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Earlier talk about keeping your office under - lock and key, investigating?

Posted: Jun 12, 2013

A few weeks ago there was talk about people thinking we should keep our work/office under lock and key, that someone was going to be showing up and because of the HIPAA law, we would be in big trouble, prosecuted, arrested, whatever. I have something to run past those that were posting. Ok, so today I take my husband to have a procedure done. I am called back to his room as he is awakening and there are 2 people sharing this room with a drawn curtain between them. The doctor comes in to talk with the patient in the next bed and goes over did you have anything to eat, drink, etc. and then starts over previous surgeries, allergies, meds they take, etc. I am sitting there gleaning information from this patient but hey, no one shows up to put the doctor behind the 8 ball. Can anyone tell me, why is this okay for the doctor to discuss another person's information out there and yet we are to put all under lock and guard because of us being MTers? What is the difference here? Okay for the doctors but OMG, we best tremble in our boots afraid of the law?

Hmmm - Good question

[ In Reply To ..]
I was so flipping sick the last time I was admitted about 9 months ago that I didn't read the mountain of paperwork I had to sign, but do you suppose somewhere in the admission papers you sign an agreement that "It is understood during the course of your admission your confidentiality cannot be 100% secured due to the nature of the facility" or something along those lines? ITA with your post, as I knew more about the woman I shared the room with than I ever needed to (facilities she had been at previously, procedures performed, current medications, social history info, the whole gamut, actually).

It's a really good point you bring up though. If I still had my admission paperwork, I'd dig through it and check but I pitched it all.

Hopefully someone knows for sure.

Answer - sm

[ In Reply To ..]
The problem is with personally identifiable health information, not just health information.

You can hear or read about toenail fungus and warts, but if you can't identify the patient, that isn't a breach.

What happened in that office is kind of tacky, but possibly necessary due to the structure of the facility. However, unless you could tell who the patient was, there was no breach.

If you could hear a name, an address, DOB, demographics, next of kin, etc., then you should report it.

Well, it just so happens it was a small - outpatient procedure place

[ In Reply To ..]
and not only was I waiting outside when this person came to the window, gave her name, signed in, etc. but this was also the patient in the room with my husband so yes, I did hear more than just toenail fungus. As far as reporting it, not a chance on this end. I just thought how it sounded when the others saying no one can be in your room while you are working, never know when Joe Law is going to come and grab you and yet this was a doctor's office.

Duty to report - sm

[ In Reply To ..]
There is absolutely nothing wrong with reporting. If you heard someone else's info, someone heard yours.

The law does not require absolute secrecy. It allows that some inadvertent disclosures may be inevitable, but requires that they be minimized.

Minimal info on sign in sheets, if used at all. Avoiding using SSNs where they can be overheard.

I would not go to a place where my privacy was not respected.

No, Joe Law is not going to come grab you if someone walks into your office. But, your family should not be able to see or hear your work.

And I say horse feathers to such - Just blows my mind

[ In Reply To ..]
Like anyone out there has the time, money and energy to come into all MTs office just to make sure no one is lurking around to "see or hear" what we are working on. If I showed everyone on my street my monitor, just how many do you think would be able to make 1 thought out of what they read (that is thinking they could even read in the first place). I am not turning anyone in, I am not paranoid like others on here that someone is coming to get me, I share my work room with my husband and who knows and who even cares. The above I posted was a come back on the postings before who thought we should be under cloak and dagger situation in regards to our work. Better to worry about someone trying to hack into your computer (or bank account) rather than someone "trying" to gain information from what is seen on a monitor.

