Interhospital Quality Improvement and HIPAA

Wed Sep 5 01:57:47 BST 2007

We can't discuss the private health information of the son of a former
Minnesota governor injured in a car crash in Florida last week.  Even though
we haven't named him or divulged his Social Security number, context is
sufficient to reasonably identify him.

If you bring to the List the case of a teenage male who lost his arm in a
recent backhoe accident, and your email address is drsmertka at emory.edu, and
you detail his surgical repair or his blood alcohol level or his bipolar
disorder, then you'd better hope there's no mention in the Atlanta media of
a young man who lost his arm to a backhoe.  Context.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Mike Smertka
Sent: Tuesday, September 04, 2007 6:39 PM
To: Trauma &amp, Critical Care mailing list
Subject: Re: Interhospital Quality Improvement and HIPAA

I would think trauma.org would only be liable for violations if there was an
identifier like name or ssn involved. otherwise wouldn't it possibly fall
under the same category as education or possibly QI, I don't know, I am not
a legal mind. But if I were liable everytime i discussed how other would
handle a similar patient or asked advise, the local law pors might as well
take what little i have now.

  Mike

Connie Potter <Connie at traumafoundation.org> wrote:
  Dear Trauma.org members:

Patient privacy and hospital/caregiver liability are both serious
issues. Unfortunately, discussions of this type will likely result in
more hospital CEOs and Boards deciding that being a trauma center poses
too great a legal and fiscal risk, particularly if some of the
trauma.org "lurkers" might be plaintiff attorneys or regulatory bodies.

HIPAA does forbid this type of disclosure, there is NO interstate
protection of PI anywhere in this nation, and only a few state trauma
systems have statutory interhospital protection of these types of
discussions. 

We need an interstate trauma care system, to include PI with all of the
protections afforded peer review within the hospital, as well as Good
Samaritan protection for those who deal with the final result of these
problems. Until then, we should beware of such in-depth critiques of
clinical and systems care issues on this website, particularly since
emails are subject to disclosure. I actually wonder if trauma.org might
be liable for patient privacy or HIPAA violations. Just my personal
opinions.

Connie Potter, RN, MBA 

-----Original Message-----
From: Ronald Gross [mailto:Rgross at harthosp.org] 
Sent: Monday, August 20, 2007 9:12 AM
To: KMATTOX at aol.com; ccm-l at ccm-l.org; Trauma & Critical Care mailing
list
Cc: SURGINET at listserv.utoronto.ca
Subject: RE: [ccm-l] Fwd: Interhospital Quality Improvement

Pret,

You were the first to come to my mind when I read Jeff's post but
decided to remain silent for your sake! ;-)

Ron

>>> "Bjorn, Pret" 
8/20/2007 10:54 AM >>>
Thanks, and well stated. 

Last time I noted this, I was flame bait for weeks.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org 
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Jeffery Hammond
Sent: Monday, August 20, 2007 10:47 AM
To: KMATTOX at aol.com; trauma-list at trauma.org; ccm-l at ccm-l.org 
Cc: SURGINET at listserv.utoronto.ca 
Subject: RE: [ccm-l] Fwd: Interhospital Quality Improvement

Aside from the clinical and systems implications, there is also a
ethical/legal issue here involving HIPAA. My understanding is that HIPAA
prohibits discussion of cases in which the patient can be identified by
date/time/location/circumstances etc. For our legal eagles, does the QI
shield/exemption apply to discussions such as these by parties who are
not
directly involved in the QI process? In short, can these discussions
legally
take place on the internet?

Jeffrey Hammond MD, MPH
New brunswick, NJ

_____ 

From: ccm-l-bounces at ccm-l.org [mailto:ccm-l-bounces at ccm-l.org] On Behalf
Of
KMATTOX at aol.com 
Sent: Sunday, August 19, 2007 2:44 PM
To: trauma-list at trauma.org; ccm-l at ccm-l.org 
Subject: [ccm-l] Fwd: Interhospital Quality Improvement

My friends on CCM-L and Trauma-list, this case was sent to me from the
SurgiNet list server. I have not commented yet, but I will to them.
I
was wondering if any of you have any comments. The City was BOSTON.
The
sending hospital was a MAJOR hospital in the region. There are
patient
care, EMS, trauma system, and even legal issues here, to say nothing of
ethical. 

I can and will forward to SURGINET at listserv.utoronto.ca any comment sent
to
me which does not have surginet in its sending list. 

k

_____ 

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