HIPAA question

[MonkeyArrow]

So I have a few questions regarding HIPAA and its use in a hospital setting. Background: I work in a hospital ER, signed all the HIPAA papers, confidentiality went through the orientation, etc. However, I do not personally have access (a login) to our online radiology viewing software.

So, if a treating physician shows me the images for teaching purposes (not officially, not a teaching hospital but still teaching me about reading the image), is it a HIPAA violation? The doctor surely has access to the images for treatment purposes but under the healthcare operations clause, does that entitle me to view them with the doctor? (Same thought process as QA/QI, I THINK it falls in the same boat.)

Now if the physician views images of other patients in the ED that they are not the assigned provider on, is this a HIPAA violation?

 

[OnceAnEMT]

In either case, if no Pt identifying information is present on the image/screen, then neither is a HIPAA violation.

If identifying info is present, I am certain that the 2nd scenario with the doctor viewing an image that is not of his patient is a HIPAA violation.

About you viewing the image, I'd say it is gray area. Personally I will spin it and say that because I am the only Tech on the floor I am part of this patient's continuum of care. That said, since I am the one doing the splints, I always get a look at the xray if it is still on the screen since it makes my job easier, in addition to speaking with the physician about specific customizations.

 

[JWalters]

What is your position in the ED?

The second situation, it is definitely a violation. The first depends on a variety of factors but if you truly looking at the law if it is not a teaching hospital and you are not part of the care team for this patient and/or the information doesn't affect your care of the patient it is a violation. I would think that if you were meant to ever view any images, possibly, you would have access.

Although, that is a little unusual compared to my experience because the images were always part of the digital chart where I worked so that aspect may just be different.

 

[OnceAnEMT]

Although, that is a little unusual compared to my experience because the images were always part of the digital chart where I worked so that aspect may just be different.

I wish. Where I am at all images are part of some fancy software that I can't think of the name of, which is only accessed on certain computers by the physician's stations. Radiologist reports are part of our chart, though.

 

[MonkeyArrow]

Tech in the ED. We use EPIC for patient charting and we view our digital images on a different program. The thing is also that we have specialized monitors that are vertically oriented and black and white dedicated to images only. Like Grimes, we have access to the radiologist's report in the chart. But with access to the images, it allows you to teach yourself by looking at the image and then at the report seeing what you got right, wrong, etc.

Another thing is that if this is a violation, what is actually going to be done about it? I can almost guarantee that HIPAA violations take place daily across every EMS system/hospital/whatever. Who's actually going to do something about it as long as you aren't doing anything maliciously? Nobody.

 

[Rialaigh]

If your a tech in the Ed, and you have rooms 1-10 for example, then within reason any information on any patients chart in 1-10 is information that you have access to with no problems. Any information on patients in 11-20 really you probably could argue you should have access to as well.

When I worked as an ED tech we frequently covered each others rooms. We always had to pile in to assist with CPR, RSI's, Splinting, Cleaning wounds, Laceration repair, Simple Amputation of Digits, Wound packing, Surgical drains, Chest Tubes, Central Lines, LP's, etc..etc..etc...At any given time during the shift I might or might not be in a room assigned to me, therefore I had no personal issues looking at charts on any patient that I had an interest in within the ED because at some point it was likely I would interact with that patient.

As far as what are they going to do about it...basically nothing without you disclosing the information to social media, newspaper, friends and family...etc...

 

[JWalters]

Another thing is that if this is a violation, what is actually going to be done about it? I can almost guarantee that HIPAA violations take place daily across every EMS system/hospital/whatever. Who's actually going to do something about it as long as you aren't doing anything maliciously? Nobody.

See now, I'm not a big supporter of HIPAA as written. I follow it because I have to, but I don't agree with much of it.

So in answering the questions, sure there are some violations there. Do I care? No. I wouldn't care if I were the patient whose scans you were looking at either. And I am quite sure that nothing will be about it and that no one, actually, really cares except the regulatory idiots who wrote the policy. Still a violation though