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Dictating with kids in room - HIPAA violation? - just took liability course

Posted: May 26, 2013

So I just took a HIPAA course regarding the "new rules" regarding our liabilities and obligations under the law. I often get dictations by doctors who are obviously working at home with their kids running freely (and loudly) through the room, and perhaps a caretaker's voice now and then. If its a HIPAA violation for ME to have other people listening to dictation, isn't the doctor dictating in the presence of others who obviously have no business hearing that dictation a reportable violation too?

HIPAA - SCHMIPA

[ In Reply To ..]
Congratulations on your HIPAA course, but as an MT who has been at this for 25+ years (and on my way out BTW), them there doctors don't give a flying saucer about HIPAA and those "new rules" them people are selling. As far as that there MD is concerned, Jim Bob and Mary Sue are free to roam the building if they see fit while he/she is dictating.

Sorry...I'm in one of those moods after a long day of studying while planning my exit from MT and them there MDs who dictate with that darn background noise. Golly gee, I sure hope you don't take offense to this.

No offense - but they say we'll all be audited - just took liability course

[ In Reply To ..]
Course said we're all subject to audit by the powers that be (who get to keep all fines for their agency's use, so they are very motivated), and we are now all equally liable - from lowly MT to multibuck megacorporation. So if I don't report this "daycare doc" for a HIPAA violation, who's to say if they audit me and listen to the dictation we won't both get fined? Its every man for himself these days, liability-wise. I know the doctors don't give a hoot, but under the new laws, we are supposed to whistleblow or we are just as guilty and subject to fines. Does that change your advice any?

Sorry, no it does not - SCHMIPA

[ In Reply To ..]
I don't know what course you're talking about, but as far as I know my responsibility is to transcribe what the MD/dictator dictates, background "nuisance" or not. I'm not telling you who to report or not, I just don't see the point.

Well, if you have anyone in your office - sm

[ In Reply To ..]
while you are working, spouse, child, friend, etc., then technically you are violating HIPAA too. You should be behind a locked door as anyone could get pt info from your computer.

according to the rules - doctors are just as liable

[ In Reply To ..]
but who is going to hold the feet of these "god-like creatures'" feet to the fire?? you? lol. don't think so. If you reported them, you would no doubt lose your job before the doctor would ever (have to) comply with the rules. like the current administration, they are "above the law."

p.s. These "rules" are not new. They have been around for years now, and I have often thought the same thing, but to no avail. good luck to you!

So you are working from the comfort of your - own home and worried

[ In Reply To ..]
about whether someone is in the same room with you, oops might be doing something wrong by a person here who could peer over my shoulder and see, a lot of words they could not possibly put together and know what was being said. Really, has it gotten this far? This to me is just irritating to even hear it being discussed. My husband has his desk/computer in the same room with me and he never is interested in 1 darn thing that I am working on much less reading (that is plumb laughable as not doing this type of work majority would not understand even if they could read the words) plus the fact scores and I mean scores of people congregate directly where dictators are - you know-you hear them ALL the time and to where you can hardly make out what the dicatator is saying, laughing, talking, whatever. This just irritates me beyond words. We are held to such standards and yet anything flies for others. Really??? And the bottom line is - how would ANYONE know what goes on in your house unless YOU told them. Really???

Please read regarding HIPAA - anon

[ In Reply To ..]
While I think the OP was a bit overboard in regard to children of physicians possibly understanding what is being said, please read what happened to me. I had to transcribe one of the write-ups myself and was EXTREMELY SERIOUS. Luckily, I was able to contain the other and now DO WORK BEHIND LOCKED DOORS. You have to have a legal subpoena to enter my office.

Incident #1: While I explained in detail numerous times to my husband HIPAA and confidentiality constantly, the following happened, resulting in a severe write-up and could have cost my job and being sued for everything we had, not to mention losing my job. At the time I worked for a local MTSO who hired me to transcribe for local pain physicians. One night, while working and my husband delivering dinner to my desk, he happened to look at the patient sheet printed and recognized a name...so common, such as John Smith. He mentioned he knew a "John Smith" and was actually an employee of his (my husband was his boss at a company who unknown to me uses this clinic for WC cases). I told him yet again about HIPAA laws/confidentiality, and even if he did know such a person (millions of people with that name), he was to ignore what he saw or thought he saw and say nothing whatsoever, not to mention there were a million John Smith's and could be anybody. I am a pain patient myself, but I was only going in for steroid injections and not medications, hated meds, so my husband never associated a pain clinic with people abusing meds or anything near that. To my absolute horror, my husband approached "John Smith" and said. "Hey, do you know a doctor so and so? My wife types his reports." Yes, he was a patient there (and a drug addict). That patient went directly to that doctor and reported the HIPAA violation AND lied that now he could be fired because he was a pain patient. I had to type up my own write-up and could have been sued for everything (as well as the owner of the service I worked for), not to mention losing one of the most profitable and best jobs ever.

Incident #2: I had undergone numerous surgeries and had a serious postop infection, requiring home healthcare nursing. Still working for the same MTSO and clients, her courier had dropped of cassette tapes of dictation with unfortunately the labels of that clinic on the envelope. You guessed it... Despite informing the nurses to always knock on my office door first and wait (I had left front door open for them), they entered.. before I could hide the envelopes. They were BOTH patients there. I then had to listen to them explain away what they never should have had to worry about EVER, worrying completely I would think they were incompetent due to being on meds, which they were actually the very best nurses I know to date). I was absolutely frantic and worrying yet again I would be written up, fired, or sued. To the fabulous nurses, I brushed this off, stating I transcribe thousands of patients a day and did not even recognize their names (I played stupid blonde), when in fact they were patients at several clinics and physicians I had transcribed for.

