As a consequence of the Affordable Care Act hospitals were
required to implement an electronic medical record (EMR) in the care of
patients. These EMRs that we use are largely designed to code and bill but we
are completely dependent on them to get the necessary data on patients to care
for them. Employed physicians willingly sign on to use these EMRs and undergo
the necessary training to use them effectively. What we don’t realize when we
sign on is that every key stroke, medical record and tab is being prospectively
audited behind the scenes. The reason this is being done is to protect the
privacy of patients as outlined by the HIPAA (Health Insurance Portability and
Accountability Act of 1996). This is a noble pursuit as whom amongst us wants
sensitive information about us accessed by someone who is not caring for us and
who could destroy our personal lives or careers with the information obtained.
The trouble with the EMR auditing for HIPAA is that it flies
in the face of how doctors practice and how this auditing information can be
used. All physicians are approached numerous times by friends, family members
and colleagues with requests for medical advice on pieces of data that can only
be accessed via the EMR. As physicians by nature want to help people we think
nothing of doling out countless free advice without entering into a
physician-patient relationship. We also are far too busy to get written
documentation approving our review of the EMR by each entity that enlists our
help. Essentially all caring physicians commit countless HIPAA violations in an
effort to help people. I would also daresay that these “violations” have
probably saved countless lies. The problem lies when a hospital or health care
corporation can use a “HIPAA violation” as a reason to terminate a physician
that they are not really fond of for any number of reasons. I liken this to
when the federal government uses tax evasion to convict a member of the mafia.
You utilize whatever weapon that will complete the task.
So the next time you enter an EMR on someone who you are trying to help but who is not your patient, ask yourself how well you are thought of by your hospital employer and if you better get written authorization by the requesting entity to access their medical record.
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