So Much for Medical Privacy

[Meadbh]

Quote:

Originally Posted by haha Then how did OP have the experience he had? I think that the Doc's responsibilities extend to training, supervising, and firing his staff members if they can't do it right. Throwing patient histories into the trash is not doing it right.

I agree with you. That is why Koolau should complain to the relevant regulatory body, which has the power to discipline the physician who is breaking the rules/law. They won't know about it until someone brings it to their attention.

Quote:

Originally Posted by haha The rules of professional associations seem largely created to stem competition. How come if I go into a restaurant I see prices on the menu? My shoe repair guy or dry cleaners post prices. Getting prices out of a doctor or dentist without burning some time and often some money can be impossible. I know you are a good doctor, and I am not talking about you. But I just had some expensive surgery and I had no idea what it was going to cost until I got my bill yesterday- 4 months after the operation, and 10 months after my first appointment with them. IMO, dentists are worse. They guard their fees as hard as we guarded the Manhattan Project. Ha

It would not be appropriate for me to comment on the financing of the US healthcare system,except to note that it does seem strange in a market economy to have this information differential.

[Koolau]

Quote:

Originally Posted by Live And Learn Ko'olau's Law - Anything which can be used can be misused. Anything which can be misused will be. ~~~~~~~~~~~~~ Is that signature line new or are you psychic ?

That tag line is the truest thing I know. I've been using that one for 3 or 4 years. Before that, I used "Murphy was an optimist." YMMV

[MRG]

Agree Meadbh,

HIPPA laws provide definition of what is to happen should a breach occur. It included fines and possible litagation. Megacorp's policy, if you caused a violation that resulted in fines, they would back you only if you had followed policy. If you didn't you would be terminated, possibly held accountable for the breach fined, sued.

The OPs claim is a clear violation of HIPPA law. Electronic records are really supposed to be much more secure. I can track everyone that has viewed a medical record, try that with a paper file.

[Koolau]

Quote:

Originally Posted by haha Medical practices do pretty much whatever they please. The docs have the whip hand. Ha

Oddly enough, the doc I see "just works there." The clinic itself is who I blame. They have come in and "gobbled up" an older clinic and now have a near monopoly on doctors and hospitals in the area. They have the nerve to call themselves "not for profit." I'm sure they have carefully met the legal requirements for that designation, but someone is getting rich from their "business." In today's climate, virtually all docs must combine their practices with other docs or "live" under the umbrella of some greedy entity like the clinic in question. One doc needs almost as much office staff as half a dozen docs combined together. The real pay off is when all the local docs are "owned" by one "not for profit" outfit. The docs don't make as much money as they used to, but someone else handles the paperwork and insulates them from many of the hassles. I see why they do it, but it becomes very impersonal until you step into the doc's exam room. In this case, I love the doc. I just hate the clinic he has been forced to join to stay in business and offer his services. I doubt he has a clue what the "front office" does. He works 10 or 12 hours a day and has to count on the clinic to responsibly handle a lot of the details.

[ERhoosier]

Quote:

Originally Posted by Meadbh Ha, I don't know where you got that idea, but I assure you that physicians are bound by the law of the land and by the rules of their professional associations, and may be held to account if they do not follow them.

And most docs (inc mine of 20+ yrs) are now employees of health care systems who have long since lost the power to run even their own offices

And FWIW- I agree 100% that health care pricing needs to be MUCH more transparent and open, but that prob deserves its own thread.

[KM]

I have been leaving SSN blank on medical forms for years. Not once have I been questioned for it. I suspect they dont even notice it's blank....

[samclem]

Quote:

Originally Posted by MRG I can track everyone that has viewed a medical record, try that with a paper file.

And if one of the (now hundreds) of people with legitimate access to the files makes a copy or a print or a screencapture and print, what then? Can we still track the info? This was obviously also a problem when records were solely on paper, too, but the universe of people with access to a particular patient's records was much smaller. It might not affect most of us, but high profile people will have very little chance of their medical conditions, prescribed medications, etc not becoming public knowledge.

[Refresher]

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Originally Posted by Derslickmeister Unfortunately, this is the new normal. It's not just medical privacy, it's privacy period. You can kiss it good bye. The casual attitude you mention has permeated into pretty much all areas of life...

Yep, not much we can do
It may be smart to freeze your credit in case someone tries to use your SS# to open accounts which you may find out about after the damage has been done.

[spncity]

Quote:

Originally Posted by Meadbh Koolau, this casual attitude to patient privacy is simply unacceptable. If I were you I would complain to the Hawaii Medical Board.

Typically medical boards allow you to make a complaint anonymously. if you are not sure there won't be retribution (as in dropping you as a patient).

Kindest regards.

[John Galt III]

This reminds me of the time I was waiting in the hallway outside my doctor's office. I noticed 2 manilla folders in a bracket on the door. One of the folders had my name on it. Since the doctor was late, as usual, and I was wasting my time, I took down my folder and started reading the documents in it. After a minute, a clerk walked by and screamed "What are you doing? You can't read those files! They're for the doctor only!" I told her I was only reading my own file, but it didn't matter to her. We had a tense standoff and she left in a huff, while I retained my folder in my possession. There was no mention made of the incident when the doctor finally did arrive. I even got to remain on their patient list!

