Just Plain Ruff

You will know when you are not welcome here. The most unwelcome notice is when you are banned but I can't remember you doing anything that could end up in a ban. I suspect there are a few people here who are not happy with you for some reason or another. Without going back in and looking at your posts and replies to them, I'd hazard to say that you might be blowing things out of proportion. I'm also going to go out on a limb here and say that this post is in response to something that happened in chat!!! Am I right?

street, what are you talking about. I don't have any issue with you here. What is the root cause of this question?

True Doc, but where I come from the services I work for are completely rural. We don't contact the trauma centers we allow for the helicopters to determine which trauma center the patient goes to because we in the rural area don't have the informaition that the helicopters have in terms of who's open and who isn't. So the majority of our flights are from a landing zone (helipad on a small rural hospital) to an available trauma center, stroke center or Heart center. Now, what becomes the gray area and the emtala issue is the patient you are transporting form that small rural hospital and that patient crashes or gets sicker. EMTALA has been addressed based on the cobra forms and the transport is begun. When I call for a helicopter to land at the helipad of the hospital I never thought there would be an EMTALA issue especially when the patient is ending up at the same facility that they started out to go to. What I have found is this on one particular call, you use the LZ (helipad) at the small hospital, my emt goes into the ER and notifies that hospital that we are using their helipad as a LZ only and the doctor in the ER gets his knickers in a bunch and cites COBRA and EMTALA. My emt then comes back out and says "the ER wants to evaluate the patient" I then say no. The doctor comes out and gets in the ambulance with me thus making my patient his. This was a critical trauma patient, the small ER doc whos hospital does not have Ortho, surgery or anything more than a 4 bed ICU. We now have a patient who is critical and is now being evaluated in the small town ED so this doctor can do whatever life saving magic he thinks he could do. In the end, the patient dies from his injuries in the small town ED and a major court case was started with the small ER/hospital losing big time, my butt being in court for several days, my being named initially to the lawsuit but dropped during the 2nd deposition. The trauma center backed my decision to divert to the helipad, they did not support the doctors decision to bring their patient into the small ER and made it abundantly clear to the court that the patient died not because of actions on my part or their part (the trauma centers) or the helicopters fault, but the fault lay completely on the small town doctor who did indeed cause the patients death. So my word of caution is use hospital landing pads with caution as some hospitals still firmly hold onto the belief that once on their property for no matter what reason, they are their patient. I can understand that belief but just beware. I am a strong advocate of scouting out particular areas in a small town or rural area and work with land owners and business owners on the use of their land as a LZ. We had a church with a huge parking lot that agreed to allow us to use their parking lot when no services as a landing zone. Biggest parking lot in the west end of the county and it suited us very well. there is still no substitute for a secure landing zone at a hospital but we have all made do in the past. Choose a nice field and land the bird. Land the helicopter onthe highway but that causes many headaches for drivers trying to get where they need to go. Work with your helicopter service that you use most to scout out good areas, the pilots know what they need for landing. Ruff

Actually Doc that's not completely true. At several of the services I've worked for the helipads at the hospitals make great landing zone and I've been involved in two distinct EMTALA complaints where the ED physician has made a complaint of my using their helipad for just that a LZ for the helicopter. Our EMTALA/COBRA investigator ruled for my ambulance service each time saying if the helipad, even on hospital property is used for a LZ only that its not a violation. Of course your localities investigator may have a dfferent interpretation of the rule. Mileage may vary of course.

this is the most disgusting of all things in this if true.

According to CNN there have been at least 12 additional victims come forward in the past day or so.

I agree wholeheartedly Flaming. I expressed my opinions to the medic but he did't seem to care.

One medic is still doing it last time I checked. He told me at one time he had 3 large file cabinets full of reports. He said that having those reports have "saved" him a couple of times. Saved him from what, not sure though.

Actually I know a couple of medics who did that. They made copies of their reports after each shift. they said that if they ever got subpoena'd that they would have the original report to review compared to a possibly redacted report given by the lawyer.

there you go again. It's never never never never ok to cover up anything in my opinion. Are you still on that issue with your relative? I'm not asking you to let that go but seriously Flaming, aren't you tired of fighting the establishment. So what involuntary manslaughter issue are you talking about? I'm outraged whenever a cover up is done no matter who it's done by, by the church, those terrible medics, those terrible doctors. it seems like you are the resident angry young man in the EMTCity community. I have yet to see you post anything that is uplifting or positive, it's always how bad people are. Don't you get exhausted trying to find the ill in this world and exposing it or are you doing this just to prove how compassionate you are and how you are going to go out there and expose everyone int he worlds sins and bad decisions. I for one know that I would get tired after scouring the internet for the bad things that happen.

