The legality of an EMT telling over non-medical info divulged during treatment

[ghurty]

My partner and I got into a discussion the other day.

Let me preface my question with this statement: I am not asking whether something is morally correct, rather the legality of it:

What is the law if while you are treating a patient (as an EMT), the patient divulges some personal information.

Basically amongst telling over you their medical info they tell you over about certain things happening in their personal life (not medically related). You normally have nothing to do with the patient, but the patient feels close to you because you are treating him/her, so the patient tells over the info.

What is the legal status of that information? Are you allowed (legally not morally) to tell it to someone else? Being that it is not medical info, it probably does not fall under HIPPA regulations. Being that you are not a doctor, it probably does not fall under doctor/patient confidentiality. I assume that if you would be requested to give over that info to a court, you would not be able to claim doctor/patient confidentiality and would have to give it over. But what about just talking about it to someone else.

Any input?

Thanks

[Chief1C]

As a general rule, I never discuss anything about any of my patients, with anyone not directly involved. If Patient AB. X tells me they like red beach balls, puppies, and their uncle Fred touched them as a child.. I'm not going to go down to the local coffee shop and casually discuss Patient AB. X's info with anyone. Telling war stories is one thing, but I never name the patient, or give any specific details. Why would someone want to do that?

HIPAA

[HERBIE1]

My partner and I got into a discussion the other day.

Let me preface my question with this statement: I am not asking whether something is morally correct, rather the legality of it:

What is the law if while you are treating a patient (as an EMT), the patient divulges some personal information.

Basically amongst telling over you their medical info they tell you over about certain things happening in their personal life (not medically related). You normally have nothing to do with the patient, but the patient feels close to you because you are treating him/her, so the patient tells over the info.

What is the legal status of that information? Are you allowed (legally not morally) to tell it to someone else? Being that it is not medical info, it probably does not fall under HIPPA regulations. Being that you are not a doctor, it probably does not fall under doctor/patient confidentiality. I assume that if you would be requested to give over that info to a court, you would not be able to claim doctor/patient confidentiality and would have to give it over. But what about just talking about it to someone else.

Any input?

Thanks

Define "personal" information. If it's not actionable- as in the case of an admission of child or elder abuse, where we are required to report it-, like you said, it's not protected health information, so there is nothing to report.

[Richard B the EMT]

I don't believe there is anything about the non-medical stuff a patient might tell us as being covered by HIPAA, but I am still not telling anyone that a patient likes pina coladas and getting caught in the rain...

[fakingpatience]

What do you mean telling someone? Do you mean telling other health care professionals/ law enforcement? Or do you mean talking about something a pt told you to someone not in a professional setting? If it is the former, I think you are well with in your rights to tell the professional what they told you (ie, if someone admits to assaulting another person...). I do not think it is legal to tell the info to someone else. Simply by telling them the non-medical information, you are inadvertently divulging medical information, specifically that that person was transported by you, which I believe is protected information.

[Lone Star]

Divulging patient information directly related to their care is protected by HIPAA, we all know this.

Unless the 'non-medical information' revealed is not something that we're morally, ethically or legally required to divulge, then one could conclude that it's still 'protected by privelidge'. Not only that, but could divulging this information be considered libelous?

We are held to the same standards as anyone in the medical community asw far as 'patient/practitioner privelidge.

[Just Plain Ruff]

The only thing you should be talking to anyone regarding a patient is the caregivers taking over patient care from you.

If you tell anyone else anything really about that patient then you have violated the patients privacy and may have committed that all too often cited Hipaa violation.

The only thing I would tell anyone about my patient is to a law enforcement officer or a child/elder neglect hotline that I thought was a problem.

If there is a danger to the public from the patient then you are obligated to report that but like the others said. If the patient says "I play with dolls while I'm naked" or something like that, keep that private and don't spread it around.

When in doubt, don't tell.

[DwayneEMTP]

The only thing you should be talking to anyone regarding a patient is thecaregivers taking over patient care from you.

If you tell anyone else anything really about that patient then you haveviolated the patients privacy and may have committed that all too often citedHipaa violation.

The only thing I would tell anyone about my patient is to a law enforcementofficer or a child/elder neglect hotline that I thought was a problem.

If there is a danger to the public from the patient then you are obligated toreport that but like the others said. If the patient says "I play withdolls while I'm naked" or something like that, keep that private and don'tspread it around.

When in doubt, don't tell.

Playing devils advocate...

What happens if your HEP positive pt is an angel until loaded into theambulance and then spits in your face while you take their blood pressure? Yourestrain them and put on a spit mask..yadda yadda. Next time they swear theywere in a bad place last time,(all sweet and doe eyed) that it will neverhappen again, but it does.

