By Tom Gross
Marin Independent Journal (California)
Copyright 2006 Marin Independent Journal, a MediaNews Group publication
All Rights Reserved
Editor’s Note: Dr. Tom Gross is the emergency medical services director for the Novato (CA) Fire Protection District.
I tried to get the results of some blood tests that I had undergone recently. I called the lab. I asked for a copy of my results.
“We’re sorry, sir, I cannot give you that Information.”
I protested, claiming that it was my blood to begin with, and that I had paid for the blood test. However, I was informed that, if the lab gave me my lab results, that they would be in “violation of HIPAA.” However, I thought that I had signed a release of information. It turned out that the release that I had signed only authorized release of my results to the health insurance company. In other words, my health insurance company could know my cholesterol level, but I could not.
As a part of the Health Insurance Portability and Accountibility Act, or HIPAA, of 1996, Congress called on the Department of Health and Human Services to issue standards for the protection of patient privacy. These regulations limit the ways that health plans, pharmacies, hospitals and the medical industry can use and distribute patient information.
One part of the regulation dictates that health-care providers must notify their patients how medical information is used. Patients are asked to sign a release stating that they have received this notice. When I had my blood drawn, I signed the HIPAA form and received a seven-page printed document in return. Every patient transported in an ambulance, no matter how sick, must be offered the opportunity to sign this HIPAA release form. So, picture us taking care of you in the back of our ambulance. One of us is starting your intravenous line. One of us is doing an electrocardiogram. One of us is listening to your heart and lungs. We have to take care of you, talk on the radio to the hospital and also document all our findings on another form.
Then, we have to talk to you about HIPAA. No matter how sick you are, we have to talk to you about HIPAA, and we have to encourage you to sign the privacy act’s release. This is not a consent form for treatment. This is a form that acknowledges that we have complied with the law by informing you of our privacy protection practices. If you are unable to sign the release, then we have to document that on the form.
I am in favor of protecting patient’s privacy and dignity. However, the requirement that we interrupt our care of a very sick person in order to obtain a signature, acknowledging the receipt of privacy information, is absolutely absurd.
Although it started as a good idea, HIPAA has gotten out of control. A nursing student was reprimanded for violating the privacy act after she was seen reviewing her very own medical record. A health department representative refused to disclose to a newspaper the number of influenza cases in the county, incorrectly citing that it would be a HIPAA violation.
When the paramedics have completed care and transport of an extremely sick patient, they often want to know the outcome. They want to know if they did everything correctly. Hospitals and EMS agencies have procedures in place that allow this information to be passed in compliance with HIPAA. According to the act’s regulations, “sharing information for treatment or health care operations is not a violation of HIPAA.” Yet, often I am prevented from getting this information by staff members who are misinformed about the privacy act, and fear for their jobs if they should release the information.
I recall that Winston Churchill, referring to the political situation in eastern Europe first coined the phrase “Iron Curtain,” symbolizing the loss of communication between East and West. Churchill’s Iron Curtain has long since rusted away, but it has been replaced by the Iron Curtain of HIPAA, which has fallen across our landscape.
It is now harder than ever to obtain information about our patients. It is ironic that these regulations were enacted in order to protect patients and may end up having the opposite effect.