review it.
     

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