Tuesday, Nov. 9, 2004 | 10:53 a.m.
Many medical patients and their loved ones are still confused by their rights and responsibilities under a federal law that took effect more than a year ago that protects patient information and privacy, some health professionals say.
The Health Insurance Portability and Accountability Act took effect on April 14, 2003. HIPAA set a federal standard for privacy and security for patient information along with other things such as health insurance portability.
"The general public as a whole doesn't understand the implications of HIPAA and how it's protecting their rights," said Nancy Leveille, director of the health information management department at Valley Hospital. "I would be more concerned as a consumer if it's easy to get your records. If you feel like you're jumping through hoops, that's good."
This week marks health information management technology week, which recognizes employees who process medical records, protect them under HIPAA and collect data on diseases and procedures that must be submitted to health departments.
Hospital officials say misconceptions abound about how patient information can be used and how it is protected.
Some people believe that because they can bring a spouse into the emergency room, spouses have a right to medical information, Leveille said. Unless the patient authorizes release of their information, hospital officials cannot release it, she said.
Another misconception is that patients think they own their medical records when they only own the information contained in the records, Leveille said.
"One of the problems we have is when a family member passes away and you have multiple family members that think they're entitled to that medical record," she said, adding that family members must provide a will or a probate order that lists them as an executor of the deceased person's estate.
Linda Mullins, ethics and compliance officer for Sunrise Hospital, said patients sometimes have an unreasonable expectation of what their privacy should be.
"Some patients feel like only having a curtain between patients is a violation of their privacy," she said, adding that it is not in fact a violation.
Another complication for patients is that the federal law creates a basic standard. States and individual health care providers can enact stricter privacy rules as long as they adopt the minimum federal standard.
For example, Nevada law allows health care providers to charge up to 60 cents per page for copies of their medical records and requires health care providers to provide records to patients within 10 days versus the federal requirement of 30 days.
Each hospital has a slightly different policy as to how it handles medical records' requests.
For example, Valley Hospital does not release patient records until the record is complete, which means patients cannot request copies until they are discharged and their physicians have signed off on the records, Leveille said
The medical record, while they're in the facility, is a work in progress and is not a legal document until the document is reviewed and signed by a physician, she said.
In contrast, Sunrise Hospital, which is owned by HCA Inc., provides medical records once patients request them, regardless of whether they are still a patient or not, Mullins said
"We recommend patients wait until records are complete," said Thuy Tran, health information management director at Sunrise Hospital. "If they want them anyway, they have to sign a form that says they are requesting a record that is incomplete so they can't hold the hospital liable."
St. Rose Dominican Hospitals -- both the Siena and Rose de Lima Campuses -- allow patients to access their records while they are in the hospital and do not charge them for copies during that time, hospital spokesman Andy North said.
Once patients are discharged they can obtain copies of their records at 60 cents per page, he said.
North Vista Hospital, which is owned by IASIS Healthcare LLC, allows patients to request records at any time, but patients are encouraged to wait until they are complete, hospital spokeswoman Mimi Gayre said.
Las Vegas Valley hospitals say they require people requesting records to sign an authorization form and show a government-issued identification card to verify their identity.
Local hospital officials said they would send copies of medical records to another health care provider at patients' requests at no charge and regardless of whether the record is complete.
Also, if patients want to review their original records, they have a right to do so and can make an appointment with the medical records departments, hospital officials say.
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