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Citations would be helpful for such a claim. I work with HIPAA daily, and while I agree that it has a lot of problems, the one you identify here would be an iss

Citations would be helpful for such a claim. I work with HIPAA daily, and while I agree that it has a lot of problems, the one you identify here would be an issue of misguided hospital policy. The hospitals would be absolutely within their rights to allow care teams to follow up with patients as they transition. Now I could easily imagine HIPAA being used as a scapegoat for a set of restrictive policies that are actually being driven by other incentives.

mikewarot 6y ago
I said at the outset it could never be proven. There will never be anything to cite, just a continuing trend towards mediocre medical practice in the USA. I'm not a medical person, but have had family in that role. They couldn't comment on it, but I sure can. Informal discussion of patients has been stopped. The feedback channels that allow for discovery of subtle problems and their solutions have been removed. ER staff used to visit their patients, and keep in touch with them, this stopped with HIPPA. This is dehumanizing. Imagine if developers weren't ever allowed to discuss bugs in their programs, unless they were actively working on the same bug? Think of how much that would kill productivity. What if we weren't allowed to discuss any software or OS we currently don't have a license to use? That's about how strict HIPPA is when it comes to discussing patients, at least as implemented by Hospitals. It is far far safer for them to shut all talk about patients down, in terms of patient satisfaction, lawyers, lawsuits and fines.
- watertom 6y ago
  Unless you work in a hospital and experience the rules first hand I suggest you remember what you were taught in kindergarten, do repeat things you’ve been told because they might not be true. I work in a hospital and I’ve never seen anything remotely like what you described. Our hospital has some of the most sophisticated monitoring systems available for inappropriate patient information access.
  - deathanatos 6y ago
    I think you missed a rather crucial "not" in that first paragraph.
  - mikewarot 6y ago
    If you see a patient in the ER, and something you did causes an effect a week later, how does your facility enable to you learn about it?
- light_hue_1 6y ago
  You don't have experience with HIPAA, and what you're describing is not at all true. > Informal discussion of patients has been stopped. The feedback channels that allow for discovery of subtle problems and their solutions have been removed. No way. I work with hospitals, there are plenty of feedback channels and cases get discussed at length. HIPAA does nothing at all to stop any communication or data sharing that is beneficial for patient safety. > ER staff used to visit their patients, and keep in touch with them, this stopped with HIPPA. This is dehumanizing. This is not at all true. > Imagine if developers weren't ever allowed to discuss bugs in their programs, unless they were actively working on the same bug? Think of how much that would kill productivity. Hospitals literally do these kinds of debriefs all the time. HIPAA does nothing to stop them at all. > It is far far safer for them to shut all talk about patients down, in terms of patient satisfaction, lawyers, lawsuits and fines. You totally misunderstood HIPAA, what it regulates, and how it regulates. It in no way shuts down conversations about patients. I deal with HIPAA-protected data and compliance all the time, I have no idea where you got this impression, but it was not from a doctor.
  - mikewarot 6y ago
    I'm glad that Doctors get to find out about outcomes of patients long after they've been handed off.. the strong impression I got indicated otherwise.
- disillusioned 6y ago
