HIPAA (Health Insurance Portability and Accountability Act) was created in 1996 to protect patients’ personal health information (PHI) in addition to other things. One of its most frequently misunderstood sections involves the release of medical information. Although it specifically allows for treating physicians to access their patient’s health information in order to provide continuity of care without needing a patient to sign a release form, it is not unusual for this to be a problem. My office has had difficulty receiving necessary records from specialty offices and hospitals. Recently one of my patients was seen in a Kroger Little Clinic where she was treated for a urinary tract infection. Since her symptoms persisted, I needed the urinalysis from the clinic in order to determine future therapy. You’d of thought I was asking for gold from Fort Knox. In my long association with HIPAA I have found it mostly intoned by medical office individuals who have been poorly trained by the entities that employ them. Kroger has not appropriately educated their staff as to the ins and outs of a complicated law, thereby bringing about the following exchange on Twitter:
Ultimately I was able to get the UA results, begrudgingly, from an NP who I know called me a bad word as soon as she got off the phone. She was right. By the end of the day, I didn’t care what she thought of me. Just give me my patient’s damn data!by
In addition to reading a number of medical bloggers, I “lurk” on twitter chats and try to watch twitter updates from the 88 people I am currently following. The majority of the people I follow are doctors who are interested in how social media can help patients, plus a few “learning” entities like Brainscape just to improve my language studying skills (which I highly recommend). I am just a neophyte to Social Media but am excited by its potential for my patients.
Suddenly the ability to followup with patients directly without a medical assistant playing messenger in between seems more attainable. Communications would be cleaner and both physicians and patients would be better served. Right now I do this on a small scale by using email but this is fraught with difficulty. Patients send me their information and sometimes they cannot open my email response because it is encrypted (per HIPPA requirements). Other times their emails are caught by my spam filter and I never see them! As I’ve written about in previous posts, there are recommendations by august bodies like the AMA on how to use email professionally but frankly, they are both out-of-date and a little out-of-touch with their recommendations. However, having said that, HIPPA fines are substantive so no one wants to be caught in the wrong while communicating with patients.
In the meantime, patients are becoming more web and social media savvy. It is exciting to have a patient come in who has been on the Mayo clinic website and is asking about what preventive steps they should be taking instead of me initiating the discussion. It makes me feel like a partner in their care instead of a mother giving advice. I am a mother and I enjoy that role. Nurturing is part of healthcare but when I feel more like the disciplinarian then an advisor, neither I nor the patient are likely to benefit.
The “early adopter” physicians and e-patients on Twitter, Facebook, Google+ and LinkedIn, among others, are working hard to improve the lines of communication so that patient care is better. It’s an exciting time to be involved and I am looking forward to learning more and sharing a lot.by