27 April 2006


The recent HIPPA law makes a big deal out of patient confidentiality and everyone's rights to keep information confidential. It requires every organization to provide patients written notice of their rights and responsibilities, lays out specific penalties, and generally makes a big to-do about PHI (protected health information). Even your zipcode is considered confidential because it might identify you. Most medical organizations had detailed privacy policies and practices before this law went into effect, the change now is just that everyone has to document everything. For every patient, I have to document that I explained the ambulance privacy policy and offered the patient a written copy including getting a patient signature, or that the patient was unable (e.g. demented) to sign. Not too bad on a transfer truck, but much more difficult during an actual emergency.

The funny thing about this is that hospital employees are the most concerned about confidentiality as patients, and the least likely to seek care in their own hospital because of a lack of confidentiality regarding their medical care. Today we transported a woman 20 minutes away because she refused to be treated in the hospital she works in. Slightly more understandable since she was having a mental health issue, but still makes you wonder how confidential anything really is when the employees won't even seek treatment there. Orientation at the ambulance company included a lecture on confidentiality and how even talking around the station, talking to your spouse, or maybe even talking in your sleep could be a breach of confidentiality. In the end though, it all comes down to patient trust. If your patients trust that you aren't going to blab, you're set. If not, people go 20 minutes down the road with us.

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