Hipaa Authorization Form 2011: Fill & Download for Free

**** EXTRA DISCLOSURES: NOT A LAWYER!!!! WHEN IN DOUBT ABOUT HIPAA CONSULT A LEGAL PROFESSIONAL!!!! ********I will admit to being ignorant of the existence of this entire genre of television until a recent This American Life episode took on a long discussion of the program Live PD (and also Cops).What Dan Taberski found out is that these shows are run on a delay, that police departments basically have veto power over what is shown, and that they all operate on the principle that events that take place in public occur without any expectation of privacy and are therefore not covered by state or Federal privacy rules. Many shows do get a waiver signed by the filmed participants, but without a ton of disclosure as to what exactly that person is signing. Shows can use the delay to put in face-blurring, edits, and other techniques to protect individual and patient privacy. However it is important to note that HIPAA does not apply to news organizations — it only applies to health care providers and their business associates (insurers, HR departments, claims processors, analysts, etc.).Thus when filming inside a private space, like a home or inside an ambulance, it is the medical providers (EMTs in this case) who are bound by HIPAA not to make disclosures without the patient’s consent, and those providers (well, their employer) could be sued for each HIPAA disclosure made. The camera crew, producers, etc. are under first amendment news protections. Hospitals (not tv producers!) have had to pay for HIPAA violations for allowing cameras into their premises.In January 2013, OCR [the HHS Office of Civil Rights, which handles HIPAA complaints] received a complaint against New York and Presbyterian Hospital (“NYP”) alleging that NYP impermissibly disclosed PHI to individuals filming “NY Med” at the hospital in April 2011. After OCR’s investigation, NYP agreed to pay $2,200,000 and enter into a Resolution Agreement and CAP [Corrective Action Plan] with OCR. There, OCR found that NYP’s impermissible disclosures of two patients’ PHI to the film crew and staff were “egregious;” NYP had permitted the filming of someone who was dying and another patient in “significant distress,” and the crew did not stop filming even when a medical professional urged it to do so.A really interesting test case would occur if a victim, in a public space, had a prescription pill bottle fall out of a pocket, and the show broadcast it without blurring the patient’s name, or the name of the drug, or obtaining the victim’s consent. It could not be a HIPAA violation, since that applies only to health care providers and their business associates. It would likely be a violation of state privacy laws, which vary and are quite a bit weaker than privacy laws in the EU or Canada. It would certainly be a violation of norms and ethical standards for news organizations. If it occurred in the presence of an EMT, then the EMT and their employer would likely face a HIPAA complaint. The producers could get sued for civil damages, if it caused the person provable harm (loss of job, etc.).See also:How Can Live PD Show Suspects' Faces Without Consent?Can health care providers invite or arrange for members of the media, including film crews, to enter treatment areas of their facilities without prior written authorizationUnauthorized Disclosure of Patients’ Protected Health Information During ABC Television Filming Results in Multiple HIPAA Settlements Totaling $999,000New Orleans crash victim becomes an unwilling participant in A&E’s reality show ‘Nightwatch’Are TV shows like Live PD allowed to film people without their permission?**** EXTRA DISCLOSURES: NOT A LAWYER!!!! WHEN IN DOUBT ABOUT HIPAA CONSULT A LEGAL PROFESSIONAL!!!! ********