  Man, I'm glad others are dragging you here, but HIPAA, pay attention here, SPECIFICALLY CARVES OUT INFORMATION SHARING IN THE CLINICAL ENVIRONMENT BY PRACTIONERS. It SPECIFICALLY calls out that practitioners are allowed to describe in detail the medically relevant information of their patient to other people in the course of providing healthcare. This is NOT what HIPAA prevents, and to say otherwise is to completely understand both its stated intent AND how it's practically implemented in the field. If you are a boarder patient (in a gurney in the hallway because there are no rooms available), a nurse or doctor IS ALLOWED to ask you questions, document your answers, and discuss your case in said hallway. Informal discussions still happen ALL THE TIME, but practitioners use a room number rather than a patient's name, and because that information isn't personally identifiable, it's HIPAA compliant. ER staff... still visit their patients. What on earth are you even talking about? Doctors and nurses round, they chart, they discuss and plan with one another. They communicate freely. While there have absolutely been rare cases where information hasn't been shared as timely as it should have been (when, say, a requesting facility was foreign to another facility, and so data sharing was limited, wrongly, in the name of HIPAA), the positives of the law, which STOP a facility from just publishing your health data, or more importantly, prevent your health insurance company from broadcasting your data or selling it or using it for marketing purposes, is positive. Patients should be able to receive quality healthcare without concern that their personal health history will be made public. HIPAA prevents the sharing of a patient's diagnosis or medical data without that patient's permission, which is how it should be. But in terms of clinical outcomes, the hospitals still work. The nursing staff still works. And everyone knows damn sure they shouldn't be discussing a patient's name outside of work, or posting a case on the 'gram.
  - mikewarot 6y ago
    >ER staff... still visit their patients. Everyone shares information about their active patients... but nobody can follow up or share information on former patients anymore. It's an ER specific corner case I'm worried about, as they tend to see patients actively for a short amount of time, then are shut out of their lives by HIPPA. >or posting a case on the 'gram. There is a chilling effect on the discussion of interesting cases via social media in general... nobody wants to get fired in this atmosphere of fear. I agree that patients should have their privacy, but the pendulum has swung a bit too far.
- claytongulick 6y ago
  The issue you raise is the opposite of what the day to day concerns are. Clinical systems, in general, are much too permissive and allow too much access to too many people. There's absolutely nothing in HIPAA that prevents coordination of care or cross functional team communication. HIPAA is actually a very well written law, and very reasonable. It says things like, you can't use an EHR to mine patient data for marketing purposes. You have to take privacy seriously and build safeguards. You have to document that you did that. You have to do risk analysis, and document breaches, and follow notification protocols. I'm a former HITRUST auditor, and CTO of healthcare company. I've been deeply involved with this law for many years, and to date, I haven't found any part of it that I disagree with.
Spooky23 6y ago
That has nothing at all to do with HIPAA. The standards of care in many hospitals are really awful, but incompetence isn’t correlated with overly aggressive information policy.
SkyPuncher 6y ago
I worked with HIPAA and am married to a physician. What he claimed isn't possible is entirely possible. You are allowed to follow patient. You are allowed to track outcomes. If a patient isn't actually in actually in your care, there are HIPAA defined means for reviewing cases for quality control.
claytongulick 6y ago
HIPAA specifically states that provider to provider disclosure of PHI does not require patient consent.

