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Old 06-04-2011, 03:23 PM
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Default Proposed Rule Would Let Patients See Who Accessed Their Electronic Health Data

Patients would have the right to request and receive a record of who accessed and viewed their electronic protected health information in a proposed change to the Health Insurance Portability and Affordability Act's Privacy Rule.

Under HIPAA, healthcare organizations are already required to track access to patient data contained in electronic records, but they're not required to disclose this access information to patients. The proposed rule change, part of the Department of Health and Human Service's implementation of the 2009 HITECH Act, "represents an important step in our continued efforts to promote accountability across the health care system, ensuring that providers properly safeguard health information," says HHS Office of Civil Rights Director Georgina Verdugo in a press release.

The proposal, currently up for public comment, would give patients the right to 2 types of information: an "access report," which would tell them who has accessed their protected health information "for purposes of treatment, payment and health care operations" in general, but would not divulge the specific purposes for each person's access; and an "accounting of disclosures" that would provide more detailed information about disclosures "most likely to impact the individual," such as disclosures to law enforcement or legal authorities, as well as the purposes of such disclosures. If the rule takes effect as written, healthcare organizations would have to update the HIPAA privacy notices they give to patients, beginning Jan. 1, 2013, to inform them of these rights and how they can go about requesting access reports, reports Medscape Medical News, quoting an anonymous HHS spokesperson.
"The changes being proposed will impact physicians," says the spokesperson. "We strongly encourage them to read the rule in the Federal Register and give us their feedback during the comment period. We want to hear from small and mid-sized providers on what they expect the impact will be on their practices."
HHS notes that "only a small minority of individuals" tend to exercise their right to an accounting of protected health information disclosures and that healthcare organizations are already required to log all the information that would be contained in an access report, so "there should be minimal, if any, changes to existing information systems." The proposal also shortens the length of time for which providers must account for disclosures from 6 years to 3 years.
The agency is accepting public comments on the proposal through Aug. 1, 2011.
http://www.outpatientsurgery.net/new...ic-Health-Data
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Old 06-04-2011, 10:42 PM
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I wonder if this will change things for students... that would make me scared to look in charts. lol.
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Old 06-05-2011, 12:33 AM
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If the PHI belongs to one of your patients and you have a need to look at their PHI then there is no problem. The issue is if you look at a patients PHI that is not your patient then that is considered a violation (snooping) for which you can be fired, suspended, or written up.

Years ago before HIPAA nurses would look through charts just for the heck of it when it was slow. I would look at them to try to learn from their symptoms as compared to their diagnosis, their labs, their radiology reports etc. With the event of HIPAA that all came to a screeching halt. I do think HIPAA is a good thing but sometimes it's carried too far.
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Old 06-05-2011, 06:18 AM
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I see a major flaw with this: Who is going to protect the information (names/identities of those who legitimately access PHI) that is in the hands of the patient. There needs to be some regulations on what the patient can do with that info in the same manner health professions have (eg, need to know, only essential information). I envision an ER druggie and/or frequent flyer is going to have a field day with getting names/identifying information on every salaried (income generating and potential property owning) person who sees them in the hospital and would be given the potential to sell or use that info for personal gain.
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Old 06-05-2011, 08:32 AM
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Quote:
The proposal, currently up for public comment, would give patients the right to 2 types of information: an "access report," which would tell them who has accessed their protected health information "for purposes of treatment, payment and health care operations" in general, but would not divulge the specific purposes for each person's access; and an "accounting of disclosures" that would provide more detailed information about disclosures "most likely to impact the individual," such as disclosures to law enforcement or legal authorities, as well as the purposes of such disclosures.
I can't imagine any of that information would be available to the patient,
I would think it would be only need to know info such as Jane N, RN in ER, etc...
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Old 06-05-2011, 09:43 AM
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We have been told many times not to be accessing any information on patients if we have no business doing it.
The only patients that I access that are not mine are those I go out on call to visit. I would not like any Tom Dick or Harry looking at my PHI.
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Old 06-05-2011, 04:21 PM
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Quote:
Originally Posted by DutchgirlRN View Post
If the PHI belongs to one of your patients and you have a need to look at their PHI then there is no problem. The issue is if you look at a patients PHI that is not your patient then that is considered a violation (snooping) for which you can be fired, suspended, or written up.

Years ago before HIPAA nurses would look through charts just for the heck of it when it was slow. I would look at them to try to learn from their symptoms as compared to their diagnosis, their labs, their radiology reports etc. With the event of HIPAA that all came to a screeching halt. I do think HIPAA is a good thing but sometimes it's carried too far.
Yeah, sometimes I have instructors who will do that for us. But, I always go by with "what happens at clinical, stays at clinical."
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