Another point - Alice

[ In Reply To ..]
I live in a small town. Our local hospital officially only has 25 beds, not including the ER and the outpatient surgery area. Anyway, I've been to the ER and outpatient surgery area with myself and various members having procedures done there. Often, we already know the person or persons who share the large preop room, separated only by curtains. All of their personal health information is freely discussed with no privacy. As a matter of fact, if I didn't already know their names, I may know them by the end of the visit, as the medical personnel do use patient's last names when speaking to them. As far as I know, I've never signed anything waiving my right to privacy; in fact, I was given a copy of the HIPAA rule and told who to contact if I had questions or concerns. I did contact that person in 2007, but was quickly brushed off. The hospital has a CYA policy and it is "understood" that they will kindly listen to complaints and do nothing about it, and most complainers will not spend the time, energy, and money to take it to the next step (court). So, it's a double standard. Seems pretty unfair to me. Frankly, if I were in my home office with my cat and someone came here to investigate and arrest me for allowing my cat to see the computer screen or whatever, I'd be the first one to contact the media, set up a website, engage social networks, etc., and use the experience to educate the public about just what happens with their personal health information, in reality.

Thanks for your insight. When we all know - well at least here in MT land

[ In Reply To ..]
where loads of the records are being sent and have been sent now for years, why be paranoid about your own home? Just keeps blowing my mind about the subject of how we need to be under lock and key in the privacy of our homes. Thanks again.

Privacy - Leaving MT

[ In Reply To ..]
I don't lock my office, and I don't worry about the privacy police coming to my home. I do keep my monitor so it is not facing my open office door (not that my husband cares about what is on my screen) and I also use earphones and not the computer speakers, but I do know some at-home MTs who use the computer speakers. I did work for a local MTSO at one time who had the tech support person come to my home and check out my home office and load software onto my computer. I had it set up then as I do now, and it passed inspection. That was a few years ago.

Last week I had a doctor's appointment, and while I was sitting in the exam room waiting for my visit, I could hear one of the doctors dictating on a patient as clear as if she were standing right next to me. I heard the patient's name, DOB, and her entire report, which included her past medical history and medications, etc. I think that probably was a privacy violation since I heard the name and DOB along with the entire report.

Leaving MT - Old Pro

[ In Reply To ..]
I hope you reported it. That is a terrible breach of ethics. What if you were not the honest person that you are and had instead copied down her info and used it?

I agree! I hope you reported it. - sm

[ In Reply To ..]
Yes, that's a violation. The office apparently hasn't noticed that people can hear the doctor dictating.

That should be reported.

To the people who say that facilities don't care . . . mine sure does. We have not one, but two privacy officers who conduct inspections, provide education, and have to log and report incidents. Every facility has them. If you think your doctor or your facility isn't responsive, and if you hear or see something that is wrong, or if you have a complaint, don't report it to THEM . . . report it to the people listed above.

The information you hear about others will be YOUR information as soon as that doctor dictates about YOU.

There is nothing wrong with a complaint. Those doctors and those employees have oodles of training. They are already supposed to know.

Locking office, privacy - anon

[ In Reply To ..]
I was in this discussion thread, but I never ever stated or implied in any way HIPAA cops were going to come to your house to check. Ever. That is sheer ludicracy unless somebody reported you specifically, and even then I doubt that. You would simply be written up and possibly terminated. You could be sued though depending on the situation.

Just because you see somebody else violating HIPAA does not mean it is OK.

I am in a situation where I provide transcription services to several local facilities, of which my husband's employers (old and current) send their employees, and my neighbors (I kid you not) and friends are patients there. Patients at other physicians' offices where I obtain healthcare are too. To my horror, so were my own home healthcare nurses (there was a packet with their facility name on it containing tapes when they came over one day, but this was prior to me taking over from another service owner). I also transcribe on police officers, etc. When they came over in regard to a friend staying here temporarily (he was on probation), I told them they needed a warrant to enter my office, which they do. I do not tell anybody who I transcribe for, especially due to the nature of the reports. I live in a huge metro area. You would be suprised how small the world really is.

I highly doubt many or very few MTs are in this position, but it is always best to be safe than sorry and lose your job or clients and violate anybody's rights.

Privacy - sharing of information

[ In Reply To ..]
It seems like the only way there would be an investigation is if the information were shared with others, right? I think most of us are prudent about keeping the stuff we transcribe private, and some MTs, based on their personal situation, might need to keep their offices locked, for example, those with local accounts and teenagers or roommates in the house that could snoop around and find information on people they might know and share that information. I think the big violations really come from people working at the hospital snooping in medical records of people they know personally or famous people's records and then talking about that information.

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