Ok, I just sent an email to the Office of Civil rights explaining our discussion and what the medic did. I hope to get a reply soon. I'll post it in it's entirety when I get it. This will be the final ruling on this discussion I suspect. I'll keep you posted.

this Hipaa and Privacy discussion has been very very good. What i'd like to see is this - post your Hipaa policy here if you are able. One that I worked under at one time X hospital is permitted to use or disclose protected health information as follows: • To the individual; • For treatment, payment, or health care operations in compliance with HIPAA Regulations; • Incident to a use or disclosure otherwise permitted or required by this policy provided that Hospital has complied with the applicable requirements of the Regulations; • Pursuant to and in compliance with a valid authorization; and • Pursuant to an agreement consistent with or as otherwise permitted by the Regulations. somewhat vague which is why the organization has developed over 30 additional policy and procedures to address HIPAA disclosures.

The only information I am allowed to release at the ER I used to work for is the following. 1. patient is here 2. Patient is being seen 3. contact the family for further information. I don't even go that far. I tell the caller to contact the family for information. We have the jane does and the no information patients but I always ask the patient this quesiton and I recommend you do the same. "If someone calls for you asking about you, do you want me to tell them you are here or not?" If they say yes you can tell them, then I ask the patient the next question. "What phone number or person do you want me to refer them to about you" that usually tells the patient I'm protecting their privacy and it allows the patient to give me a name and number of someone they trust to give to the caller. Usually it's the wife or husband but other times it their pastor or friend. Depends on the patient. Same with people who ask you about the patients you see int he ambulance. the simplest thing to say is this "I cant tell you that, sorry"

Let's discuss what the medic did in terms of the above 3 points. All the reference internet sites cited have no bearing on this particular thread at least for the original post. Which was the supposed violation of HIPAA in regards to the medic taking the hospital face sheet, taking the patients number from that face sheet and using it to call the patient supposedly on a follow up call but then he asks her out on a date. How many of you medics out there request a face sheet from registration in the ED? I'll bet every single one of you do. Unless you get a good gathering of patient information along with insurance information, the face sheet is the best method to get all your billing information in one place. Hipaa violation - I don't believe so. let's look at the three items HLPP pointed out a the end of her most recent post Individually identifiable health information" is information, including demographic data, that relates to: •the individual's past, present or future physical or mental health or condition, •the provision of health care to the individual, or •the past, present, or future payment for the provision of health care to the individual, the phone number is included in demographic data - that's a undeniable fact but does it relate to the next three bullet points. NO I don't think it does. Does a phone number relate to the patients past, present or future medical condition - NO Is a phone number a required piece of information in the provision of health care to the individual - NO does the phone number constitute part of payment for past, present or future payments for the provision of medical care? NOPE not a bit. A phone number is a protected piece of patient data. As per my additional email question to the HIPAA lady I know, she didn't really wish to discuss it further since she had a meeting out of town she was going to but she did allow additional questions after she returned next week. So this is possibly a HIPAA violation but she said that anyone can claim a violation at any time and it will be investigated first by the agency involved along with the OCR or it's investigated by the OCR if the report or complaint is filed directly with the OCR. (OCR = Office of Civil Rights). I would suspect that if there is a complaint made, there will be no fine but I'll bet that the agency involved that this guy works at doesn't have a HIPAA policy or it has a very weak policy. Be that as it may, the threat of a HIPAA/OCR investigation is daunting and scary to the organization involved and it behooves you to find out what your agencies HIPAA policy is and to have them develop a policy regarding HIPAA Now sooner than later. The medic should be punished by breaking patient privacy and maybe HIPAA violations. Edited to clarify my friends position as well as a miswritten statement.

good catch CP I didn't catch it nor do I think anyone else. The tongue and cheek article is pretty darn funny. I wonder how many nasty phone calls the fire department has gotten.

A cover up is NEVER NEVER NEVER Right. Simple as that. Unless it has to do with National security or something like that. (that was sarcasm if you didn't catch that) What the vatican and the catholic church has done is completely disgusting and so out of the realm of decency that I can't express it in mere words. And we in the US only hear about what happens in the US not other countries with much less stringent reporting systems in place. Nuff said on that. We could put together a tremendous response thread regarding the catholic church and it's behaviour but I hope we do not.

I believe I already posted that link earlier this week. I pulled many specific points out of that website.

Wow he gets to drive 80 miles a hour through town. He must feel special. I'm sure if confronted over that statement he'd just say that it was a mis-statement and in his eagerness over his new car. Personally I think that it's a STUPID Idea to have a car like that as his personal/official car.

Ruffems, on 09 November 2011 - 07:19 PM, said: Ok so sick day wasn't the politically correct term but they did get the opportunity to take the day off using their PTO time. That constitutes either a sick day or personal day. It's all semantics though. And where did you get your knowledge that being exhausted was workmans comp instead of a sick day or a personal day? from thew nsw industrial relations commission See you are using your terms and I'm using mine. Exhaustion I don't believe is a work comp related reason to file work comp. I could be wrong but if it is then every one of my co-workers would apply for it every single day. So we are comparing USA apples to NSW oranges. We both might be right.

Apparantly Oregon didn't get the message. I hear they had minimal if not a non-existent signal. Many good things will come from this test, least of all a better reporting system that will be tweaked and upgraded for the safety of all americans, unless you have dish network(I hear they didn't get a signal either).