HIPAA claims another victim - when will we stop the insanity?

[hoosierdoc]

Texas nurse treats a measles kid. Posts about it in an anti-vax forum (of which she is a member, and a non-vaxxer). Someone screenshots it and posts it on hospital FB. They fire her.

This is absurd. HIPAA fears are real, administrative reactions are as bad as corporations removing sponsorships from you for things your dad said before you were born, that were not racist.

If it's some mortal sin to post that, why did the newspaper reprint it. I know they are not bound by HIPAA, but if the offense is someone posting the info, why did they do it? So freaking stupid.


Here is story about publicly released info.

CONFIRMED: a little boy b/w 1-3 YO, has tested POSITIVE for measles, and is being treated @TexasChildrens in #Katy. Doctors say he contracted it while on a trip abroad. This virus is HIGHLY CONTAGIOUS & PREVENTABLE. Parents, docs say please vaccinate your kids. #khou11 #htownrush

https://www.khou.com/article/news/h...positive-for-measles-in-houston/285-588240441

Here is a story about what she posted

“I think it’s easy for us nonvaxxers to make assumptions but most of us have never and will never see one of theses diseases,” the self-identified nurse wrote, according to the screenshots. "[F]or the first time in my career I saw measles this week. Actually most of my coworkers and the ER docs saw measles for the first time as well. And honestly, it was rough. The kid was super sick. Sick enough to be admitted to the ICU and he looked miserable. “By no means have I changed my vax stance, and I never will. But I just wanted to share my experience and how much worse it was than I expected," she added.

https://abcnews.go.com/US/texas-nur...ts-measles-anti-vaccination/story?id=57443736

 

[femurphy77]

Nowadays there are a lot of "crimes" that when reported will be overreacted on to protect against collateral damage. Unfortunately it's easier to fire one person and deal with that aftermath than to deal with the outrage of social media and the press. Even if an allegation is proven to be completely false all the general public will remember is that X did Y. Not that X was only accused and later completely cleared of Y.

Guilty even if proven innocent is the new norm.

 

[hoosierdoc]

I don't understand how health records became so freaking important that there is jail time, massive fines, and firing for mentioning that you saw a patient.

if a reporter says "I saw Mr Smith at the pharmacy asking for medication to treat herpes", that is totally fine. But if a nurse says "I saw a sick kid with measles" she's fired. wth

If a family puts on FB their kid has measles and it being admitted, and the nurse said she saw a measles kid, is that still criminal? It's publicly revealed information. Yes... yes. it is. Because it's "protected health information" about what condition he has even though she didn't say who it was. Hospitals will fire you even if there is NO WAY to connect who you are talking about to an actual person.

It's beyond stupid and needs to be tossed away. No, I don't think medical people should tell people about a patient's condition or diagnosis, but HIPAA is a horrible piece of legislation to try to make that happen. I'd love to see how much that increases the cost of medical care. It's a significant percentage with all the compliance necessary.

 

[HoughMade]

Anyone remember this? I was minimally involved in some legal actions that resulted when I was a young'un. This short article doesn't say much, but it was an anti-vax nurse at a family practice who gave about 1,300 kids fake vaccinations, that is, she injected saline (I think) rather than the vaccine.

Fake Immunizations Charged - tribunedigital-chicagotribune

Perhaps the hospital does not want to take a chance by having an anti-vaxxer on staff or it really didn't like the PR nightmare which is having an anti-vaxxer on staff.

...but the OP story really isn't a HIPAA issue. If no identifying information is given, I do not believe it is a violation of the Privacy Rule.

 

[hoosierdoc]

the interpretation we hear is that if the info can be connected back to a patient in any way then it's a violation. Parents know their child was admitted and it's obvious that is who the nurse is posting about. But again... what's the PHI? The diagnosis? That was made public before her post.

If I say I recently saw a patient with a GSW to his hand, and someone on here had shot themselves in the hand recently and complained to my hospital, they could probably do the same thing. Of course I've seen SEVERAL patients who have shot themselves in the hand, how do you know which one I was talking about? Does it matter? They don't care, they just fire you to stop whatever PR problem there might be, as a result of this stupid law. But I guarantee NO ONE (relatively speaking) knew about her post until they fired her, and now the entire country does. Idiots.

 

[Trigger Time]

Next thing you know they're gonna make doctors and nurses take vows of celibacy.

This sounds rediculous. Lots of good healthcare workers are getting th shaft.
Also like Doc said, how much is this adding to my cost? This cant be cheap. The healthcare business is the biggest ripoff and scam in our country. Surpassing financial institutions slimyness.
We need to find ways to make healthcare costs lower and more competative and not do **** like this that scares companies and good people away

 

[HoughMade]

the interpretation we hear is that if the info can be connected back to a patient in any way then it's a violation. Parents know their child was admitted and it's obvious that is who the nurse is posting about. But again... what's the PHI? The diagnosis? That was made public before her post...

That may be their interpretation, but it's not the law. You know better than most that physicians routinely use case studies to discuss various practice issues.

 

[IndyTom]

Maybe they fired her for being an idiot. 'This is awful, but not as bad as vax.'

ETA:

Perhaps the hospital does not want to take a chance by having an anti-vaxxer on staff or it really didn't like the PR nightmare which is having an anti-vaxxer on staff.

This.

 

[hoosierdoc]

any thoughts on whether this case violated a confidentiality law, independent of HIPAA? Does there have to be harm for that?

