Hi all,please, I would like to hear any one's opinion about this scenario regarding HIPPA privacy rules and safeguarding patients medical health records. Thanks!A resident in cardiology is viewing patients that are currently in the cath lab. He also is accessing charts from pts that have been seen within the last month in cardiology in an outpatient setting. He also has accessed 15 or more patients that are deceased some of which are from 15 years ago. Given the different settings and the accesses of deceased patients would any of his behavior be questionable to you?
I may be off base here, but it sounds like the resident is doing some research possibly on types of treatments and outcomes, etc. Especially if they are just viewing records and not printing anything or if when you run the audit trail and see that they are viewing the same documents or sections of each chart, it most likely is research.
What is your facility's policy on conducing chart audits for research? Make sure the resident is following that policy for compliance: proper approvals (IRB) as needed and appropriate access.
My two cents. I would assume it is harmless and could be a great teaching opportunity for you and the rest of the facility and would make a good in-service. If there is no policy in place for research by residents, there probably should be one.
If they are just snooping around, then the answer to your initial question is yes, this is questionable behavior.
Interested in how you handle this because it would make a great case study for my students in the HIM bachelor program.
University of Wisconsin - Stevens Point
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I think that you should be asking his superior why he would need to be accessing these records. They are not part of his job duties on a daily basis. Maybe he is using the information for reference purposes, or maybe his superior asked that he looked at older cases to see what has improved. In any case, they should have come to you or informed you that he would be doing this. From what you have described, it doesn't seem right that he accesses old records, especially from deceased patients.
Valerie L. Berkebile, RHIT | Medical Records Director/HIPAA Privacy Coordinator
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I would pose the question to the Residency Teacher.......we are just starting a residency program and those potentially could all be "assigned" chart reviews for learning purposes....
Wendy Mangin, MS, RHIA
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