New privacy rules designed to protect patient information

November 23, 2003|HERB BROCK

You took a series of laboratory tests and X-rays to help your doctor determine what's causing some respiratory problems. You're told that the results will be ready on a certain day, but when that day comes, you'll be out of town. No problem. You have an answering machine hooked to the phone and it can retrieve the information.

When you get home, you check your messages and there is one from your doctor's office. The person making the call says the following: "This is nurse Jane Adams from Dr. Smith's office and this call is for John Jones. Please call us at 555-1234."

You were expecting to hear "nurse Adams" tell you if the tests and X-ray were negative or positive and even give you at least a hint of what tests mean in determining your condition. After all, such information is fairly routinely related by phone from doctors' offices to patients, both at home and at their places of work.


Not any more. Not since the implementation in recent months of the Health Insurance Portability and Accountability Act, which established the first federal privacy standards for medical information. In fact, because of HIPAA, you might not even get a message asking you to call the office. And even if you are at home to answer the call in person, you may only be told to call the office and won't get information about the test results.

It's not that medical professionals and their office staffs - long promoters and protectors of the sanctity and sacredness of the doctor-patient comnfidentiality tenet of medicine - were blabbers or gossips. But, among many other things, the HIPAA privacy standards have caused doctors' offices to be even more careful about handling, transmitting and disseminating patient information, down to the signatures of patients on the sign-in pads where they write their names when they arrive at an office for a routine appointment.

A random survey of a dozen area doctors' offices shows that staffs have always been protective of patients' medical information, but are taking steps required by HIPAA to ensure privacy. They had kept their lips sealed in most cases. Now under HIPAA, they're practically clamped shut.

"We have always been sensitive about handling patient information, but HIPAA has caused us to keep our guard up even more," said Skarlett Hardesty, office manager for Dr. Finley Hendrickson and his colleagues at Danville Family Physicians.

"HIPAA has caused some changes," Hardesty said. "For instance, in the past, if you called and wanted the results of some tests that had been done on your spouse and if we knew you and your spouse, we likely would have given the results to you over the phone.

"Now, we not only wouldn't give the results to you, we probably wouldn't give them to your spouse. We'd specifically call your spouse and ask him or her to call the office to set up an appointment for them to come in. That's all we would say."

Here are some of the steps being taken

Here are some of the steps area doctors' offices have taken to protect patient information privacy, as required under HIPAA:

* Like the situation described by Hardesty, doctors, nurses and staffs no longer will give out test results or any other information over the phone, either to the patient or an answering machine. Most will simply identify themselves and tell the patient to call the office or leave a message to that effect.

* Some doctors, nurses and their office staffs now are even declining to leave messages of any kind on answering machine, even simple requests for patients to call offices.

* Those offices that had been mailing appointment-reminder postcards to patients have discontinued the practice. They will call a patient's home or workplace only if the patient misses an appointment.

* Offices are even being more discreet with the patient sign-in sheets. Once the patient has signed in, some office workers will quickly write the name down on their own pad and use a heavy black mark to blot out the name on the sign-in pad so no other patients or any one else in the waiting room can see it. Others no longer keep sign-in pads, or keep them inside the office, out of a patient's view.

* Patient charts routinely are placed by doctors and nurses inside the examining area of the office on a desk or counter, as they go from one examining room to the next. Office staffs now will close the chart folder or the lid to the metal clipboard-like container the chart is in if they're open and turn the chart folders or containers around to esnure that no other patients, who also may be walking around the examining area, can see the medical information inside them.

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