Patient Privacy Scenario

[FullArrest]

**SORRY FOR THE LONG POST, BUT THIS WAS A BIT OF A COMPLEX SITUATION**

I work a lot of private events as a means for some extra income. I have often come across organizations (especially professional level sports organizations) which have their own medical paperwork (entirely risk management tools) that they like hired EMS personnel to fill out.

These forms always include (at the very least) the patients first and last name and will sometimes include contact information such as address and telephone number. The forms also request information regarding the incident including description of illness/injury.

I have never filled out one of these forms and generally advise officials from whichever organization publishes them to have one of their people fill them out as long as the patient directly consents to them and as long as their questioning does not interfere with my care of the patient.

I recently worked with an EMT with >20 years experience who advised me that filling out these forms is not a violation of HIPAA because the patients are either athletes who have signed releases with the organization or patrons who are on private property. Furthermore, he stated that since the only demographic information on the forms was the patients first and last name.

While I see the logic in the first argument, we never saw any such release. As far as patrons on private property, I really don't see how that serves as an exemption.

Either way, we treated several patients, all of whom my partner filled out the private agency paperwork on despite my protest. All patients except for one were injured while participating in the event and were subsequently transported to local hospitals. The final one was sent to an area hospital with severe, sudden onset RLQ pain. None of these patients were advised that their information would be released to the organization that sponsored the event.

I attempted to talk my partner out of filling out these forms, but he stated that he knew "a lot" about HIPAA and suggested that I read up on it. I argued with him that after a few years in the emergency department and 7 years in medical offices, that I was at least fairly well versed and that I felt uncomfortable with him releasing the information.

He ended up filling out the forms and submitting them to the organization that sponsored the event.

Am I crazy here, or what? The situation seemed pretty clear to me, but I figured I would run it by some other people and get some ideas about how others would have handled the situation.

 

[MedicPrincess]

It would seem to me that YOU (or your partner) filling them out and providing this information to the facility or oranization that simply sponsors the event, would indeed be a HIPAA violation. The sponsoring organization would not fall into the need to know for continuing care catagory that is covered by HIPAA. What sort of continuing care is a sponsoring organization providing?

Now, a representative of the sponsoring organization could come gather that same information from the patient themselves as you suggested.

 

[firecoins]

I don't see the problem. The sponsoring organization is entitled to know the incidents that occur at their events. HIPPA does not prevent them from knowing about these incidents.

 

[MedicPrincess]

The incidents that occur, yes....

The patients personal information....NO.

Just like at your local Wal-Mart....a person codes in the checkout line, slips in the produce aisle, passes out shoe shopping....it is not our responsibility to provide that patients personal information to the store, however they do have the right to know something happened.

 

[reaper]

Most places do have the right to the information. The injuries occurred on their property, which means their insurance is liable.

Do you not provide pt info to the insurance companies that you bill, on a ambulance?

HIPPA provides that the insurance company directly involved with the payment for services, is entitled to the Pt's info.

 

[Ridryder911]

Not a HIPAA violation if does NOT involve billing, maybe privacy act but NOT HIPAA! To be specific, the billing has to be electronically billed to be under HIPAA. Everyone should really learn the HIPAA Act.

R/r 911

 

[firecoins]

If some organization sponsors an event and specifically an athletic event, the producers are entitled to know WHO got hurt and HOW. They are liable for these injuries and they have responisiblity of knowing how to prevent such injuries if possible. The sponsors do NOT need to know unrelated medical information. This is not like someone who just codes in a Walmart for a random unrelated reason.

HIPPA as rid had pointed out has to do with billing. You are not violating HIPPA in any such way by informing the sponsors.

 

[ffemt8978]

If some organization sponsors an event and specifically an athletic event, the producers are entitled to know WHO got hurt and HOW. They are liable for these injuries and they have responisiblity of knowing how to prevent such injuries if possible. The sponsors do NOT need to know unrelated medical information. This is not like someone who just codes in a Walmart for a random unrelated reason.

HIPPA as rid had pointed out has to do with billing. You are not violating HIPPA in any such way by informing the sponsors.

SPOT ON POST! They have a right to know who was injured, their injuries, and their contact information. They don't need to now the patient's past history, allergies, meds, etc...

 

[Jon]

The company where I work that covers events has worked a HUGE bike race for the last few years... we have a separate waiver we have the patients sign that allows us to share our information with the sponsoring organization. We also fill out basic info on the patient on a form for the sponsor... name, rider #, and complaint/treatment. We can do this BECAUSE we have a HIPPA waiver form signed by the paient. No signature, the ride sponsor's staff must get what they can from observing us.

 

[certguy]

The sponsors should have the right to the info they need for thier insurance only . Unfortunately , the insurance would need the pt's name , address , phone no. etc. Anything else would be protected . Perhaps thier own risk management folks should be doing the info collecting for the insurance , which would leave your pt. care info non - comprimised .

