Confidentiality, Privacy and Security

To share or not to share information

  • 1.  To share or not to share information

    Posted 24 days ago
    Hi everyone, I am looking for some insights on the following:
    I  work for a hospice and palliative organization and today I had a conversation with our risk manager about who we can share information to in this situation. On our new consents for new admissions, we have a security code listed as well as an area for patients or legal rep to list who they want to share information with. Unfortunately, it looks like due to lack of education to the admission staff (nurses), we are seeing a good amount of consents where patients or legal rep sign but decline to have anyone access to their phi. As I shared my concerns, the risk  mgr claimed that it doesn't affect anything as information are going to be given verbally anyway to family or whoever has the code. The listed name only affects sharing through paper records. My logic is if patient said no sharing, it means no sharing unless we have legal paperwork, patient authorization, or sharing only in patient best interest.
    My question to you all is what are your thoughts on this? I need your expertise please.

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    Louise Boucicaut MS, RHIA
    Corporate Medical Records Manager
    Community Hospice and Palliative Care
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  • 2.  RE: To share or not to share information

    Posted 21 days ago
    This seems problematic to me.   It is true that HIPAA allows the sharing of information (PHI) with friends and family members involved in the care of the patient.   However, if you are specifically asking the patient or legal representative to delineate or consent to the sharing, and they refuse, that seems to negate the general principle of HIPAA allowing the sharing.   I would think that in a hospice situation, you may have patients who want to limit information to spare their loved ones...  It seems like you may have to retool your processes to make it very clear when and how you share information and if you really want to impose a consent process for this.

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    Nancy Davis, MS, RHIA, CHPS
    Director of Compliance & Safety
    Door County Medical Center
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  • 3.  RE: To share or not to share information

    Posted 20 days ago
    Thank you, Nancy. I agree with everything you have written. I have the same reservation on this case; specially, when the risk Mgr shared that the PHI will still be given over  the phone or in person with the security code when patient declined to share with anyone. We are a large hospice organization in 16 counties and growing and  I  can see huge negative or legal impacts with this change. I wouldn't see too much of a problem, if I knew minimum necessary information as allowed by HIPAA was shared with family members during care. However, it's new and our clinicians used to verbally share all info with family and friends with the code. I see a moment of education for all and unfortunately, our risk mgr doesn't see it that way as if the  name part on the consents only applies to paper records, but not verbal disclosures. Thank you

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    Louise Boucicaut MS, RHIA
    Corporate Medical Records Manager
    Community Hospice and Palliative Care
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  • 4.  RE: To share or not to share information

    Posted 20 days ago
    Sorry to jump in, but I am a current HIM student at Monroe Community College and would love further insight into legal situations that can arise from missharing or oversharing of patient information. While in class learning about the legal aspects of the job I felt it was briefly passed over and would like to know either of your opinions on whether the majority of facilities really know how to keep track and keep ahold of their information when necessary.

    Thank you in advance for any insights you can offer on the subject.

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    Sarah Wilkin
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