Legal Corner

Alabama Nurse,  Sep-Nov 2003  by Eddins, Don

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In no field is confidentiality more important than the medical profession. Registered nurses always have been aware of that fact, but they face a new emphasis on confidentiality as the federal Health Insurance Portability and Accountability Act (HIPAA) is phased in.

Believe it or not, HIPAA is designed to simplify and standardize certain medical record components. At the same time, the law establishes national standards with regard to patient privacy.

Of utmost importance to the staff nurse is to know your health care employer's policy. What can be released? And how can it be released?

The law solidifies the standard that patients have a right to access their own medical records. Medical facilities, however, can establish policies for review. Many hospitals, for instance, make a professional available to go over the records with the patient, who might not understand the medical jargon therein.

While providing access to the patient, the law creates obstacles to others seeking patient records it allows patients to place reasonable restrictions upon who can access their records. An insurance company, for instance, may need to know only information pertinent to billing. A patient can restrict a family member's access to information, as long as it does not inhibit treatment.

The law applies a "minimum necessary" standard. That is, release only the minimum necessary to those few with a legitimate need to know.

Nurses can stay out of trouble if they know the privacy policies of the facility where they work. And if they use common sense. It is always wise to limit information given out over the telephone, especially if you don't know the party seeking the information. How can you be sure of the identity of the person on the other end of the line? A good policy is to direct the person to speak with a member of the family.

We all know to avoid emails and faxes. But we should also be careful about conversations in elevators or hallways where you might be overheard.

HIPAA was first approved in 1996 and is being impiemented over a period of years. A next step, for instance, is development of nationwide, standard insurance forms.

We've heard a lot about it lately, but confidentiality is not new to nurses. Violation of privacy standards long has been an area which could get you into trouble with the Alabama Board of Nursing.

Be careful and use good common sense. You'll survive this new-found emphasis on patient privacy.

by Don Eddins, BS, MS, JD

Attorney at Law

Copyright Alabama State Nurses' Association Sep-Nov 2003
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