Do you tell the crews that you think likely to run on this pt to be aware thatthis pt is a terribly sneaky spitter? Or protect that information and let themlearn, and be exposed, on their own?

Dwayne

Edited (God only knows how many times it will take) to fix formating.

Edited October 21, 2010 by DwayneEMTP

[Just Plain Ruff]

Honestly Dwanye, there's nothing in the back of an ambulance that is said that is covered by HIPAA except what you said.

I wholeheartedly agree on that.

I also agree that there are things that are said in the back of an ambulance that i can comfortably relay to my wife and co-workers.

For example - patient is a ww1 vet or a veteran and he tells me of all his escapades while over in Europe fighting, I'm going to tell others about those stories.

It's a fine line in what to tell again and what not.

I would think that this rule would be appropriate to follow: If it pertains to his treatment then don't repeat unless repeating to someone involved in his current care. If it has nothing to do with the treatement and his illness then it can be shared.

I for one don't share much about who I treat and transport but there are some things that I will share.

If we take the hard line and say we share nothing that goes on inside the ambulance and sharing that information is steadfast wrong - then how would you address the issue regarding an unsafe scene be it unsafe stairs or knives or guns lying around the house.

Somewhere the playing devils advocate got lost in the threads. I beleive the devils advocate was in response to my first post

I would definately report this guy to my crews. I think I clarified my statements in a subsequent post

The sneaky spitter is a safety hazard to my co-workers so I'm going to tell them about this guy. This is not protected patient information and it lends itself to keeping me and my co-workers safe.

As far as I'm concerned privacy laws don't cover this aspect. If my safety is in danger I'll let my crews know the danger. Be it rickety stairs, sneaky spitters, guns and knives in the house or a mean dog.

I don't think, but I could be wrong, that this guy spitting on me is covered under HIPAA or Privacy laws.

If someone spit on me and said "I'm sorry I was in a bad place when I did that" and then he spit again, well the police are going to be waiting on this patient when we got to the hospital. I'm going to put a mask on him or on me to keep him from spitting on anyone else. He's proven to me that he cannot be trusted and my safety is more important that him getting a nice comfortable ride.

[DwayneEMTP]

Man...great question. I'm going to take a differentroute, as sometimes happens..

I don't believe that all of the pt statements are covered under HIPAA. In fact,I believe that very little of the information that they may give me in the backof the rig is. About a hundred years ago akflightmedic and Dust convinced methat I was a shithead if I operated under a legal document that I hadn'tactually read. I agreed, and did so, but can't really remember much of it now.So I'm thinking I've returned to being a shithead by default. :-) But I'mpretty confident that HIPAA is concerned mostly with personallyidentifying and insurance information.

Having said that I'm not sure what is covered legally. I can't claim to be asprofessional as the others here as I often talk about personal information withmy coworkers concerning my pts. Not with malice, most often, but it happenedregularly. I was running in a small community where the odds were great thatthe others in the crew were going to be transporting the same patients that Ihad so sometimes information that I would normally consider morally, if notlegally protected was shared. "If you run on Bob be aware that he has a'special' towel next to the bed. You may not want to touch it any more thannecessary." "If you get dispatched to Mary at X address her healthhas been failing so she mostly wants someone to come and change her O2 out andvisit for a bit. She keeps her spare O2 bottles in the garage, but forgetssometimes. She's likely to be relatively hypoxic before she calls, so you'llwant to watch for that." And the like. Would this be morally and ethicallyprotected information? I'm not sure, as it's shared with the intention ofeducating people that I believe to be future providers for these patients.

Also, of the information given, how much is given because the pt is in anambulance? And would this somehow affect the legal standing of thatinformation? Again, I'm not sure.

I had a really good medic coworker who ran a car accident, truck off in theditch. She found one pt, covered in blood. Loaded him up, did her first ratemedic thing as always, but after cutting off his clothes couldn't find anywounds?? As she's getting his history he tells her that "I just killed theguy that owns that truck. I'm ok, none of this is my blood." She calleddispatch to get some police assistance and was told by dispatch that as she wasout in the county she would have to call the Sheriffs dept directly, and no,they didn't have that number as they always dispatched them by radio. Nice.

She of course told what she had heard, they did in fact find a man beaten todeath, and with a supervisor in tow did the mountain of reporting involved. Ithink that this case is pretty clear cut.

Man..I like this question a lot...I look forward to hearing from those that aremore versed in the law.

Dwayne

Sorry all...formating was completely hosed. While trying to fix it, (The editor doesn't seem to like long quotes or many multiquotes) they got out of order and well...you'll see...