Yes. And my answer may make a lot of people upset, especially since my observations will touch on more than just emergency medical services (EMS).When I was a new emergency medical technician (EMT) I assumed EMT-Paramedics (Paramedics) were gods. I mean, seriously, anyone who could read those squiggly ECG rhythms must be magical! We even called them “paragods.”Later I learned that though there are a few very good medics, the vast majority are mediocre and just get by. There is also a significant number of truly scary, incompetent medics that manage to squeak by, possibly because many systems have at least two medics respond to each call, the stronger medic usually covering for the weak medic. Very good medics are quite rare. A very few are true professionals who think with excellent logical processes based on a solid understanding of physiology and pathophysiology, while the remaining medics stumble along using a splash of real understanding coupled with memorized protocols in a sort of medicine via “rolodex” fashion, i.e. “I see this sign and hear this symptom and it matches protocol 2A, so use protocol 2A and hope that works.”PS: Not my creation, but reflective of the fear of one's incompetent peersThough the EMS Profession officially abhors this “cookbook medicine,” it’s a reality that exists due to several factors, including shortages of EMTs/Paramedics, lack of funding for longer and more thorough training periods, and competition between programs for students, the result being quality of care where, as the joke goes, “Patients survive despite our best efforts.” Later still, I realized the same holds at several levels to include nurses, physicians assistant and, to a lesser degree, physicians.On a personal level, knowing there were really bad or stupid paramedics out in the field did help me because, several times during my own program, my confidence would waver and I’d wonder if I would be able to pass. It was at these times I’d think to myself: “If so and so could pass medic school, so can I.”Perhaps the biggest systemic shortcoming in EMS in the USA is the lack of a consistent feedback loop for EMTs and Paramedics. For example, when I assess and treat a patient in the field, turn the patient over to the ER, and the patient is then treated & discharged, or admitted to the hospital, there is NO built in mechanism to tell if my actions were correct. Learning the outcome of the case, thereby helping to improve my assessment, diagnostic, and treatment skills, involves a tedious process of phone calls and often personal visits to the hospital in question to catch the right nurse while they're on shift. Much of this happens on my off-duty time.“Sorry, can’t tell you that. Its because of HIPAA you know. Click.”Complicating this are the US HIPAA laws which, though designed to allow sharing of relevant case information for training and education, are so poorly understood, hospital and medical staff will almost never give you any info unless you have a personal rapport with whichever nurse you’re talking to. In a perverse way, the system-wide ignorance of the privacy law’s intent reinforces continued ignorance, making Continuous Quality Insurance (CQI) something of a joke.To be perfectly fair, in Southern California at least, hospitals often have a single Paramediic Liaison Nurse (PLN) with the additional duty of helping curious paramedics find out what happened to a particular patient, and they can be very helpful. However, as one nurse, often saddled with a myriad of other duties, their ability or willingness to do the chasing down of any given patient’s particular outcomes is quite variable.Currently (as I write this), I'm awaiting to find out what happened to a patient. The effort has thus far required repeated outreach via text, phone calls, and emails. With any luck, next Thursday the right person will be on shift and have enough time to get me an answer. Fingers crossed!Overall, the proces is such a headache hardly any medics bother, making feedback something that happens only if something went really wrong, and the hospital thinks you're to blame.Put EMS care another way, it’s as if EMTs/Paramedics are shooting baskets at a basketball net hidden behind a high wall. You can’t see the basket, but you keep shooting for it without seeing if you’re getting the baskets or not, or how badly and in which way you’re missing.Why no one addresses this has many factors, not the least of which is the administrative headache and costs of coordinating thousands of providers with tens of thousands of health care facilities, local area governments, etc. So EMS is guided largely by protocols used by paramedics and EMTs from programs that vary WIDELY in quality and product.As a patient, your choices when it comes to EMS are much more constrained. But when it comes to other health care providers of ANY level, you truly must shop carefully because the health care field is full of incompetent providers, including among specialists.I wouldn't care so much about the wide range of competence, except in healthcare, incompetence hurts. It is responsible for an incredible volume of unnecessary suffering and unneeded deaths and disability. A Johns Hopkins study suggests medical errors are third-leading cause of death in U.S. Keep in mind this study used data on death certificates which often use generic terminology of death, e.g. “heart failure" or “multi system organ failure” which is sort of like mechanics saying “the car broke because it didn't work,” i.e. it tells you little.Put another way, the researchers relied on what attending physicians documented as the cause of death without knowing the truth of things. Few hospitals autopsy patients anymore, meaning for many, if not most patients, the cause of death is an uneducated guess. No one argues with “heart failure” or “cardiac arrest” or “multi-system organ failure” because those are the end result of pretty much any fatal disease process.The decline in autopsies has several reasons, including reduced quality control standards, cost and possibly lack of interest, but the lack of autopsies probably robs medical personnel of invaluable feedback on pathological processes that must now be assumed rather than “proven" (insofar as an autopsy can prove certain causes of death. In 1972, almost 1 out of 5 deaths were autopsied. From 1972 through 2003, however, the autopsy rate dropped 58 percent from 19.3 percent to 8.1 percent. Although the autopsy rate has increased slightly since 2003, only 8.5 percent, or fewer than 1 out of 10 deaths, were autopsied in 2007 (Products - Data Briefs - Number 67 - August 2011).The authors from the previous study continue "Right now, cancer and heart disease get a ton of attention, but since medical errors don't appear on the list, the problem doesn't get the funding and attention it deserves." In other words, no one (or at least not enough people) really care, therefore, we simply don’t know, and I don’t know if we really do want to know.

Different medical centers and facilities have their own written rules and guidelines which cover the rules of patient confidentiality including HIPAA. In formulating such internal regulations, consideration is given to the circumstances by which there is an inadvertant, improper release of medical record(s). The severity of the punishment is dependent on what fines and penalties could be levied against the institution.It is recognized that no single employee might be at fault and the inadvertant release of a medical record is the result from a systemic error. Hence, an investigation into any HIPAA violation is always undertaken. Systemic errors need to be eliminated; this is normally charged to the IT department. When there are no obvious systemic issues, then the investigation has to look at the individual user(s).(Since my retirement in 2011, the University has tightened down on use of personal computers in the medical center. Only university-provided or authorized computers and laptops have direct access to its ethernet backbone.)I personally know of no egregious problems that has resulted in a HIPAA violation in my institution. However, I am familiar with instances where there were immediate terminations in other centers where employees tried to gain improper access into the EMR. For the most part, the HIPPA violations are typically minor through mechanical user errors or due to lack of or improper training in the HIPAA rules. These are promptly remediated before the user regains certification and access.Do note, however, that an utilization record is maintained for every authorized user to the institution’s IT system. It is reviewed for excessive errors that could result in a formal reprimand to outright suspension. And conditions for termination are listed in the Institution’s HIPAA Compliance Manual.Thanks for A2A.