My Health Department is working to finalize guidelines, and I've appreciated
the discussions on lactnet re: HIPAA.
Here is my understanding (for what its worth, being an outsider...)
Per Formula samples:
Samples themselves are okay, but getting patient information in order to
give them out is not. Therefore, can't give/sell patient contact info to
marketers. Also, Reps should not be anywhere where they can see patient
information -- eg., nurses stations, etc. Therefore, they can probably be
restricted from stocking areas. If they can't restock themselves, you may
have a related case that staff shouldn't have to do the stocking for them...
I don't know if VOLUNTEERS can be restricted in the same way (although I
should think that volunteers as well as paid staff must abide by these
guidelines). Also, I don't know how this will affect companies like First
Foto (who might then sell their client information to a third party - eg.,
formula co).
Per lc in-patient visits:
Well, one would assume that there is already some kind of existing hospital
policy concerning lc in-patient visits. When the patient is admitted, they
will have signed a Notice of Privacy Practices, which spells out when
*additional* signed authorization is needed. Based on your policies, the
Notice of Privacy Practices your facility develops should include in-patient
referrals for treatment (eg., to PT/OT, nutrition counseling, classes, etc.
as well as bf assistance).
Per Telephone Follow-up
Again, the hospital probably already has a policy concerning follow-up
contacts (phone calls, mailed surveys, etc) for their patients. The Notice
of Privacy Practices should note that follow-up contacts DON'T REQUIRE
additional signed permission. In a sample Notice of Privacy Practices
published by HIPAA Compliance Alert, is the statement, "We will use and
disclose elements of your protected health information... without additional
signed consent... to contact you about appointment reminders, treatment
alternatives and other health related benefits and services." Again,
follow-up calls policies should cover ANY follow-up calls made by the
institution.
Per patient referrals:
There is probably an existing policy for providing patient info to the
patient's primary health care provider, which ensures information
protection. Also, for HIPAA the hospital will have had to track ALL of the
folks they share patient health info with (eg., health dept., MD offices,
billing agcys, DMEs, etc) and the context in which they would share such
info. In general, it is sharing information on MUTUAL PATIENTS. If a mom
would qualify for WIC, the hospital can give the mom program referral
papers, but it is up to the patient herself to contact WIC and make an
appointment the program. OR additional consent can be obtained (say, by the
NICU Social Worker) to contact the program and make an appointment on her
behalf. This kind of policy/procedure should also be spelled out.
In general, personal health information (PHI) is to be used ONLY for
healthcare purposes to do your job. The previous poster was right -- you
can't look up Uncle Bud's next dialysis appointment in the hospital computer
if it doesn't have anything to do directly with your job.
Also, HIPAA doesn't preempt state laws for reporting public health info (eg,
vital statistics, child abuse, disease/illness (eg., syphilis, TB, PKU)).
These exemptions should be spelled out in the Privacy Notice.
The law DOES require that health care workers must report violations of
patient confidentiality to their supervisor or the institution's HIPAA
Compliance Officer; there ARE whistleblower protections.
I hope this is helpful. I look forward to hearing more.
Doraine Bailey
Lexington-Fayette County (KY, USA) Health Department
Celebrating: *2003 World Breastfeeding Week , August 1-7
"Breastfeeding in a Globalized World"
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