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Pippi
Supporter
Username: Pippi
Post Number: 1667
Registered: 8-2003
| | Posted on Friday, January 20, 2006 - 2:20 pm: |     |
appropriate or not?
I was the first patient in a doctors' office this morning. I got there at 8:50, 10 minutes before they officially begin their day. They saw me, I signed in and sat down.
Someone played the answering machine messages on speaker phone so loudly I heard every single message (including a recording conversation between a patient and the answering servcie). I heard 4 messages, including names, clearly.
I didn't say anything, but I was truly appalled.
My opinion is highly inappropriate and extremely unprofessional
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las
Citizen
Username: Las
Post Number: 832
Registered: 10-2003
| | Posted on Friday, January 20, 2006 - 2:30 pm: | |
Agreed. Highly inappropriate and extremely unprofessional.
But....did you hear anything the piqued your interest? |
musicme
Citizen
Username: Musicme
Post Number: 1552
Registered: 5-2001
| | Posted on Friday, January 20, 2006 - 2:38 pm: | |
or ours? |
greenetree
Supporter
Username: Greenetree
Post Number: 6596
Registered: 5-2001
| | Posted on Friday, January 20, 2006 - 2:38 pm: | |
I am hyper aware of patient confidentiality stuff, so I would have said something. It makes me nuts when charts are left out, messages played or other patients discussed within earshot.
I even have my mom's oncologist's home phone number because it was on a wall at the receptionist desk. I've never used it, but I will if I have to. |
Rastro
Citizen
Username: Rastro
Post Number: 2274
Registered: 5-2004
| | Posted on Friday, January 20, 2006 - 2:44 pm: | |
They have violated patient confidentiality, and unless there is something special about that doctor, I'd find another. If they don't care about other patients' condfidentiality, you can bet they don't care about yours. |
Marty Tuohy
Supporter
Username: Martyt
Post Number: 72
Registered: 6-2002
| | Posted on Friday, January 20, 2006 - 2:57 pm: | |
I don't think I would simply drop the doctor for this, at least without discussing it.
Maybe speak directly with the doctor and then, depending on the reaction, decide how to proceed.
Good luck. |
greenetree
Supporter
Username: Greenetree
Post Number: 6600
Registered: 5-2001
| | Posted on Friday, January 20, 2006 - 2:59 pm: | |
Most of the time, they just never thought about it. When I say things, it is usually along the lines of "Wow, did you know that you can hear everything on that machine from over hear"? |
Pippi
Supporter
Username: Pippi
Post Number: 1669
Registered: 8-2003
| | Posted on Friday, January 20, 2006 - 3:00 pm: | |
thanks guys
I was really uncomfortable and was *this close* to speaking up, but I didn't. I regret it now. Rastro's point is well taken.
dare I say that I got this doctor from a reco on MOL??? |
peteglider
Citizen
Username: Peteglider
Post Number: 1721
Registered: 8-2002
| | Posted on Friday, January 20, 2006 - 3:04 pm: | |
There are still some real HIPA privacy gaffes going on. Like this one, most inadvertent.
Do let the doc and the staff know.
/p |
The Man
Citizen
Username: Bumboklaat
Post Number: 130
Registered: 2-2005
| | Posted on Friday, January 20, 2006 - 3:17 pm: | |
Hey Glider-
It's HIPAA-Health Insurance Portability & Accountability Act. Not sure why they picked that name for a law dealing with patient confidentiality but they did. |
doulamomma
Citizen
Username: Doulamomma
Post Number: 827
Registered: 3-2002
| | Posted on Friday, January 20, 2006 - 4:00 pm: | |
In regards to fairly recent HIPAA changes, the staff should have been made well aware of confidentiality issues (in case they were not already aware!) |
Lizziecat
Citizen
Username: Lizziecat
Post Number: 1031
Registered: 5-2003
| | Posted on Friday, January 20, 2006 - 4:12 pm: | |
Doctors are frequently unaware of or oblivious to what their clerical office staff are doing. I would send a letter, marked personal, to the doctor telling him/her what went on. S/he might be grateful to be informed. |
Innisowen
Citizen
Username: Innisowen
Post Number: 1388
Registered: 3-2004
| | Posted on Friday, January 20, 2006 - 5:49 pm: | |
Direct violation of HIPAA patient confidentiality regulations.
Funny, since most med practices these days have signs all over their offices about observing HIPAA-protected patient confidentiality. |
shoshannah
Citizen
Username: Shoshannah
Post Number: 1145
Registered: 7-2002
| | Posted on Friday, January 20, 2006 - 5:49 pm: | |
Actually, the first HIPAA violation occurred when they required you to sign in. |
Marty Tuohy
Supporter
Username: Martyt
Post Number: 74
Registered: 6-2002
| | Posted on Friday, January 20, 2006 - 7:11 pm: | |
I'm fairly certain that a simple patient sign-in sheet (name and arrival time) is not a HIPAA violation. I suspect that would be considered an "incidental disclosure" under the Act. Playing back detailed medical info from the answering machine on the other hand ... |
The Soulful Mr T
Citizen
Username: Howardt
Post Number: 1311
Registered: 11-2004
| | Posted on Friday, January 20, 2006 - 7:32 pm: | |
Doctors are •••-holes. |
Jersey Boy
Citizen
Username: Jersey_boy
Post Number: 24
Registered: 1-2006
| | Posted on Friday, January 20, 2006 - 8:33 pm: | |
Did you hear this message?:
"I'm calling to find out the results of my Syphilis test. By the way my crabs have completely resolved, and the cream you gave me for my herpes really helped. Do you think those conditions are work related? My lawyer wants to know.
