Health Information Management

Q&A: X-ray results

HIM-HIPAA Insider, June 22, 2009

Q. An employee health nurse for a hospital is authorized access to patient medical records and related PHI. The employee health nurse is responsible for workers’ compensation case management. The same nurse is the head of tuberculosis (TB) surveillance. The hospital’s employee health department orders chest x-rays for employees and volunteers who have tested positive for TB. May this nurse access employees’ and volunteers’ chest x-ray results?

A. Given that the nurse would be accessing the chest x-ray results as the employer (versus in the capacity of a covered entity), and the sole purpose for accessing the x-ray is to determine whether the employee or volunteer contracted TB, the nurse could access the information.

This represents a safety issue and is related to employment in the hospital. When a covered entity is acting as the employer, such access is not a HIPAA violation (this is similar to obtaining medical information related to the Family Medical Leave Act). Again, the organization should reasonably ensure that such access is truly employment related.

Editor's note: Chris Apgar, president of Portland, OR-based Apgar & Associates, LLC, answered this question. This is not legal advice. Consult your attorney regarding legal matters.



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