Confidentiality, Privacy and Security

Do others see this much anymore???

  • 1.  Do others see this much anymore???

    Posted 12 days ago
    I still hear from patients that when they request access to their records under HIPAA, they only get copies of records from the Designated Record Set (DRS) that were created by the provider receiving the request for access.  The patients are told that they need to go to the provider that originally created the records in order to request access.

    Now I don't run into this nearly as much as I used to...but still enough that it happens somewhat regularly.  Do others run into this as well?  Note, this question applies to requests for access where there is no reason to deny the request for access as allowed by HIPAA.

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    Frank Ruelas
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  • 2.  RE: Do others see this much anymore???

    Posted 9 days ago
    As a rule, we do not provide copies of external records unless asked.  If asked, we are happy to provide and will do so.   External records are always a challenge, especially when they may contain hundred, and yes, even thousands of pages...

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    Nancy Davis, MS, RHIA, CHPS
    Director of Compliance & Safety
    Door County Medical Center
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  • 3.  RE: Do others see this much anymore???

    Posted 9 days ago
    Thanks for sharing Nancy.  Good to hear you would provide copies if asked.  This was a much bigger problem in the earlier years of HIPAA, so I'm glad to see that it has gone down quite a bit.

    I also see more and more organizations work with patients to clarify what patients are requesting and often this can help reduce the workload.  One common example is that a patient seen in the ED may request "any and all records from my ED visit of 6/29/20".  After a quick call to the patient, the patient then considers that a copy of the physician's discharge summary is really all that they need.

    This often means...I like your example...that instead of dozens and certainly a hundred or more pages from an ED visit, the patient is fine with a couple of pages which serve their purpose and give the next physician (example: PCP) what info they need.

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    Frank Ruelas
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  • 4.  RE: Do others see this much anymore???

    Posted 8 days ago
    Unfortunately, through first hand experience with breast cancer, I have learned that the only documents that I need in my hand (or personal file) are the operative reports, pathology reports, and treatment plan.   The rest is just "noise."

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    Nancy Davis, MS, RHIA, CHPS
    Director of Compliance & Safety
    Door County Medical Center
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  • 5.  RE: Do others see this much anymore???

    Posted 8 days ago
    I do not want to make assumptions...so forgive me if I am misunderstood.  I applaud you in dealing with breast cancer (whether you personally or as you supported someone with breast cancer.)

    My Mom fought the good fight against cancer for 10 years.  In the end, they gave her 2 weeks when she was discharged to home hospice in my home.  I truly believe that being surrounded by those she loved and in a place she could call "home"...it made all the difference in the world.

    She stayed with us another 12 weeks before she was finally called to Heaven.  Your posting brought back some wonderful memories....thank you!

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    Frank Ruelas
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  • 6.  RE: Do others see this much anymore???

    Posted 8 days ago
    We don't typically have that concern with general requests, though it does occasionally happen. We normally see the "any and all records" on  investigative subpeonas. Our clerks weren't giving "any and all" and were only giving the more commonly requested ED Record, diagnostic reports and discharge info. I recently attended a local law enforcement detective's meeting where I explained our process and rules and they explained what they needed and what they were generally looking for. We all agreed that when law enforcement is looking for "any and all," it will mean everything but photos. If they suspect or expect photographs, it will need to be listed specifically.

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    Kathryn Wood, RHIA
    Assist Dir of Information Systems/Privacy Officer
    War Memorial Hospital
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  • 7.  RE: Do others see this much anymore???

    Posted 8 days ago
    Makes sense since when you get an "any and all" type of request from law enforcement, one possibility is that quite frankly law enforcement may not know what is in the DRS and is looking to receive whatever is available.

    The upside...and I have yet to find an organization that is different...many providers get many more requests from individuals/patients/personal representatives than from law enforcement.  Given the significant differences in the numbers, this is where working with requesters that are not law enforcement can really help save some work and minimize sending unnecessary records.

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    Frank Ruelas
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