quietmedic Posted April 13, 2016 Share Posted April 13, 2016 Hey all. Question about Hipaa: If we are working in an ED, and a primary care office calls to find out information about their patient, may we disclose it? Does it matter if we can verify who is calling by the caller ID or by information only the PCP would know? How does it differ, legally, from if WE call the PCP ourselves? Thanks... Link to comment Share on other sites More sharing options...
cop to pa Posted April 13, 2016 Share Posted April 13, 2016 Just spit-balling here: has the pt. Authorized release of the medical info? Can the MTF be independently verified or confirmed? Caller ID can be faked these days by free phone apps. A fax on letter head with an identifiable fax receipt number, or a call back to a verified number may be safer. An email address from a medical institution (i.e. @hopkinsmedicine.org or @massgeneral.org)? Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 13, 2016 Moderator Share Posted April 13, 2016 HIPPA SHOULD NEVER INTERFERE WITH DELIVERY OF CARE!!!!!!!!!!!!! This is truly a pet peeve of mine - I sent a patient to the ER, then called to check up and they refused to give me an update, then the ER doc gave him opiates against my advice. needless to say when the patient called back 4 days later for a refill I directed him to his physician in the ER I called everyone short of the CEO in the hospital and got no where..... stupid.... but that hospital ended up closing with out notice a few months later - there were HUGE issues If the ER is in doubt - you call them - and then no issue - or ask for a bunch of info they would know - ie dea and state lic # Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted April 13, 2016 Share Posted April 13, 2016 Malpractice case from years back where ED physician disclosed info to PCP that pt. didn't want relayed. Jury found in favor of pt.. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 13, 2016 Administrator Share Posted April 13, 2016 http://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/disclosure-to-health-care-provider-for-treatment/index.html Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 13, 2016 Administrator Share Posted April 13, 2016 Malpractice case from years back where ED physician disclosed info to PCP that pt. didn't want relayed. Jury found in favor of pt.. That'd be interesting to see. Can we get a cite for that? The apparent solution, if this proves to be correct, is to have the intake form give a 1-year blanket grant for EVERYTHING from any other provider to PCP office, for any reason at all, without notice to patient. And then a renewal clause to every visit form. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted April 13, 2016 Share Posted April 13, 2016 Malpractice case from years back where ED physician disclosed info to PCP that pt. didn't want relayed. Jury found in favor of pt..T This wouldn't surprise me because a) Lawyers are dirtballs who will take money from any source they can, b) our court systems are hopelessly broken, and c) jury's are stupid. All we can do is practice medicine to the best of our abilities despite the legal environment. However I don't think HIPAA violations are malpractice cases. Link to comment Share on other sites More sharing options...
CAAdmission Posted April 13, 2016 Share Posted April 13, 2016 If you're not sure, put the doc on the phone with the patient. They can chat and confirm identities and you can take over. I especially like doing this if I get one of these "I won't talk to a PA" docs on the phone. Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 13, 2016 Moderator Share Posted April 13, 2016 Malpractice case from years back where ED physician disclosed info to PCP that pt. didn't want relayed. Jury found in favor of pt.. would not believe this till I saw specific case law sounds way fishy and I am sure every ED in the country would have stopped autofaxing reports if it were the case... Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 13, 2016 Moderator Share Posted April 13, 2016 If you're not sure, put the doc on the phone with the patient. They can chat and confirm identities and you can take over. I especially like doing this if I get one of these "I won't talk to a PA" docs on the phone. What??? Is there some super power ring that a doc can only be the one to ID another doc? Only way I would do this deference of control - would be if they knew each other prior - otherwise it is my mess, I will clean it up.. Link to comment Share on other sites More sharing options...
sas5814 Posted April 13, 2016 Share Posted April 13, 2016 It is a sticky subject and can get pretty frustrating. I work in a rural area and had a patient coming in for a hospital follow up and I had the staff call and ask for the relevant records to be sent so I could read up ahead of the visit do a proper follow up. They refused stating they needed a written request signed by the patient. I explained it is continuity of care, HIPAA exception etc all to no avail. I understand their concerns. It could have been anyone on the phone but still frustrating... So when the patient arrived I got them to sign a form and faxed it with a cover and we waited and about an hour later the records finally arrived. Just to illustrate a point I made several fax cover sheets for the Mayo Clinic, Presbyterian Hospital, UCLA Medical Center and a couple more, killed the caller ID on the fax line, and faxed them to the same office with the note "anyone can make a cover sheet and form. It proves nothing." I know...adolescent... As for doctors not talking to anyone but doctors...I worked as the sole provider in a critical access ER with the local Docs on backup. I can tell many stories of ER docs and specialists in the big city asking me "why are you calling? Where is your doctor" when I was trying to get someone transferred. My usual response was "at home in bed but he doesn't know anything about the patient." IMHO people have gotten so HIPAA frightened they just don't know how to act anymore. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted April 13, 2016 Share Posted April 13, 2016 see image Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted April 13, 2016 Share Posted April 13, 2016 would not believe this till I saw specific case law sounds way fishy and I am sure every ED in the country would have stopped autofaxing reports if it were the case... Believe as you wish folks. It may have been one of the legal scenarios as brought up in Clinical Advisor. It was read by myself back around my ED days and was a topic of conversation in the department (HIPAA effective 2003). Sorry I can't quote the case for you. Again, it wasn't providing information related to the purpose of the visit but information that was provided to the ED staff in confidence that didn't need to be relayed to the PCP, such as a secondary medical problem/dx.. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 13, 2016 Administrator Share Posted April 13, 2016 It's not that we don't believe you, because courts are inconsistent and cases are weird, but I'd really like to see the case so we can see *what* *exactly* the conduct was, how it was determined to be inappropriate, and what penalty was assessed. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted April 14, 2016 Share Posted April 14, 2016 No offense taken. It was a while ago and I just remember the interest that it created with the physician group. Something along the lines of the pt. had an STI in his PMH or some such that was somehow relevant to the visit but that he had never shared with his PCP, who may have been a personal friend as well as I recall? Any way, this information was somehow relayed to the PCP. I tried to Google it but there were too many variables without enough specific information to localize the search. The main take away that I meant to pass along in the initial post was make sure to stick to the relevant details of that particular visit and make sure that the pt. is aware that you are contacting their PCP. Link to comment Share on other sites More sharing options...
HopefulPA Posted April 19, 2016 Share Posted April 19, 2016 I'd just like to add (and I don't work in the ER) but if a PCP is going to send a patient to the ER, they can always call the ER and give the ER a heads up of a patients history and why your sending them.... I am willing to bet they'd be more cooperative in providing you with an update. Link to comment Share on other sites More sharing options...
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