I still need the referrals for the plastic surgeon and the hemorrhoid doctor. By the way, I've decided not to see a Psychiatrist; I'm going to treat myself with acupuncture and marajuana. Also the pills you gave me for 'you-know-what' worked."
If so, I think I know who the doctor is...
J.B.
P.S. Definitely tell the doctors to stop doing this. |
shoshannah
Citizen
Username: Shoshannah
Post Number: 1146
Registered: 7-2002
| | Posted on Friday, January 20, 2006 - 9:36 pm: | |
Marty, I am fairly certain that a patient sign-in sheet IS a violation of HIPAA. A doctor is not even permitted to confirm or deny that any individual is a patient of the practice -- let alone that a particular patient visited on a particular day. Doesn't everyone read all the names above their own? At a pediatrician's office it may not be a big deal, but if you go to an oncology practice you probably wouldn't want to sign in -- and I have seen oncology practices that ask people to sign in. Regardless, I hate sign-in sheets because they are so cold and impersonal. To me, they are just a way for the office staff to avoid greeting you. I hate when I arrive and say, "Hi I'm Shoshannah and I'm here to see Dr. Smith for my 10:00 appointment," and the receptionist just says, "sign in." |
kmk
Supporter
Username: Kmk
Post Number: 924
Registered: 5-2001
| | Posted on Friday, January 20, 2006 - 9:53 pm: | |
St. Barnabas Ambulatory Care states very clearly that you must only sign in using your intitials.
Now I understand why. |
Suzanne Ng
Citizen
Username: Suzanneng
Post Number: 591
Registered: 3-2002
| | Posted on Friday, January 20, 2006 - 9:58 pm: | |
I met someone from MOL at my physical therapists clinic... I recognized their name from the sign in sheet. |
monster
Supporter
Username: Monster
Post Number: 1903
Registered: 7-2002
| | Posted on Friday, January 20, 2006 - 11:28 pm: | |
Sign in sheets are NOT a HIPAA violation.
Incidental Use and Disclosure -- The final Rule acknowledges that uses or disclosures that are incidental to an otherwise permitted use or disclosure may occur. Such incidental uses or disclosures are not considered a violation of the Rule provided that the covered entity has met the reasonable safeguards and minimum necessary requirements. For example, if these requirements are met, doctors' offices may use waiting room sign-in sheets, hospitals may keep patient charts at bedside, doctors can talk to patients in semi-private rooms, and doctors can confer at nurse's stations without fear of violating the rule if overheard by a passerby. |
Marty Tuohy
Supporter
Username: Martyt
Post Number: 75
Registered: 6-2002
| | Posted on Saturday, January 21, 2006 - 12:00 am: | |
Shoshannah, LOL, this is actually pretty funny. We clearly have way too much free time on our hands for a Friday night.
Anyway, to recap, I was fairly certain that a limited patient sign-in sheet (name and arrival time) was not a HIPAA violation. You were fairly certain that it was a HIPAA violation.
OK, I'm going for all the marbles on this one.
Here is my answer: I don't know if New Jersey has an additional level of protection in this area, but HIPAA absolutely does NOT prohibit a patient sign-in sheet limited to, for example, patient name and arrival time. In fact, sort of along the lines of what you mentioned in your post, it also is not necessarily a violation for a doctor/nurse to call out a patient name in a doctors office. These are just incidental disclosures and are permitted by HIPAA.
The statute is fairly boring to read (shocking!) but the United States Department of Health and Human Services has a helpful list of frequently asked questions that address a number of questions, including exactly what we are discussing.
http://healthprivacy.answers.hhs.gov/cgi-bin/hipaa.cfg/php/enduser/std_alp.php?p _cv=1.7%3B2.u0&%20p_cats=7%2C0&%20cat_lvl1=7&cat_lvl2=0&p_search_text
Question number 11 on this list is as follows:
"May health care providers use sign-in sheets or call out names in waiting rooms?"
The answer is as folllows:
"Yes. Covered entities, such as physician’s offices, may use patient sign-in sheets or call out patient names in waiting rooms, so long as the information disclosed is appropriately limited. The HIPAA Privacy Rule explicitly permits the incidental disclosures that may result from this practice, for example, when other patients in a waiting room hear the identity of the person whose name is called, or see other patient names on a sign-in sheet. However, these incidental disclosures are permitted only when the covered entity has implemented reasonable safeguards and the minimum necessary standard, where appropriate. For example, the sign-in sheet may not display medical information that is not necessary for the purpose of signing in (e.g., the medical problem for which the patient is seeing the physician). See 45 CFR 164.502(a)(1)(iii)."
Again, I don't know if New Jersey law offers additional patient protection (it can not offer less protection) but HIPAA allows limited patient sign-in sheets.
Back at where this whole thing started, however, I bet we agree that letting the answering machine playback for all to hear was a heck of a lot more than an incidental disclosure.
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Marty Tuohy
Supporter
Username: Martyt
Post Number: 76
Registered: 6-2002
| | Posted on Saturday, January 21, 2006 - 2:03 am: | |
Sorry, make that Question number 12.
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