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Old 01-27-2013, 11:04 AM   #151
dbrn
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Originally Posted by DisneyATlast View Post
I don't see anything "stupid" about a mother contacting another mother to try to resolve a problem (that may or may not even be a problem) before involving everybody and their brother. Everyone has a right to their own opinion.

I think the majority of people in general are a little naive when it comes to HIPAA though. Everyone is making something that is very complex seem so cut and dried. It's not. Just because you didn't meet a person and shake their hand doesn't mean that they were not "involved in your care" or that they don't have the right to access your record.

Who's to say that an MD from hospital ABC didn't request that an MD (mom?) at hospital XYZ look at the CT and collaborate about the findings? The "minimum extent necessary" and all those other phrases you'll find throughout HIPAA are determined by the providers, not the patients. Everyone seeking medical care signs papers that say just that.

So, even if the mom's name is on this list that everyone thinks is going to be a piece of cake to obtain, that doesn't automatically mean that she violated HIPAA. Assuming that the mom did access the record and had a reason to do so, it would be nearly impossible to prove that she said anything to her daughter. Thankfully, people can't lose their jobs because Bobby's mom said that Suzy's mom did such and such.

More than one person would have to be involved in MD mom's ability to obtain records that she shouldn't have access to. She couldn't just go and pull up the record from another hospital on her own without any help. Help being someone at the other hospital giving her access, and I just don't believe this high school rumor is really the conspiracy that it would have to be for this story to be true. It'll be interesting to see what the outcome is either way.
This is exactly why I recommend telling the privacy officer exactly what the concern is so that the concern can be investigated fully, not just relying on an audit trail list as interpreted by a layperson. The privacy officer will conduct the investigation thoroughly, taking the audit trail and any other supporting information into account, and no one will get in trouble if nothing was done wrong.

Even if the doc had good reason to look at the record, it would still be inappropriate to pass that information along to her daughter.
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Old 01-27-2013, 11:05 AM   #152
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Sorry, I don't get this. What good does calling the mom do? If she says "yes, I looked and told my DD", shouldn't she be punished? If she says "no, I didn't look", you don't know if she's lying or not.
As I said, if she's not satisfied after talking with mom then the record is still going to be there. What is there to LOSE by talking to the mom directly?

Some people are good at reading other people's reactions, tone of voice, etc. If the MD mom is shocked and has no idea who this person is contacting her then that would be a good sign (to me anyway) that it isn't true and not worth dragging everyone (including the child/victim) through the mud.
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Old 01-27-2013, 11:07 AM   #153
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Originally Posted by DisneyATlast View Post
I don't see anything "stupid" about a mother contacting another mother to try to resolve a problem (that may or may not even be a problem) before involving everybody and their brother. Everyone has a right to their own opinion.

I think the majority of people in general are a little naive when it comes to HIPAA though. Everyone is making something that is very complex seem so cut and dried. It's not. Just because you didn't meet a person and shake their hand doesn't mean that they were not "involved in your care" or that they don't have the right to access your record.

Who's to say that an MD from hospital ABC didn't request that an MD (mom?) at hospital XYZ look at the CT and collaborate about the findings? The "minimum extent necessary" and all those other phrases you'll find throughout HIPAA are determined by the providers, not the patients. Everyone seeking medical care signs papers that say just that.

So, even if the mom's name is on this list that everyone thinks is going to be a piece of cake to obtain, that doesn't automatically mean that she violated HIPAA. Assuming that the mom did access the record and had a reason to do so, it would be nearly impossible to prove that she said anything to her daughter. Thankfully, people can't lose their jobs because Bobby's mom said that Suzy's mom did such and such.

More than one person would have to be involved in MD mom's ability to obtain records that she shouldn't have access to. She couldn't just go and pull up the record from another hospital on her own without any help. Help being someone at the other hospital giving her access, and I just don't believe this high school rumor is really the conspiracy that it would have to be for this story to be true. It'll be interesting to see what the outcome is either way.
But if her name is on the list then it would be the job of the Privacy Officer to determine if she was legally allowed to access the records. The OP will not have to do anything but let them know she wants to know whether they had authority to access his records and why?
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Old 01-27-2013, 11:08 AM   #154
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This is exactly why I recommend telling the privacy officer exactly what the concern is so that the concern can be investigated fully, not just relying on an audit trail list as interpreted by a layperson. The privacy officer will conduct the investigation thoroughly, taking the audit trail and any other supporting information into account, and no one will get in trouble if nothing was done wrong.

Even if the doc had good reason to look at the record, it would still be inappropriate to pass that information along to her daughter.
It would definitely be inappropriate to say the least, but proving that it happened would be difficult if not impossible to do.
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Old 01-27-2013, 11:08 AM   #155
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As I said, if she's not satisfied after talking with mom then the record is still going to be there. What is there to LOSE by talking to the mom directly?

