Dispatch and HIPAA

HotRod07

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I work for a private 911 EMS agency and we are being forced to call in patient information, specifically name and DOB, to our dispatch after clearing from a call. We used to do in-house billing so I could see the need and use for patient information but we have outsourced our billing. A lot of medics on the street see this as a HIPAA violation. I even asked a dispatcher about it and was told that I couldn't be cleared from the call unless I give them patient information and that was a direct order from his supervisor. It seems to me that this is a violation but I haven't been able to find any similar situations online anywhere. Should I be concerned or is this permissible?
 

VentMonkey

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NysEms2117

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i would ask your supervisors first. However, in my un-official legal opinion. I would say your playing with fire a bit. However if you are i'm sure thousands of others are too. What about going to a secure channel? I know whenever i need to talk to a sup when i'm in the field (LEO all be it) i tell dispatch to ask bureau chief so and so, to go to secure channel 4 or whatever one is open. The scanner app for the iphones and what not can't pick that up. I would have to assume since it's a private company policy it got cleared at some point.
 

akflightmedic

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Ummm consult a lawyer....however....my unlegal opinion is you are making a mountain out of a mole hill.

First, you are all employees of the same company, right? If so, then you are all under the same HIPAA training and compliance regulations.
Second, 911 call takers hear far more personal and confidential stuff that you do on any given day of the week.
Third, having a name and DOB only makes it seem like they are also keeping a log of their own for cross referencing, maybe billing follow up, etc.
 

EpiEMS

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@NysEms2117, I agree that there is a need for caution - however, because HIPAA has many exemptions, I think a lawyer is needed to tease out the nuances (not for a field provider, necessarily - unless they think something isn't above board).

@akflightmedic, to your point, it's possible that the dispatch center may not even be a HIPAA covered entity
 

NysEms2117

ex-Parole officer/EMT
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Ummm consult a lawyer....however....my unlegal opinion is you are making a mountain out of a mole hill.

First, you are all employees of the same company, right? If so, then you are all under the same HIPAA training and compliance regulations.
Second, 911 call takers hear far more personal and confidential stuff that you do on any given day of the week.
Third, having a name and DOB only makes it seem like they are also keeping a log of their own for cross referencing, maybe billing follow up, etc.
@NysEms2117, I agree that there is a need for caution - however, because HIPAA has many exemptions, I think a lawyer is needed to tease out the nuances (not for a field provider, necessarily - unless they think something isn't above board).

@akflightmedic, to your point, it's possible that the dispatch center may not even be a HIPAA covered entity
couldn't agree more
 

NPO

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The county to the north has some base hospital radio traffic bleed over to our dispatch radio sometimes. I think it's their VA hospital. They often give patient name, DOB, and last 4 of SSN over the radio. I've heard that the VA will turn away non VA members, so that might be why?

I've never taken to a VA hospital except on transfer.

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ERDoc

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The VA does not bill medicare/caid so HIPAA does not apply (nor does EMTALA).
 

NPO

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The VA does not bill medicare/caid so HIPAA does not apply (nor does EMTALA).
But any violation from the radio would be on the Ambulance, but not having EMTALA apply would mean they can turn people away.

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EpiEMS

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But any violation from the radio would be on the Ambulance, but not having EMTALA apply would mean they can turn people away.

VA can turn people away, I believe (even if it's arguably unethical).
That's a good question re: the EMS agency in this context, but I don't think it would be an issue, especially if it's incidental to patient care.
 

DrParasite

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If you are "forced" to call it into dispatch, and worried about it being a hippa violation to do it over the radio, why don't you just call them on the phone?
 

akflightmedic

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When he said "call in", my assumption was on the phone. If they are "calling in" on the radio, then there are inherent issues with broadcasting this information.

Vernacular..cause in my small world we radio stuff in and we call stuff in.
 

EpiEMS

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Agreed that it is perhaps ethically problematic to "call it in" on the radio, but from a HIPAA perspective, it is *potentially* OK, given some of the exemptions that HIPAA provides for*.

*Based on a non-attorney's casual reading of the rule
 

Dennhop

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The VA does not bill medicare/caid so HIPAA does not apply (nor does EMTALA).

HIPAA does apply to the VA, just as much as any other hospital/healthcare facility. I know they suck at it, but they do technically have to abide by it. As a VA patient, I've had to fill out HIPAA statements plenty of times in the past going there. As far as identification, we are only required to give first and last initial and last 4 SSN, which allows them to verify whether or not the PT is eligible for VA healthcare.
 

ERDoc

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HIPAA does apply to the VA, just as much as any other hospital/healthcare facility. I know they suck at it, but they do technically have to abide by it. As a VA patient, I've had to fill out HIPAA statements plenty of times in the past going there. As far as identification, we are only required to give first and last initial and last 4 SSN, which allows them to verify whether or not the PT is eligible for VA healthcare.

You're correct. I was reading/typing during a busy shift and wasn't paying attention to what I was writing.
 

Aprz

The New Beach Medic
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https://www.hhs.gov/hipaa/for-profe...ent-payment-health-care-operations/index.html

I was taught TPO. Protected Health Information (PHI) can be given for treatment, payment, and operation. If this is related to payment and operation, I think it is fair game. It is the same way as them giving the address verbally over the radio in 911 or a clinic shouting out your first/last name in a waiting room. There are always ways to reduce it (eg no more radio, just do MDC or texting; no more shouting name, take a number and wait for it to be called out), but reasonable limitation is OK. I would say calling it by phone for billing and operation purpose is absolutely okay.

People are way overkill with HIPAA. Just use sound judgement. Are you giving it to the public? No? You are okay. Are you in a public spot and about to ask something sensitive? Move them to a more private spot or don't be so loud when saying it. Stuff like that. In this case, you are calling a fellow employee giving them a name and date of birth for billing purposes over a private line. I don't see the problem.
 
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