--- From: "J.D. Abolins" <jda-ir@private> Reply-To: jda-ir@private To: Declan McCullagh <declan@private> Subject: Another unintended consequence of recent health privacy laws. Date: Fri, 3 Oct 2003 12:12:01 -0400 Cc: "Jim Harper - Privacilla.org" <jim.harper@private> An interesting article below about HIPAA and one of its side effects not generally covered in newspapers and TV reports in my area of the USA (NYC-Philadelphia metro). Jim Harper touched upon it briefly on the Privacilla.org site. (See http://www.privacilla.org/business/medical/medicalbackfire.html) My further comment follow the article snippets. -JDA ------- http://www.jewishworldreview.com/0803/clergy_privacy.php3 Jewish World Review Sept. 24, 2003 / 27 Elul, 5763 Privacy law hinders clergy's access to parishioners who are hospitalized By Sarah Carr and Scott Williams Religious and ill? An expanding government is making it harder for you to receive "spiritual healing" along with your medical treatment MILWAUKEE — Rabbi Leonard Lewy worries about what could be lost in the name of privacy. Gone are the days when members of the clergy could walk into a hospital, open the patient files and scan the names for their parishioners. New federal rules designed to protect patient privacy have complicated one of the traditional roles of the clergy: visiting and aiding the sick and the dying in the hospital. In most cases, patients must now consent to having their names and conditions released before the hospital may do so. In one instance, Lewy said, three members of a group for Jewish adults with special needs fell ill and died in the hospital without the Jewish Chaplaincy Program even finding out they had been hospitalized. He believes his organization would have been aware of the illnesses before the latest version of the federal Health Insurance Portability and Accountability Act took effect in April. The law is aimed at preserving patients' rights by ensuring their names and conditions are not released against their will. "Sometimes in protecting privacy, we can cut off our nose to spite our own face," Lewy said. [...] Because of the complexity of the act's regulations and their relative newness, hospitals have interpreted the rules in varying ways. Some no longer allow clergy access to computerized databases of patients, for instance. Others now compile lists of patients who have agreed to release their names and present them to clergy. Clergy members have responded by educating their flocks - posting notices in newsletters instructing them to call religious leaders directly if a family member is hospitalized. Still, they worry that a newly admitted patient without the ability to ask for a clergy member may never be discovered. [...] "In some situations, I think there has been confusion and concern that the hospital is holding back a name when in reality the family and patient have requested that it be held back," said Mary Kay Grasmick, Wisconsin Hospital Association spokeswoman. No rabbi or priest expressed a wish to visit parishioners against their will - or publicize to a congregation information about an illness that a member wishes to keep quiet. But they are concerned that amid all the confusion of being admitted to a hospital, a patient may forget or be incapable of requesting clergy. [...] Sarah Carr and Scott Williams are reporters for Milwaukee Journal Sentinel. © 2003, Milwaukee Journal Sentinel Distributed by Knight Ridder/Tribune Information Services <snip> End of article snippets My comments: Besides the interpretation of HIPAA by various hospitals blocking clergy access, the article shows how the combination of confusion about what it takes for a hospital to comply with HIPAA and the stiff liability potential pushes aside many other, worthwhile, functions. Keep in mind that the fear, uncertainty, and doubt (FUD) are not lingering over the egregious scenarios (hospitals leaking juicy patient info to the tabloids, staff telling patient employers of substance abuse problems without consent/authorization, etc.) but over the interpretation of petty disclosures that can occur in day-to-day operations. Things such as a pharmacist talking with a customer and Mr. Nosey-with-Excellent-Hearing picks up bits and pieces to blab about town; somebody in hospital recognizing a neighbor in the hospital's ER and calls the neighbor's family to tell of the news, etc. How much is "reasonable" of a safeguard to provide defense against a HIPAA-based penalty or suit? Nobody seems to know and nobody wants to be the "lucky one" to be in the early cases that begin to give some answer, of sorts, from the courts. But if the cases settle outside of court, then we are still in the dark. Oh, incidentally, one of the revenge effects of this approach to medical privacy is that the rewards/penalties are pushed towards cutting various communications that were generally beneficial or tolerable in favor of legal defensibility. Acts of kindness, such as a hospital volunteer helping a clergy member find a congregant who did give all kinds of overt authorizations, threaten death by a thousand lawyers. <grin & groan> I believe that the HIPAA approach has made negotiations about medical privacy and information handling much more complicated and often impossible for patients and physicians, at least without going underground, going oversees, or to the few physicians who can work in the areas outside of HIPAA. (I am not an expert of HIPAA but I see some limitations in its applicability whereby a physician could provide care without the hindrances. The practitioner and her patients would have to forgo certain resources common in medical care, but it can be done. Marcus Welby, where are you when we need somebody like you? <grin; 1970s reference> J.D. Abolins _______________________________________________ Politech mailing list Archived at http://www.politechbot.com/ Moderated by Declan McCullagh (http://www.mccullagh.org/)
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