Some people are good at reading other people's reactions, tone of voice, etc. If the MD mom is shocked and has no idea who this person is contacting her then that would be a good sign (to me anyway) that it isn't true and not worth dragging everyone (including the child/victim) through the mud.
If she contacts the Privacy Officer and follows protocol nobody is being "dragged through the mud". It is all done privately and nobody is the wiser unless they find an issue.
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Old 01-27-2013, 11:09 AM   #156
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Originally Posted by DisneyATlast View Post
I don't see anything "stupid" about a mother contacting another mother to try to resolve a problem (that may or may not even be a problem) before involving everybody and their brother. Everyone has a right to their own opinion.

I think the majority of people in general are a little naive when it comes to HIPAA though. Everyone is making something that is very complex seem so cut and dried. It's not. Just because you didn't meet a person and shake their hand doesn't mean that they were not "involved in your care" or that they don't have the right to access your record. True. But then the Privacy Officer would have the person explain exactly how they were involved in the patient's care. If the attending MD for the OP's DS (let's call him Dr.X) asked Dr.ER Mom to review his CT scan for some reason, then the explanation by Dr.ER Mom would be "Yes, I did review that CT scan as part of the patient's trauma work-up as requested by the patient's attending physician Dr.X". Of course then the issue becomes "so, you had legitimate access to the patient's chart and a couple of days later your DD comes to school stating to the patient that you said the patient wasn't injured"....still a problem because now someone with legitimate access to the patient's chart then violated HIPAA. Or at least her DD says she did. At the very least the DD needs to be taught how much trouble she can get her mother in by shooting her mouth off and at the very most the Dr.ER Mom needs to be reprimanded if it can, in fact, be proven that she violated HIPAA.

Who's to say that an MD from hospital ABC didn't request that an MD (mom?) at hospital XYZ look at the CT and collaborate about the findings? The "minimum extent necessary" and all those other phrases you'll find throughout HIPAA are determined by the providers, not the patients. Everyone seeking medical care signs papers that say just that. Then Dr.ER Mom would be able to explain that, as noted above.

So, even if the mom's name is on this list that everyone thinks is going to be a piece of cake to obtain, that doesn't automatically mean that she violated HIPAA. Assuming that the mom did access the record and had a reason to do so, it would be nearly impossible to prove that she said anything to her daughter. Thankfully, people can't lose their jobs because Bobby's mom said that Suzy's mom did such and such. True, but when Suzy says directly to Bobby "My Mom the ER MD said she looked at your CT scan and you didn't have a concussion", it becomes a bit more of an issue. How would Suzy know that other wise? Even if Suzy's Mom had legitimate access to the record, speakign about the contents of it is still a HIPAA violation. Like if I am taking care of a friend of my mother's, I cannot come home and say "Mom I took care of Mrs.Smith today and she has pneumonia and is on antibiotics". Actually I can't tell Mom I even took care of Mrs.Smith unless Mrs.Smith tells me it's OK.

More than one person would have to be involved in MD mom's ability to obtain records that she shouldn't have access to. She couldn't just go and pull up the record from another hospital on her own without any help. Help being someone at the other hospital giving her access, and I just don't believe this high school rumor is really the conspiracy that it would have to be for this story to be true. It'll be interesting to see what the outcome is either way. Yes it will.
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Old 01-27-2013, 11:10 AM   #157
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But if her name is on the list then it would be the job of the Privacy Officer to determine if she was legally allowed to access the records. The OP will not have to do anything but let them know she wants to know whether they had authority to access his records and why?
Exactly, but in order for the privacy officer to do this they will have to be given a name. The majority of the responses I saw here are telling mom to just request a list of names period. That's not sufficient proof.
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Old 01-27-2013, 11:12 AM   #158
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But if her name is on the list then it would be the job of the Privacy Officer to determine if she was legally allowed to access the records. The OP will not have to do anything but let them know she wants to know whether they had authority to access his records and why?
It's two fold. A HIPPA violation isn't just accessing the records. It's also talking about it. If the doctor did access the records it doesn't fare well with her daughter bragging about her mother's impressions of the child's medical condition.

I don't know about "proving". How would the daughter know the mother accessed the boy's chart if the mother didn't talk to her about it? That's full circle, if in fact the doctor did do it.

ETA: Sorry quoted the wrong post.
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Old 01-27-2013, 11:42 AM   #159
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It's two fold. A HIPPA violation isn't just accessing the records. It's also talking about it. If the doctor did access the records it doesn't fare well with her daughter bragging about her mother's impressions of the child's medical condition.

I don't know about "proving". How would the daughter know the mother accessed the boy's chart if the mother didn't talk to her about it? That's full circle, if in fact the doctor did do it.

ETA: Sorry quoted the wrong post.
I agree with you. I don't understand why this should not be considered a huge issue, it would be for me. My BIL was a DR before he passed away, my sister is a Resp therapist and for 6 years was a FRT, my older sister is a charge nurse in a nursing home and prior to that was an asst director in a huge nursing home. Believe me, accessing private records happens and it is not good. Records that are on the same system can be accessed electronically and if that happens the medical personnel have been known to "peek". If this happens there should be repercussions and they should be severe.

