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Mailing Lab Results, Hippa?


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Hey all -- my SP recently stopped mailing lab results and other pt info after a patient complained that "someone could have read their mail."  

 

I'd really hate to put all the call backs on my nurse -- we work in a rural health clinic and most of my patients do not have a reliable cell phone or house phone for contact. We typically send a letter stating something like: 

 

"The PA has reviewed your recent lab work and would like to start X , which has been sent to your pharmacy." 

 

I think for now I will continue with letters.  My thought is that US MAIL is considered confidential and anyone who knowingly opens another person's mail is in violation of the law, which I cannot control. 

 

Anyone have a better idea/thoughts? HIPPA proof?

 

Thanks, 

 

SCPA

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First class mail is assumed to be confidential by default, and is how all sort of PHI, tax info, and every other bit of sensitive info under the sun is mailed.  If the patient is worried about someone else opening their mail, then the problem is on their end--they can get a locking PO box if they want. Your SP should have instead referred the complaining patient to psych for evaluation of possible paranoia, rather than try and re-engineer clinic data flow based off of one unreasonable complaint.

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HIPAA

 

Are you guys mailing all labs or only when the pt requests?

 

 

No , but like I said we use mail to addressing abnormals and med changes .. i.e. We will mail a letter saying their vitamin D was low and we sent them a prescription to the pharmacy. 

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We don't mail labs but anytime we communicate via mail with a patient over their medical care, it is always sent by certified mail requiring a signature from the recipient.

And what DO you mail certified?  You're the practice owner, so what makes you believe that the added expense is worthwhile?

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The DEA sends me my renewal in the dumbest of all envelopes with exactly what is inside written on the outer envelope.

It SCREAMS steal me in the mail.

 

I have always sent my patients lab letters. Centricity was good enough to do little charts showing trends in lipids or glucose.

In 25 years, a patient has never complained about a lab result being mailed to them.

Now, there are patient portals which have ZERO interpretive notes and patients can make up whatever they think about a CO2 that is one point out of normal or a chloride value that means nothing clinically.

 

I would ask the patient if we, as a practice, can mail lab results with a letter and have them sign to that affect in the chart. For those that say no - they get to come in for a copay and a visit to have labs interpreted.

 

Unless patients develop implanted wifi receivers in their heads to look on Google Glass - some stuff just has to happen.

 

Fine line between reasonable and paranoid..........................

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Rev, I think your are right. This is what I got from a Hipaa website:

 

Q. I work at a teaching hospital affiliated with one of the nation's top universities and medical schools.

Our emergency department staff forgot to return a patient's insurance card and mailed it to the patient via regular first-class mail without notifying her that they were doing so. A few days later, the patient was traveling when she discovered that the insurance card was missing. She called our emergency department and was told the card had been mailed to her home address.

The patient said she understands that mistakes happen occasionally, but that she was far more upset by our failure to contact her and ask her preference for returning the card than by our initial failure to return it while she was at the hospital. The patient said that had we called her, she would have come to the hospital to retrieve it and that she would have done so promptly because of her imminent travel plans.

Did we do the right thing by sending the ­insurance card via regular first-class mail without calling the ­patient first? Should we have sent it via certified mail or in some other manner that required a signature confirming receipt?

Also, should our privacy policy address situations like this?

A. This amounts to a violation of patient preference versus a violation of the privacy or security of the patient's information. There is no regulatory requirement to contact the patient before sending back a left-behind insurance card. First-class mail is protected by federal mail tampering laws, so intercepting and ­fraudulently using another individual's insurance card would amount to a criminal act.

There is no need to change your privacy policy in an effort to comply with state or federal law. HIPAA represents the privacy and security floor-you need to at least comply with HIPAA. You may implement more stringent privacy practices if you wish, and this could include a procedure that requires a call to the patient before sending that left-behind insurance card back. Implementing such a procedure would probably lead to a happier patient, but it's not legally required.

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