New privacy rules could leave patients’ families in dark

Jace Radke

Friday, April 11, 2003 | 10:58 a.m.

Ruth Whittacre's family didn't have any problems making their way to the maternity ward to celebrate the birth of a baby girl Wednesday evening at St. Rose Dominican Hospital-Sienna Campus.

Bearing flowers and gifts, family members visited with the new mom and daughter -- but if Whittacre had had her baby next week, she would have been able to leave her many well-wishers in the dark. She could have even chosen to have the hospital refuse to tell her relatives if she was even in the hospital.

New federally mandated privacy rules for the release of health information will go into effect Monday, giving patients the chance to choose what if any information about their hospital stay can be given to family, friends or the media.

"I think the idea that the patient has a choice is a good thing," Whittacre, 27, said while her husband, Nathan, watched their daughter, Natalie. "The decision would really depend why you were in the hospital.

"If it was something involving an accident or if I was a victim, maybe I wouldn't want that information out there."

The new policy is part of the Health Insurance Portability Act of 1996, designed to protect the integrity, confidentiality and availability of electronic health information. The legislation sets Monday as the deadline for hospitals to comply with new regulations for protected health information.

The policy could lead to well-wishers and family members not knowing if their friends and family members are in the hospital, and could snarl things as innocuous as flower deliveries, officials said.

Valley Hospital Chief Operating Officer Blain Claypool said the change is really just a shoring up of the regulations that hospitals already use to protect patient information from scam artists or those who might sell it to pharmaceutical firms or other companies.

"Hospitals have always been protective and very careful of patient privacy, but now it has been tightened up and the standards have been made more uniform," Claypool said.

Beginning Monday patients admitted to Las Vegas area hospitals will receive a form notifying them of their privacy rights. Patients can then decide whether or not to have their names entered into a hospital database that shows they are being treated.

If someone has been critically injured or is deceased, information will not be released until a next of kin is notified, as is currently the case.

There are concerns about the possibility that families and friends of hospital patients may not be able to get information about loved ones if the patient has opted out of the database, but hospital officials say that responsibility falls to the patient.

"If it's all or nothing, I'd probably opt to have my information out there," Whittacre said. "My family would be pretty angry if there was a mix-up and they couldn't get in to see me."

University Medical Center officials said they know the new policy will upset friends and relatives of patients who will be denied information.

"We have that happen now," said Hope Hammond, UMC's privacy officer, a position that has been added to staffs or tacked on to the duties of hospital administrators who will oversee the new privacy rules. "We try to work with people and check with the patient or other family members if there is a question.

"We try to get the patient to designate a family contact that we can talk to and bring questions to."

Hospital officials and Whittacre also predicted plenty of people will be infuriated when the new system interferes with deliveries to patients.

"I want my flowers," she said, nodding toward the three arrangements decorating her hospital room.

But if the patients decide they want their information protected, flowers would be stopped at the reception area, unless those sending the flowers provide a a room number or have the OK from the family, said Linda Mullins, Sunrise Hospital ethics compliance officer.

Michelle Jones, who owns and operates Flowers by Michelle, often gets calls for deliveries to hospitals.

"Right now we just get a name, but if that's not enough anymore we may have to get passwords or room numbers," Jones said. "It's a concern because if they aren't accepted we might have to deal with refund issues."

UMC and Mountain View have instituted a password system to allow family members to easily get information. The patient and the hospital come up with the password and then it's the patient's responsibility to distribute the password to friends and family.

"We're just going to use the database for now, but if the passwords are a success at the other hospitals we could go that route," said John Zedick, director of quality management for St. Rose Dominican Hospitals. "This is new, so we're all looking for the best system."

Patients who have suffered critical injuries and can't make a decision when they are admitted will automatically go into the hospital database so that information can be given to families. Once a next of kin is established that family member will be able to make a decision on behalf of the injured or unconscious relative.

Dennis Luck, a pastor and former president of the Head Injury Association of Southern Nevada, said that he welcomes the new regulations.

"I see a lot of people in the hospital since I wear a backwards collar now, and privacy is a courtesy that they are due," Luck said.

The new guidelines do not affect local emergency services providers, such as police and fire departments. Those agencies will release names and information about people that are identified in public records documents, such as fire and police reports. The coroner's office also is expected to be exempt from the rules.

The regulations also mean some changes that may seem simple, but are important in meeting a patient's wishes, Lake Mead Hospital Information Systems Director Ken McGee said.

"We've gone from writing a person's full name to only putting their last name on the big white dry-erase tracking boards in the hospital," McGee said.

The law does allow some leeway for some incidental disclosure, such as a name on a board or a sign-in sheet.

The hospitals will set up a database for patients who agree to have their information released. If their name is in the database, then friends, family and anyone else can get general condition information about the patient simply by knowing the patient's name. If the patient opts out of the database, then hospital officials won't release any information about the patient -- including the fact that they are in the hospital.

A second secure database for use only by doctors and hospital officials allows medical information to be shared for treatment and billing purposes.

Automated phone messages, such as the one at Lake Mead Hospital that asks callers to punch in the bed number of the patient they are calling, may need to be changed.

Hospitals will rely on a combination of rules and good judgment in determining who to release information to, Mountain View spokesman Rick Plummer said.

"This is the biggest industry-wide change in health care in decades, and there is going to be an ongoing education that comes with that," Plummer said. "We may have to go up and check with the patient if we have someone calling who isn't cleared for information.

"There will most likely be some problems along the way, but we're hoping that people will work with us and be patient."