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HIPAA privacy: Excuses, excuses

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Health information privacy concerns have been getting in the way of care providers’ efforts to communicate with patients’ families, and with people who could be affected by patients with violent tendencies, witnesses agreed today at hearing.

Some of the witnesses said policymakers need to create new exceptions in the Health Insurance Portability and Accountability Act (HIPAA) privacy statute and the HIPAA privacy regulations.

Other witnesses said the U.S. Department of Health and Human Services (HHS) simply needs to do a better job publicizing HIPAA privacy rule exceptions that already give providers the flexibility they say they want.

The House Energy & Commerce oversight subcommittee organized the hearing to look at charges that HIPAA privacy rules may be hindering patient care and public safety. 

Rep. Tim Murphy, R-Pa., said he convened the hearing because of comments that cropped up at a recent forum on the relationship between severe mental illness and violence. One participant, the father of a son who had killed himself at the age 22, talked about the reluctance of the son’s doctors to discuss the son’s high risk of suicide.

HIPAA was supposed to help providers share information when they should share information, by replacing and clarifying complicated and clashing state health privacy laws, but, “unfortunately, ‘if you want to be safe, don’t tell anyone anything’ became the prevailing attitude,” Murphy said.

Deven McGraw, director of the health privacy project at the Center for Democracy and Technology, said HIPAA privacy protections and other privacy protections improve patient care, by addressing patients’ fears about what will happen if they share information with doctors.

McGraw cited survey results indicating that 17 percent of the participants said that withhold relevant information from health care providers because of privacy concerns.

HIPAA already lets providers disclose information when public safety is involved, or when a patient is incapacitated, McGraw said.

“It sounds to me like too many people are hiding behind” the privacy rules, McGraw said. “People are being told that HIPAA is something that it’s not.”

Another witness, Carol Levine of the United Hospital Fund, said she believes providers use privacy rules to get a patient’s relatives to stop annoying them with unwanted advice and questions.

From some nurses’ perspective, “family members are important at discharge but not during the course of hospitalization,” Levine said.

Regulators need to make sure health care providers get clear training about when they can and should share information as well as when they cannot, Levine said.

Other witnesses on the panel emphasized that regulators and others must be sure that families have the right to get information about care for severely mentally ill patients who are unable to recognize that they are ill.

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