Every hospital and healthcare facility has some variation of this sign: “It's the law. Be careful not to discuss patients in public.” Like World War II posters warning that “Loose lips sink ships,” these notices stress that information falling into the wrong hands can lead to disaster. Staff training that emphasizes the punitive consequences of improper disclosures of protected health information reinforces this caution.
The source is, of course, HIPAA, the federal Health Insurance Portability and Accountability Act. As a longtime advocate for patients' rights, especially the right to privacy, I am chagrined that a law intended to protect patients' medical information is so often used as a bar to communication.
And even with my knowledge of what the law really says, I was waylaid by HIPAA when I was denied permission to accompany my sister, who was suffering severe pain, into the office with the triage nurse in an emergency department. My sister practically begged the nurse to let me come with her. Not a chance. But later, when my sister was on a gurney in the ED corridor for two days, patient privacy was absent. We couldn't help but hear about everyone's medical, financial and relationship problems.
At a time when “patient engagement” and “person- and family-centered care” are buzzwords in healthcare, it is an unfortunate reality that a family member has to leap over a HIPAA barrier to become engaged. The irony, of course, is that patients with complex medical needs are discharged from hospitals to the care of untrained and unprepared family members and all too often are readmitted because of failures in communication around discharge planning.