 

[Jon]

When we cover the convention center, the Convention Center Security staff, as well as the event's security staff respond to medical emergencies. Both security companies complete reports on the incident, that way the convention center and the show sponsor have records.

 

[FullArrest]

The company where I work that covers events has worked a HUGE bike race for the last few years... we have a separate waiver we have the patients sign that allows us to share our information with the sponsoring organization. We also fill out basic info on the patient on a form for the sponsor... name, rider #, and complaint/treatment. We can do this BECAUSE we have a HIPPA waiver form signed by the paient. No signature, the ride sponsor's staff must get what they can from observing us.

I really like the idea of having a waiver signed by the patient to release their information.

Collection of information for risk management purposes really is not the job of EMS professionals and doing so without informed consent surely presents an ethical problem if not a legal one.

I will see what I can do about getting a waiver drawn up for these types of events.

Thank you to everybody for your feedback.

 

[reaper]

The OP stated that they wanted Name, Contact info, and Injury. No Medical hx was asked for. You can pass on Contact info and hx of present incident.

I see nothing wrong with OP situation, as described.

 

[FullArrest]

The OP stated that they wanted Name, Contact info, and Injury. No Medical hx was asked for. You can pass on Contact info and hx of present incident.

I see nothing wrong with OP situation, as described.

Where does it say that we can pass on information regarding a patients contact information and history of present incident? There are a number of cases I have found in which EMS agencies and individual EMTs have been successfully sued for passing along such information to people not directly involved in the MEDICAL care of the patient.

Again, the above IS a HIPAA violation. And yes, I do realize that HIPAA has to do with insurance and that patients have no right to recover damages even if a HIPAA violation occurs. Where HIPAA comes in regarding patient privacy lawsuits (according to risk management at one of my former employers) is that is serves as a documented standard of care by establishing a manner in which documents containing sensitive information can be shared. Violation of HIPAA standards CAN be brought into civil proceedings as evidence of a violation of the standard of care.

The bottom line is that filling out medical information on a patient (hx of present illness IS medical information that some patients DO NOT want released to a private entity) on a form for a non-medical entity does NOTHING to serve the patient and is not legally mandated of us.

Because of the unique nature of private event EMS, I do not mind sharing information with a venue SO LONG AS THE PATIENT GIVES INFORMED CONSENT TO RELEASE SUCH INFORMATION. To me, it just seems a lot easier to have staff connected to the particular event fill out such paperwork.

 

[BossyCow]

If some organization sponsors an event and specifically an athletic event, the producers are entitled to know WHO got hurt and HOW. They are liable for these injuries and they have responisiblity of knowing how to prevent such injuries if possible. The sponsors do NOT need to know unrelated medical information. This is not like someone who just codes in a Walmart for a random unrelated reason.

HIPPA as rid had pointed out has to do with billing. You are not violating HIPPA in any such way by informing the sponsors.

HIPAA not HIPPA. I know this because I just had to have all our MIRs reprinted for this same typo.

 

[rsdemt]

patient confidentiatally question

I agree with you.
I would tell the people, I am treating , about the form.
And get their permission, to fill it out.
If they refuse, to give the information, I would simply pit something on the form about person refuses to give information.
I would also talk to the organization about the issue, and HIPPA. Maybe they are not as knowledgable about HIPPA, as medical professionals are.
I mean if I can not find out about patients, I transport (offically at least. As we know nurses will tell us, buy that is personal.) How can you give personal info. to what is really strangers?

 

[BossyCow]

One more time folks.. it's HIPAA

 

[firecoins]

One more time folks.. it's HIPAA

GET OFF THE TYPOS. Its really annoying.

 

[skyemt]

GET OFF THE TYPOS. Its really annoying.

seems kind of rude...

it's not a typo, but rather knowing what the acronym is... if you look back through past posts, many mistake it for HIPAA...i was one of them, and was happy to correct myself...

 

[wolfwyndd]

HIPAA = Health Insurance Portability Act
I have no idea what HIPPA is. Just throwin' that out there.

Back to the posts at hand. I would have to agree that writing down someone's contact information (IE, name, address, phone number) isn't going to violate anything. A SSN would violate someone's privacy, but nothing to do with HIPAA. I really don't think writing down someone 'History of PRESENT illness' is going to violate HIPAA either. And the sponsoring organization will need that information if they are going to cover an illness / injury that occurred during one of their events.

FullArrest: I can see your concern for this information, however, based on the information you provided, I don't believe you'd be violating HIPAA for any of the questions you've stated. However, in that same vein, I'd also be a bit hesitant to fill out that information and give it to some sponsoring adgency's representative. I'd be much more comfortable if a representative from the sponsoring organization was there to gather that information for themselves with the patient. Unless they consider YOU the representative from the sponsoring organization since THEY are paying YOU to provide a service.

But that's only a guess.