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Three patient-request scenarios

HIPAA Weekly Advisor, March 29, 2004

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Scenario one:

Q: A patient says she wants to see a list of every doctor and nurse who looked at her record during her three-day hospital stay because she has a right to an accounting of disclosures. Are you required to give the patient this list?

A: No. An accounting of disclosures does not have to include uses of the
record for treatment purposes. If the patient suspects that a staff member inappropriately viewed her medical record, she can file a complaint with either the privacy official or the appointee in charge of handling
complaints.

Scenario two:

Q: A patient requests that his name and information not be included in the hospital's directory. A woman asks for that patient by name, identifies herself as the patient's mother, and shows the name on her driver's license to prove her relationship to the patient. What can the clerk tell the patient's mother?

A: Unless the mother is known to caregivers and has been actively involved in her son's care during this hospital stay, the clerk is not permitted to tell her anything.

Hospital staff are not permitted to give out any information about a patient who requests to not be included in the directory, regardless of the
requestor's relationship to the patient.

To avoid a customer-relations problem, provide a copy of the notice of
privacy practices to the mother. Explain that your patients' privacy is of
the utmost importance, and if any patient requests confidentiality, you must abide by that request.

Scenario three:

Q: A patient who receives psychiatric counseling as well as treatment for diabetes at your hospital requests a copy of his medical record. Should the documentation from the psychiatric counseling sessions be removed before providing access to the record?

A: No. Special treatment applies only to psychotherapy notes, which are very narrowly defined under HIPAA. They must be kept separate from the rest of the patient's medical record to qualify. The patient has a right to see the rest of the documentation of his psychiatric treatment including, but not limited to, medication prescription and monitoring, the types and
frequencies of treatment, results of clinical tests, prognosis, and progress
to date.

This week's Q&A adapted from the "HIPAA Training Handbook for HIM Staff: Privacy, security, and patients' rights under HIPAA." Visit
http://www.hcmarketplace.com/Prod.cfm?id=1307&S=EHPAA for more information
or to order.

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