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View Full Version : Federal Agents Now Invade Hospital Exam Rooms, Thanks to HIPPA




DamianTV
06-16-2013, 12:23 PM
http://joemiller.us/2013/06/federal-agents-now-invade-the-sanctum-of-the-exam-room-thanks-to-hippa/


I recently endured my third round of invasion by the Joint Commission, or JCAHO (Joint Commission on Accreditation of Healthcare Organizations). I am still reeling from the experience. Without my consent and without warning, the investigator invited herself into the sanctum of our exam room, explaining that she had verbal consent from the patient to observe, “and we learn so much!” I was caught completely off guard, and working as a private contractor in a government sponsored facility, I didn’t resist, but I can say now in retrospect…it will never happen to me again.

Never in more than 20 years of medical practice have I had a government agent invade the sacred space of my private exam room. Oh yes, I have acceded to the review of my private medical records by their auditors, holy ground that never should have been given, but this was too much. Ah, but she had HIPAA in her hand.




It has taken me a while to get the big picture. At first when I heard of HIPAA (Health Insurance Portability and Accountability Act of 1996) I was mystified, why should we need such a law? After all, the idea of doctor-patient confidentiality has been an essential foundation of western medicine for two thousand years before there ever was a United States of America, so we surely didn’t just think it up. Furthermore, if the King’s Court jesters (or shall we say ‘Supreme Court’) can find an “implied right to privacy” in the US Constitution for a woman to kill her unborn baby, why in the world would we need a new set of laws to protect privacy between a doctor and patient?

It’s really quite simple, the cost of medicine today has escaped us. When my Grand daddy was still around, he either paid for his medical care out of his pocket, or he didn’t get it, simple as that. Today, nobody can afford to pay their own medical costs, why a small cut on your finger with a trip to the emergency room for a few stitches could run over a thousand dollars, and a woman recently confided to me that her hysterectomy cost in excess of $65,000! Now think about how many women in this country will need a hysterectomy this year, can we afford this? How about a $90,000 heart catheterization and stent followed by a new blood thinner drug that will cost $2000 a month to keep it working? So we see that more and more we have to rely on our government to foot the bill of the things we could never pay for.

There it is… if the government is going to pay for health care, they want to get the ‘most bang for their buck’ so they need a way to measure, and to measure, they need beans to count, and to have beans to count, they have to have records, and to have records—they can’t be in a safe paper chart in some doctors office, they need to be electronic and available, hence the advent of the EHR (Electronic Health Record). Nobody honestly finds this actually facilitates patient care (everyone I talk to finds that all this data entry increases the time need to see one patient), but it sure gives the government beans to count.

Now for them to sell us on this idea, they had to create the illusion of protecting the privacy of medical information when in reality the foxes were just letting themselves into the hen house! Remember, the “P” in HIPAA does not stand for privacy like they want us to believe, but for portability, so it’s easier for them to access. The government now has an information highway to the most private thing you have, your own medical record. And remember, next time you sit down with your doctor in confidence, you may look up and find they have invited themselves to sit in, after all, “they can learn so much!” Welcome to the 21st century and a brave new world (soon to be ‘Logan’s Run’).

AFPVet
06-16-2013, 12:48 PM
When I worked in HR, HIPAA protected your information from private entities... unfortunately, what you're saying is that public entities are exempt. It's one of those hypocrisies.

Carson
06-16-2013, 12:52 PM
There needs to be allowances in the law that allow a firm slap to stop the stuttering of people that rattle off acronyms...


then again it has been pretty easy to just be on my way somewhere else.

Neil Desmond
06-16-2013, 02:11 PM
I have worked at healthcare facilities for many years, and am aware of HIPAA and JCAHO. Although I don't work directly with patients, visitors, etc. (not normally, but I can be if called on under mitigating circumstances), there are some things that I think need clarification:

Don't let this article mislead or deceive you. JCAHO investigators are not federal agents, which is the impression the article and title seem to give or cause.

JCAHO is a non-profit accreditation organization: http://en.wikipedia.org/wiki/JCAHO

HIPAA is a law, or act, or regulations (I'm not sure of the technical legal differences) that was created by Congress: http://en.wikipedia.org/wiki/Hipaa

HIPAA and JCAHO are two different, unrelated things that as far as I'm aware have nothing to do with each other and have no reason for having anything to do with each other; in other words, as far as I know or am aware, the purpose of JCAHO is not to enforce HIPAA, and the purpose of HIPAA has nothing to do with accreditation.

Apparently the patient didn't inform this healthcare provider about any consent given to this investigator to observe the exam, based on the way the scenario is described by the author. If anything, HIPAA probably does the opposite of granting anyone access to a room while a healthcare provider is examining a patient. If I were this healthcare provider in that scenario, I would challenge this investigator to prove consent was given, because otherwise what if this was a test by the investigator to see if the healthcare provider would just let anyone who claims they have consent access to observe? I would think that by not challenging this investigator, it could've counted against the accreditation (it probably did, too). If someone from Joint Commission ever came up to me and asked for or claimed to have access to a patient room, documents, a workstation with patient data, etc., I wouldn't grant or give them any such access and instead would instruct them to speak to my supervisor, the unit secretary of the nursing station, the charge nurse, the nursing supervisor, the manager or director of the department in question, etc.

Even if the patient did give the investigator consent and HIPAA regulations did permit JCAHO investigators to observe with consent, I would think that it's still up to the healthcare provider whether or not they approve of anyone else being in the exam room to observe.

It's not clear to me why the author goes from that to talking about paying for healthcare or the cost of it; these are economic & insurance financial aspect issues, etc. & neither HIPAA nor JCAHO have anything to do with the finance or economics aspects of the healthcare industry, that I know of.