If this may have happened to any parent here, would it be okay? Would you want any information concerning your family to be accessed and then discussed with your child's peers? How about with your peers in your workplace?

I think that the OP should register a complaint with the appropriate people at the hospital her son was treated. IF the DR did access the information there would have been a reason. If the Dr shared any information with her DD she should be reprimanded. IF the DD knew the information about the OP's son the DR better have a darn good explanation.
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Old 01-27-2013, 11:49 AM   #160
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As I said, if she's not satisfied after talking with mom then the record is still going to be there. What is there to LOSE by talking to the mom directly?

Some people are good at reading other people's reactions, tone of voice, etc. If the MD mom is shocked and has no idea who this person is contacting her then that would be a good sign (to me anyway) that it isn't true and not worth dragging everyone (including the child/victim) through the mud.
The only thing I see to "lose" by talking to the mom is her possibly "circling the wagons". What I don't get is what is there to GAIN by talking to the mom?
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Old 01-27-2013, 12:03 PM   #161
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Exactly, but in order for the privacy officer to do this they will have to be given a name. The majority of the responses I saw here are telling mom to just request a list of names period. That's not sufficient proof.
It's sufficient to start.

OP gets a list of names as to who accessed the chart.

Dr.ER Mom is on it.

OP then goes back and tells the Privacy Officer that she would like to know why Dr.ER Mom accessed her son's medical record. She can tell the Privacy Officer some background detail at that point as to why she is concerned about a HIPAA violation.

Privacy Officer then asks Dr.ER Mom why she accessed the medical record. If Dr. ER Mom has a good reason, then so be it.

There is still the issue of Dr.ER Mom's child knowing details of the medical record however. If Dr.ER Mom had a legitimate reason to access the record (ie-asked to consult on the case) it would still beg the question "Did you discuss this with your daughter because your daughter told the patient details about his medical record that she should not have known".

That's where it could get tricky in terms of "he said, she said". Remember the OP's son did not hear this 2nd or 3rd hand...the child of this ER MD came to the OP's son and said it directly. It would then be up to the Privacy Officer to do more reasearch and make some kind of determination.

Frankly it would be better for the Dr.ER Mom to not have her name appear on the list of people who accessed the medical record because then it could chalked up to a teenager blabbing & knowing just enough to make herself sound "authentic". In that case, I might consider being nice to Dr.ER Mom by letting her know that her DD is going around telling people that her Mom accessed medical records and that as her Mom, she might want advise her lying blabbermouth kid as to the possible repercussions of doing that.

Frankly, as an RN, privacy violations infuriate me and perpetrators of them get absolutely no sympathy from me. Patients trust us to keep their private information private. I wouldn't like it of someone who had no business doing so was looking at my private information and I also wouldn't like it if someone who did have some reason to look at my private info (ie-direct caregiver) then went and blabbed it all over town. It is the epitome of unprofessional behavior IMHO and those who do it deserve to be punished.
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Old 01-27-2013, 02:50 PM   #162
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Exactly, but in order for the privacy officer to do this they will have to be given a name. The majority of the responses I saw here are telling mom to just request a list of names period. That's not sufficient proof.
There are many responses that state get the list. If her name is on it then follow up accordingly. I think the OP understands that there are additional steps if after the obtaining the list if the Dr. ERs name is on the list.
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Old 01-27-2013, 03:01 PM   #163
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There are many responses that state get the list. If her name is on it then follow up accordingly. I think the OP understands that there are additional steps if after the obtaining the list if the Dr. ERs name is on the list.
Ditto. BTW, she doesn't have to talk about it for it to be a violation, she only has to access the record.

The chance of her being a consult on a straightforward case from another institution is almost 0%, and if she was, there will be a record of the consult and her findings, even if it's one sentence long.

If her name is not on the list and mom wants further follow up, the Privacy Officer can call in the ER/radiology staff and ask if anyone has contacted them regarding his records. They still don't have to disclose the doctor's name to anyone.
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Old 01-27-2013, 03:01 PM   #164
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Exactly, but in order for the privacy officer to do this they will have to be given a name. The majority of the responses I saw here are telling mom to just request a list of names period. That's not sufficient proof.
Nobody said it was sufficient proof. It's the starting point, which I'm sure the OP understands.
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Old 01-27-2013, 03:06 PM   #165
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Nobody said it was sufficient proof. It's the starting point, which I'm sure the OP understands.
I hope so!

Holy Moly all this "what if"...the bottom line is the OP has the right to request an audit of her son's records (yes she has the right as the parent of a minor child).

If the ER doc's name is on there, then she can move forward with the help of the HIPAA compliance officer/Privacy Officer.

If the ER doc's name is not there, the issue is closed.
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