HIPAA regulations should be followed to maintain office privacy

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At least one HIPAA issue is widely misinterpreted, so it is a potential source of unanticipated liability costs for healthcare providers and insurers. The issue has viable cost-effective solutions, but a lack of awareness has created a vacuum that needs to be addressed.

The issue is this: Health and Human Services (HHS's) March 2002 proposed HIPAA changes appear to relax requirements on "incidental use or disclosure." But a closer look reveals Oral Privacy is an area of significant exposure for covered entities and insurers. The proposed changes state a "...disclosure [of Patient History Information, or PHI] that occurs as a result of a failure to apply reasonable safeguards...is ...a violation of the Privacy Rule." What is The Office of Civil Rights (OCR's) message? Incidental disclosure is tolerable only if reasonable means to prevent it have been implemented, in accord with the December 2000 guidance that "the same protections afforded to paper and electronically based information must apply to verbal communications as well."

Covered entities are required to identify "reasonable means" in the form of best practices as a basis for compliance.

But accepted standards from ISO, ANSI, and ASTM already define "Oral Privacy" in a manner that can be quantitatively measured. They also describe available methods for monitoring private environments where Oral Privacy is required but walls are impractical. These standards already meet the "reasonableness" test and provide "best practices" to follow. And they enable providers to go about their business without disruption or fear of disclosure.

The View from HHS & OCR?

William Braithwaite, senior HHS advisor and HIPAA West/East keynote speaker, points out that "ignorance [of standards and best practices] will not be seen as an acceptable defense for non-compliance." Nevertheless, many entities have ignored Oral Privacy-in most cases, they are unaware that objective standards exist that can be inexpensively applied. But in the long run, inattention or inaction are unlikely to be judged "reasonable safeguards."

Four important facts:

Oral privacy can be measured with instruments.
Oral privacy is defined by ISO, ANSI, and ASTM standards.
Oral privacy can be provided without restricting physician behavior or retraining.
Oral privacy can be provided without walls or capital expenditure.

Who Is Affected?

Pharmacies

Physician's offices

Medical clinics

Public health authorities

Life insurers

Billing agencies

Information system vendors

Service organizations

Hospitals

Military medical bases

Employers

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