[MichaelB]

I think medical privacy is alive and well. Just call a doctor's office and ask for information about someone other than yourself. Even when you have a clear need and legal authorization, it is denied more often than not. Except for paying a bill, of course.

[travelover]

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Originally Posted by John Galt III ....... I told her I was only reading my own file, but it didn't matter to her. We had a tense standoff and she left in a huff, while I retained my folder in my possession. .........

Ironic isn't it that your own medical records are denied to you, but any clerk has access? Especially given that you paid for all the services within.

[John Galt III]

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Originally Posted by travelover Ironic isn't it that your own medical records are denied to you, but any clerk has access? Especially given that you paid for all the services within.

Indeed.

[MRG]

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Originally Posted by samclem And if one of the (now hundreds) of people with legitimate access to the files makes a copy or a print or a screencapture and print, what then? Can we still track the info? This was obviously also a problem when records were solely on paper, too, but the universe of people with access to a particular patient's records was much smaller. It might not affect most of us, but high profile people will have very little chance of their medical conditions, prescribed medications, etc not becoming public knowledge.

Well printing is normally strictly controlled, as in you have no reason to print. Yes printing is an auditable occurance. Most medical record systems I've seen obsufcate any data the user doesn't need to do their job, so the intent is less acess to your data. This carries though the printing proces. If you had ever seen the back office filing systems used in many hospitals you might believe your data is more secure as electrons.

Of course it would help to understand specific concerns. Dr's. office, insuranace companies, the myriad of third parties that have processed your personal data for the past 30 years. Who are we concerned about disclosing PHI?

My guess is it's Dr's. and clinics, as they are newer to electronic records. Their training and procedures will come up to speed, laws are in place to ensure that.

[growing_older]

Quote:

Well printing is normally strictly controlled, as in you have no reason to print. Yes printing is an auditable occurance.

Not at any doctor office I've been in. My current doc has a practice of printing all the ID info and asking you to sign it EVERY time you go for an appointment. Very similar to what others have described. I think your idea that all printing is tightly controlled is nothing like actual practice.

[samclem]

Quote:

Originally Posted by MRG Their training and procedures will come up to speed, laws are in place to ensure that.

The world would be a different place if laws somehow ensured behavior.

There are already laws against a lot of the things described in this thread. In the real world, I don't think they accomplish very much, except maybe to provide grounds for punishing people on the very rare occasions when the offenses come to light and are reported appropriately and somebody is motivated to do something about the situation and the perpetrator can be identified. That's a dang thin string by the end.

Anyway, I hope you are right and these privacy issues won't become a problem, but I am not optimistic.

[Gotadimple]

The issue of requiring a social security number is a complicated one - historically. As many have stated, using the SSN is considered protected info under HIPPAA.

Historically, clinics collected the SSN from patients because it was (generally) it was a unique number reserved for one individual (I say generally because fake SSNs are how many collect Medicaid benefits if the state isn't verifying the number).

Many insurance carriers also used the SSN as the member number. Most carriers have converted to unique member numbers (except Medicare), but they may carry the SSN in their records as a cross-reference.

So, here we are today, where an SSN in the medical setting is just not necessary, AND is considered protected by HIPPAA. That a clinic hassles one about the SSN is unfortunate.

Koola'u - I would gently remind the front office staff that you will not release it as it protected under HIPPAA and you would appreciate it if they strike it from their system. That's the first step. Secondly, ask for their Quality Assurance Director, and if not local ask for a phone number to their corporate customer service for QA. Report it, and report it to the Hawaii Medical Quality Assurance Board as well.

Rita

[samclem]

Quote:

Originally Posted by Gotadimple Secondly, ask for their Quality Assurance Director, and if not local ask for a phone number to their corporate customer service for QA. Report it, and report it to the Hawaii Medical Quality Assurance Board as well.

And then when you go back to that office and they need a blood sample, let us know if they get a good painless "hit" right away, or if they have to kinda "search around" with the needle in your arm for a few minutes until they finally get it. I'd expect that to start happening a lot--if they'll even see you again. "Sorry--our client list is just to full now."

[Koolau]

Quote:

Originally Posted by samclem And then when you go back to that office and they need a blood sample, let us know if they get a good painless "hit" right away, or if they have to kinda "search around" with the needle in your arm for a few minutes until they finally get it. I'd expect that to start happening a lot--if they'll even see you again. "Sorry--our client list is just to full now."

Heh, heh. I thought about these scenarios if I made an "official" complaint. My guess is that the "medical professionals" would still do their best - just because that is how they have been trained. It would not surprise me if I became persona non grata at the clinic itself.

I agree with you about "laws" rarely being effective at stopping most behavior (Benjamin, I have just one word for you. "Drugs".)

As I suggested earlier, I'm guessing a big "test case" will come up some day - sort of like when Target lost however many credit card records. Unfortunately, we may have to wait until then to "test" medical records privacy to any real extent. It is all very frustrating, somewhat frightening and also pretty much out of our control in the main. YMMV

[travelover]

Quote:

Originally Posted by samclem And then when you go back to that office and they need a blood sample, let us know if they get a good painless "hit" right away, or if they have to kinda "search around" with the needle in your arm for a few minutes until they finally get it.........

This is why I never pi$$ off my dentist.