mikewarot 6y ago

I said at the outset it could never be proven. There will never be anything to cite, just a continuing trend towards mediocre medical practice in the USA. I'm not a medical person, but have had family in that role. They couldn't comment on it, but I sure can. Informal discussion of patients has been stopped. The feedback channels that allow for discovery of subtle problems and their solutions have been removed. ER staff used to visit their patients, and keep in touch with them, this stopped with HIPPA. This is dehumanizing. Imagine if developers weren't ever allowed to discuss bugs in their programs, unless they were actively working on the same bug? Think of how much that would kill productivity. What if we weren't allowed to discuss any software or OS we currently don't have a license to use? That's about how strict HIPPA is when it comes to discussing patients, at least as implemented by Hospitals. It is far far safer for them to shut all talk about patients down, in terms of patient satisfaction, lawyers, lawsuits and fines.

watertom 6y ago
Unless you work in a hospital and experience the rules first hand I suggest you remember what you were taught in kindergarten, do repeat things you’ve been told because they might not be true. I work in a hospital and I’ve never seen anything remotely like what you described. Our hospital has some of the most sophisticated monitoring systems available for inappropriate patient information access.
- deathanatos 6y ago
  I think you missed a rather crucial "not" in that first paragraph.
- mikewarot 6y ago
  If you see a patient in the ER, and something you did causes an effect a week later, how does your facility enable to you learn about it?
light_hue_1 6y ago
You don't have experience with HIPAA, and what you're describing is not at all true. > Informal discussion of patients has been stopped. The feedback channels that allow for discovery of subtle problems and their solutions have been removed. No way. I work with hospitals, there are plenty of feedback channels and cases get discussed at length. HIPAA does nothing at all to stop any communication or data sharing that is beneficial for patient safety. > ER staff used to visit their patients, and keep in touch with them, this stopped with HIPPA. This is dehumanizing. This is not at all true. > Imagine if developers weren't ever allowed to discuss bugs in their programs, unless they were actively working on the same bug? Think of how much that would kill productivity. Hospitals literally do these kinds of debriefs all the time. HIPAA does nothing to stop them at all. > It is far far safer for them to shut all talk about patients down, in terms of patient satisfaction, lawyers, lawsuits and fines. You totally misunderstood HIPAA, what it regulates, and how it regulates. It in no way shuts down conversations about patients. I deal with HIPAA-protected data and compliance all the time, I have no idea where you got this impression, but it was not from a doctor.
- mikewarot 6y ago
  I'm glad that Doctors get to find out about outcomes of patients long after they've been handed off.. the strong impression I got indicated otherwise.
disillusioned 6y ago
Man, I'm glad others are dragging you here, but HIPAA, pay attention here, SPECIFICALLY CARVES OUT INFORMATION SHARING IN THE CLINICAL ENVIRONMENT BY PRACTIONERS. It SPECIFICALLY calls out that practitioners are allowed to describe in detail the medically relevant information of their patient to other people in the course of providing healthcare. This is NOT what HIPAA prevents, and to say otherwise is to completely understand both its stated intent AND how it's practically implemented in the field. If you are a boarder patient (in a gurney in the hallway because there are no rooms available), a nurse or doctor IS ALLOWED to ask you questions, document your answers, and discuss your case in said hallway. Informal discussions still happen ALL THE TIME, but practitioners use a room number rather than a patient's name, and because that information isn't personally identifiable, it's HIPAA compliant. ER staff... still visit their patients. What on earth are you even talking about? Doctors and nurses round, they chart, they discuss and plan with one another. They communicate freely. While there have absolutely been rare cases where information hasn't been shared as timely as it should have been (when, say, a requesting facility was foreign to another facility, and so data sharing was limited, wrongly, in the name of HIPAA), the positives of the law, which STOP a facility from just publishing your health data, or more importantly, prevent your health insurance company from broadcasting your data or selling it or using it for marketing purposes, is positive. Patients should be able to receive quality healthcare without concern that their personal health history will be made public. HIPAA prevents the sharing of a patient's diagnosis or medical data without that patient's permission, which is how it should be. But in terms of clinical outcomes, the hospitals still work. The nursing staff still works. And everyone knows damn sure they shouldn't be discussing a patient's name outside of work, or posting a case on the 'gram.
- mikewarot 6y ago
  >ER staff... still visit their patients. Everyone shares information about their active patients... but nobody can follow up or share information on former patients anymore. It's an ER specific corner case I'm worried about, as they tend to see patients actively for a short amount of time, then are shut out of their lives by HIPPA. >or posting a case on the 'gram. There is a chilling effect on the discussion of interesting cases via social media in general... nobody wants to get fired in this atmosphere of fear. I agree that patients should have their privacy, but the pendulum has swung a bit too far.
claytongulick 6y ago
The issue you raise is the opposite of what the day to day concerns are. Clinical systems, in general, are much too permissive and allow too much access to too many people. There's absolutely nothing in HIPAA that prevents coordination of care or cross functional team communication. HIPAA is actually a very well written law, and very reasonable. It says things like, you can't use an EHR to mine patient data for marketing purposes. You have to take privacy seriously and build safeguards. You have to document that you did that. You have to do risk analysis, and document breaches, and follow notification protocols. I'm a former HITRUST auditor, and CTO of healthcare company. I've been deeply involved with this law for many years, and to date, I haven't found any part of it that I disagree with.

Spooky23 6y ago

That has nothing at all to do with HIPAA. The standards of care in many hospitals are really awful, but incompetence isn’t correlated with overly aggressive information policy.

SkyPuncher 6y ago

I worked with HIPAA and am married to a physician. What he claimed isn't possible is entirely possible. You are allowed to follow patient. You are allowed to track outcomes. If a patient isn't actually in actually in your care, there are HIPAA defined means for reviewing cases for quality control.

claytongulick 6y ago

HIPAA specifically states that provider to provider disclosure of PHI does not require patient consent.