Interhospital Quality Improvement and HIPAA

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Mike,

 

You're making it too complicated, and I'm not helping.  Let's start
over:

 

As a direct healthcare provider, you have special access to information
about your patient which is inherently and absolutely private.  The only
reasons to discuss or divulge ANY aspect of a patient's medical history
or treatment are 1) for the purposes of direct care; or 2) as part of a
structured and systematically protected performance improvement process;
or 3) under subpoena.  

 

For all other circumstances, your extracurricular thoughts and actions
should leave the impression that you have never met the guy.  Period.
It's no less a part of your job than securing the airway or giving the
right dose of antibiotic.

 

If the local paper or CNN or the Drudge Report features your patient,
you have no control except to not participate.  Whatever knowledge
you've gained from the patient/provider relationship STILL BELONGS TO
THE PATIENT, and is not yours to share, even as a function of merely
concurring with other published reports.  

 

Protected health information is pretty freaking global in scope,
including such rudimentary details as whether someone is hospitalized:
even if Katie Couric says Joe Smith is a patient at your hospital, you
need Joe's permission to confirm or deny it.  No exceptions.  That's
what your Community Relations department is for.

 

If you want to discuss a particular patient's splenectomy on the
Trauma-List, or at a conference, or a Super Bowl party, your options are
predictably restricted: you can obtain written informed consent, or you
can harmlessly alter the details so that the patient's identity is
hidden and irrelevant -- that is, you can turn it into a hypothetical.
In every imaginable way, the patient's identity is unimportant anyhow;
else, you're gossiping.

 

So (in the previous email) the backhoe becomes a forklift.  The teenager
is now 35.  Voila, you can discuss the amputation now.  How tough was
that?

 

Pret

 

 

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