January 13, 2006

Answering questions about protecting patient privacy

Protecting patient privacy is one of the most important ethical obligations in the health care system today. And since the Health Insurance Portability and Accountability Act (HIPAA) was introduced in 2003, protecting patient information has become even more important — and more complicated. Like many health care organizations, the MGH offers continuing education about the HIPAA guidelines. Privacy breaches, however, continue to occur — sometimes accidentally. To help clarify the hospital's confidentiality policies and to help employees and staff avoid privacy breaches, specific questions and answers about patient confidentiality will be published regularly in MGH Hotline. The questions are answered by Eileen Bryan, MGH HIPAA compliance specialist.

Q. Recently, an employee was hospitalized with a serious illness. His coworkers were very concerned but heard no news about his recovery. The employee's manager stated she was bound by HIPAA and could not disclose any information. After a week of not hearing any news, one of the coworkers checked her colleague's electronic medical record just to see how he was doing. She also looked up his address so that a card and gift could be sent to his home. While the employee had the best intentions, this action was a serious privacy breach. How can this kind of situation be avoided?

A. This kind of situation is challenging because it has no malicious intent. The employee's coworkers were genuinely concerned, but they still had no right to access his medical record. Varying degrees of disciplinary action — up to termination — are taken in privacy breach cases, including this one. Most likely, the manager in this case was in touch with the employee-patient. To avoid a potential breach, it would be helpful if the manager could have asked the employee-patient what, if any, information she could share with his concerned colleagues. The manager also could ask the employee-patient if he would feel comfortable with a gift and card being sent to his home address. At the same time, colleagues need to understand that some individuals are very private while others share lots of personal information. But it's the individual's choice to share information, and that decision should be respected. To make it easier for employees who are patients or other MGH patients to keep friends, family and coworkers apprised of their medical condition and recovery, the hospital offers a password-protected website service called CarePages. The free service allows patients to create their own website that they can continuously update for others to see their treatment progress. The site is located at www.massgeneral.org/carepages.