HIPAA in the ER: Exceptions, suggestions for compliance in a chaotic clinical setting

The emergency room (ER) is one place where unpre­dictability is the norm, where critical and noncritical cases walk through the same doors, and where 2 a.m. on a weekday can resemble Grand Central Station at rush hour.

 

HIPAA requirements only further complicate work in the ER if you don’t have the right policies and proce­dures to address known challenges.

 

“Chaotic settings do not mean sloppy use and sharing of PHI [is acceptable],” says Susan A. Miller, JD, chief operations and privacy officer of HealthTransactions, Inc. Staff members will have trouble if their guide to HIPAA compliance in the ER consists of imprecise procedures and sloppy training, she says.

 

Misconception about what HIPAA permits and does not permit ER staff members to say and do often presents a far greater challenge than the frenetic pace of their work envi­ronment, says Michael Tulloch, MD, an internist at a private practice in Potsdam, NY. “Most healthcare workers in the ER go too far and are not willing to discuss a patient’s condition [when they should],” he says.

 

For example, when a patient is unconscious due to al­cohol poisoning, a family member, usually a parent, will often request information. “Often, the parents are not informed because the health­care worker fears violating HIPAA,” Tulloch says. “Health­care workers need to be educated as to their freedom under HIPAA, as well as when and from whom to protect the information. I am afraid this education is lacking.”

 

Real-life scenarios are ideal training tools, even in the form of a quick pop quiz. Occasionally, ask staff mem­bers how they would respond in various situations. This will facilitate staff members’ awareness of HIPAA and en­courage them to think about the appropriate response instead of hiding behind HIPAA.

 

Oral communication is another topic that requires fre­quent review. Teach staff members what constitutes oral communication and how to protect it, Miller says. This training must occur periodically.

 

Your policy should require education for ER staff mem­bers to ensure that they comply with HIPAA and that they understand when it does not apply in the ER.