 

[HoughMade]

any thoughts on whether this case violated a confidentiality law, independent of HIPAA? Does there have to be harm for that?

If she is talking about a measles case that in no way identifies the patient (to someone who was not already in the know), I don't see another law that applies.

 

[yeti rider]

It would be one thing if the nurse gave her name, the patient's name, the hospital this was at, and the person's diagnosis. If she was just posting in general terms, i see nothing wrong.

 

[hoosierdoc]

If she is talking about a measles case that in no way identifies the patient (to someone who was not already in the know), I don't see another law that applies.

I think that is the root of the problem I have. The only way anyone can identify who she was talking about is if they already knew that the kid had measles and was admitted there.

I posted this on a physician message board and almost everyone slamming her as an idiot anti-VAX person. They said she gets what she deserves for her position on vaccines. Harsh.

 

[Fargo]

I think that is the root of the problem I have. The only way anyone can identify who she was talking about is if they already knew that the kid had measles and was admitted there.

I posted this on a physician message board and almost everyone slamming her as an idiot anti-VAX person. They said she gets what she deserves for her position on vaccines. Harsh.

This is in no way directed at you doc, but when the medical community goes dogmatic to the point of purging anyone not toeing the line on vaccine safety, there is a reason that a lot of people stop trusting it’s official position on the matter.


Whenever there is science, that “shall not be questioned” I cease to believe that it is science.

 

[jkaetz]

I don't understand how health records became so freaking important that there is jail time, massive fines, and firing for mentioning that you saw a patient.

if a reporter says "I saw Mr Smith at the pharmacy asking for medication to treat herpes", that is totally fine. But if a nurse says "I saw a sick kid with measles" she's fired. wth

If a family puts on FB their kid has measles and it being admitted, and the nurse said she saw a measles kid, is that still criminal? It's publicly revealed information. Yes... yes. it is. Because it's "protected health information" about what condition he has even though she didn't say who it was. Hospitals will fire you even if there is NO WAY to connect who you are talking about to an actual person.

It's beyond stupid and needs to be tossed away. No, I don't think medical people should tell people about a patient's condition or diagnosis, but HIPAA is a horrible piece of legislation to try to make that happen. I'd love to see how much that increases the cost of medical care. It's a significant percentage with all the compliance necessary.

My previous position was doing all the back end IT work for a clinical affairs operation. I posed a similar question to one of my colleagues and the only response I got was that it could be used against you. IMO insurance companies are the only ones who would try to use it against the average person. I'm sure there are public figures it would be used against as well should it be public knowledge/easier to share. Our AVP would refer to PHI as people's most critical information. For most people I believe that is financial info.

 

[hoosierdoc]

I agree on the dogmatic issues. If she’s telling patients not to get vaccinated then fire her butt. Not for this though.

 

[femurphy77]

I routinely tell our team members that if it is necessary to enter a patient room to only ask what protocols should be followed. If the clinical staff starts going into anything remotely related to condition they should politely remind the staff that their only concern is the safety of the patient and themselves. We've become so litigious that you have to protect yourself from every little slip. Unfortunately I'm guessing most business' will also take the same path when confronted with similar issues.

I got a call one weekend about a problem in a patient room and asked the tech to text me a picture of the issue. The nurse went ape **** on him! Ended up having compliance come up and take the exact same picture to "ensure the patient's privacy". They were taking a close up of a med gas outlet.

 

[bwframe]

 

[IndyIN]

Texas nurse treats a measles kid. Posts about it in an anti-vax forum (of which she is a member, and a non-vaxxer). Someone screenshots it and posts it on hospital FB. They fire her.

This is absurd. HIPAA fears are real, administrative reactions are as bad as corporations removing sponsorships from you for things your dad said before you were born, that were not racist.

If it's some mortal sin to post that, why did the newspaper reprint it. I know they are not bound by HIPAA, but if the offense is someone posting the info, why did they do it? So freaking stupid.

So... the Safe Harbor method of de-identification states that in order for PHI to be not identifiable a few conditions must be met. https://www.hhs.gov/hipaa/for-profe...topics/de-identification/index.html#protected

The following identifiers of the individual or of relatives, employers, or household members of the individual, are removed:
(B) All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP code, and their equivalent geocodes, except for the initial three digits of the ZIP code if, according to the current publicly available data from the Bureau of the Census:
(1) The geographic unit formed by combining all ZIP codes with the same three initial digits contains more than 20,000 people; and
(2) The initial three digits of a ZIP code for all such geographic units containing 20,000 or fewer people is changed to 000
(C) All elements of dates (except year) for dates that are directly related to an individual, including birth date, admission date, discharge date, death date, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older

Seems like posting a patient was admitted this week at a specific location ticks a couple of those boxes? Really though, it is just not professional... Easy to second guess this, but was this the 1st or 30th bad judgement decision this person made? Do stupid things... get stupid prizes.

 

[hoosierdoc]

I am challenging what constitutes “professional”

.

 

[Hohn]

I think that is the root of the problem I have. The only way anyone can identify who she was talking about is if they already knew that the kid had measles and was admitted there.

I posted this on a physician message board and almost everyone slamming her as an idiot anti-VAX person. They said she gets what she deserves for her position on vaccines. Harsh.

She might be an idiot. But what has that to do with this at all? Seems like a non-sequitur to me.