The Office of Civil Rights, the federal agency responsible for enforcing
HIPAA, has on its website http://www.hhs.gov/ocr/hipaa/privacy.html guidance
explaining significant aspects of the law. The section on Incidental Uses
and Disclosures (45 CFR 164.502(a)) addresses these issues. The following Q
& A was cut from those that section:
Q: May physicians offices use patient sign-in sheets or call out the
names of their patients in their waiting rooms?
A: Yes. Covered entities, such as physician's offices, may use patient
sign-in sheets or call out patient names in waiting rooms, so long as the
information disclosed is appropriately limited. The HIPAA Privacy Rule
explicitly permits the incidental disclosures that may result from this
practice, for example, when other patients in a waiting room hear the
identity of the person whose name is called, or see other patient names on a
sign-in sheet. However, these incidental disclosures are permitted only
when the covered entity has implemented reasonable safeguards and the
minimum necessary standard, where appropriate. For example, the sign-in
sheet may not display medical information that is not necessary for the
purpose of signing in (e.g., the medical problem for which the patient is
seeing the physician). See 45 CFR 164.502(a)(1)(iii).
Q: A hospital customarily displays patients' names next to the
door of the hospital rooms that they occupy. Will the HIPAA Privacy Rule
allow the hospital to continue this practice?
A: The Privacy Rule explicitly permits certain incidental
disclosures that occur as a by-product of an otherwise permitted
disclosure-for example, the disclosure to other patients in a waiting room
of the identity of the person whose name is called. In this case,
disclosure of patient names by posting on the wall is permitted by the
Privacy Rule, if the use or disclosure is for treatment (for example, to
ensure that patient care is provided to the correct individual) or health
care operations purposes (for example, as a service for patients and their
families). The disclosure of such information to other persons (such as
other visitors) that will likely also occur due to the posting is an
incidental disclosure.
Incidental disclosures are permitted only to the extent that the
covered entity has applied reasonable and appropriate safeguards and
implemented the minimum necessary standard, where appropriate. See 45 CFR
164.502(a)(1)(iii). In this case, it would appear that the disclosure of
names is the minimum necessary for the purposes of the permitted uses or
disclosures described above, and there do not appear to be additional
safeguards that would be reasonable to take in these circumstances.
However, each covered entity must evaluate what measures are reasonable and
appropriate in its environment. Covered entities may tailor measures to
their particular circumstances.
Visit the site for more detail.
Cynthia Arpin, R.N.
Trauma Program Manager
W.W. Backus Hospital
326 Washington Street
Norwich, C.T. 06360
(860)889-8331 ext. 3220
FAX (860)892-2798
-----Original Message-----
From: Smith, Bobby [mailto:bobby.smith@tenethealth.com]
Sent: Wednesday, March 12, 2003 10:11 AM
To: Trauma nurses list (E-mail)
Subject: [traumanurses]
Hello All,
I am looking for information about how others are dealing with HIPPA in
regards to sign in, calling patients from the waiting area, whiteboards,
etc. You may respond on or off list.
Thanks, Bobby
Bobby Smith RN, BSN, CEN, EMT-P
Trauma Coordinator / Educator
Frye Regional Medical Center
Hickory, NC 28601
(828)345-5660
(828)328-0406 pager
bobby.smith@tenethealth.com
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