Yes, we are legally responsible for HIPAA and privacy. You should be working in a completely private office, not sharing computers, desks with spouses, etc. I also constantly run into patients that are in clinics where I receive medical care or for whom I transcribe for, and numerous patients live even on my same street and surrounding neighborhood.

Your office should be locked and completely secured. Do not share with spouses, roommmates, etc. I have had incidences when we allowed his other coworkers to stay here briefly or even when I called over a domestic violence issue, and I refuse to allow anybody, even police officers, in my office without a search warrant.

For me this is absolute rubbish and I will tell - you why

[ In Reply To ..]
What your husband did and what mine would do are so far apart it probably would be astronomical to think ever of my husband approaching the first person to ask "did you so and so." Whereas you have a husband who is more out there so to say, I have a husband who is tremendously shy and does not interact with the people on his job on a day to day basis. He tells he he "listens" but to say something, bring up a subject he would literally die. He is a person who I have to pull things out of, he has ideas, thoughts, opinions but I as his wife are not privy to them. We do not have company here, like people spending the night or even coming in while I am doing work never. We have had some work done recently at our house but they have to be here on my day off as not to make noise and disrupt my ability to hear. Your husband is chatty- mine never is and I have absolutely NO concerns at all being here with him behind me in the same office if I had to work. He would never look over my shoulder, never even if I had family/friends stop by he makes himself out of the way by being in his room playing his guitar or tinkering around outside in the yard. He says it gives me "my time" with someone. He is never intrusive, never noisy (like me) and again, this is absolute rubbish for person with 1 husband and bunch of cats around, no one else. You board up your house, have several alarms put in, install cameras all around, get guard dogs to make sure you are "safe" but you and I come from such different places.

And you are violating the law - RHIA

[ In Reply To ..]
The law is that you will not disclose personally identifiable information. You are making an exception because you think your husband is ok.

The person above you is not overreacting . . . you are underreacting and completely ignoring the needs of the patient and the law.

HIPAA... you NEVER know... - anon

[ In Reply To ..]
Thank you. No, I was not overreacting. Unfortunately, I thought my sheets were completely covered up.

From absolutle rubbish, again. I have a - husbahd who would not

[ In Reply To ..]
even turn his head if a bikini clad woman walked right in front of him in Wal-Mart. Oh, I have my TV in the front with me, wonder if someone out there in television land perhaps has someone "watching" me. There is no one who comes into my house ever without my permission. The people here are sounding like paranoid city, like the higher ups are sitting right under their windows outside ready to make their move and come in your home and find out if OMG someone is able to see your computer. Really? With all the outsourcing that is done, with all the scribes going from room to room taking down information, with all the people standing around the dictating stations, do you think someone has enough time to come to each individual home to make sure we are "safe with people's information?" I do not disclose personal information. Seems to me like doctor offices are not that concerned about it, otherwise when you were at the desk signing in, etc. they would ask others to step back so you could complete the process but do they? I have much more important things to think about, not worry about, than this mountain you seem to want to make out of a mole hill. Ridiculous!!!

Ab rubbish again, just reminded me about - what I overheard at the

[ In Reply To ..]
doctor's office recently. I was in the waiting room to see the doctor and the EMPLOYEES were sitting behind a wall with only the glass thingy where you sign in, give insurance cards, what have you and THEY were talking about a conversation had with a patient about the patient calling in and I was in the waiting room, not right under their nose and I could hear from several feet away THEIR conversation about a patient. Do you think for 1 minute I am worried???

I don't give one hoot about HIPAA - - sm

[ In Reply To ..]
Why? Because it's constantly violated at the provider level! One of my contracts has a doctor who dictates every single patient on an airplane as he's flying to the next exam! Yes, right next to someone, names, claim numbers, etc, and all. My desk is right in the middle of my house. My daughter comes and goes by it. No one even glances at my screen - they could care less. Until off-shoring ceases, I am not going to care about HIPAA and any ramifications. I do not live in a paranoid world. No one is going to come knocking at my door and do a sudden HIPAA compliance check. What your husband did was a bad deal for you. An isolated event. You must live in a small town - where I live, in the thousands upon thousands of reports I've typed, never have I come across anyone I even thought I might know. I do law enforcement typing, too. Now, if I came across someone I knew, I would absolutely refuse to type the job.

HIPAA, living in Los Angeles - anon

[ In Reply To ..]
I live in Los Angeles, CA. I was only mentioning it because you never know what situation might come up. Patients live on my street, in my neighborhood, and shop at the stores we shop at. They also go to the same doctors.... it is a smaller world than one might think. I also transcribe work comp reports to include police officers, some of whom are old friends of mine. I definitely do not mention who I transcribe for to anybody, and nobody enters my office but me.

Living in a large several million people town - and not paranoid in the least

[ In Reply To ..]
Have no idea where the people on my street go to the doctors/hospitals, whatever, have no idea where most shop, never see anyone I know at any store I visit, I have transcribed VIPs before, worked inhouse and now do same work for the hospital was outsourced from, tell people the name of the hospital (did the same while working inhouse, no big secret there?) and right now have my work room door wide open. I am not scared nor intimidated by HIPAA as some seem to be. BOO!

Do ya think OS abides by HIPAA? (Yes is not the - correct answer.) nm

[ In Reply To ..]
x

This is the main reason I consider it a farce too. - Offshoring and HIPAA compliance, give me a break.

[ In Reply To ..]
nm

Technically, a legal airplane could fall on your head, but it - be as reasonable to worry about the real thing.

[ In Reply To ..]
Regulatory agencies have better things to do than come get an MT who didn't report that a 4-year-old was playing in the room while Mommy dictated.

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