Hey Baby, You Look Sexy In That C-Collar

[Bernhard]

I would find it unethical, trying on a patient having the phone number or address from the patient data set. I would find it unprofessional directly asking the patient or even accepting an offer from the patient during a call. [*]

But I would find it romantic if true love makes it anyway.

[*] Why? Because in both settings the provider has significant emotional advantages over the patient in a situation, where trust & reliability are two of the most significant factors. Playing out advantages simply is not a good base for ethics and professionalism. In rare, romantic situations it may work for both, but most probably it would be scary or at least a little upsetting for the (ex-)patient. Better try to "accidentally" step into her/his way in the supermarket. Don't tell anyone. Make a movie.

Edited November 9, 2011 by Bernhard

[DFIB]

I think there is a factor that we have not considered yet, ( if I missed it, sorry). EMS Health care is not a long term relationship and care. The care is not psychological, at least not therapy. People meet through a variety of circumstances and means. The chemistry of love can spark at any time. Nothing says I love you like a OPA and an IV. I really don’t know.

In any post service contact that is "accidental" and not "pre planned" HIPPA should be respected. The patient should not feel intimidated or harassed (unless of course they want to). I suppose the patient could strike a conversation with the medic without crossing any lines. The single medic might possibly wait for the patient to make the first move

Good questions all. Not sure what I think. Having been married for so long my dating skills and protocols are a little rusty. My standard line is, that is very flattering honey but I’m married, it isn’t you … it’s me I'm married, and you have beautiful eyes and a wonderful smile as well, but I’m still married.

[ERDoc]

First, I don't think this is a HIPAA violation. He was involved with her care and is privy to the information. He did not share it with anyone not involved with her care. To use that information in the way he did is, to me, unethical but not illegal. It is one thing for the patient to make the first move, but it should never be the provider.

[DwayneEMTP]

...[*] Why? Because in both settings the provider has significant emotional advantages over the patient in a situation, where trust & reliability are two of the most significant factors....

I agree completely. At the grocery store man=1 and woman=1, the rest is to be discovered. Having responded to this ladies emergent situation, woman=-1 (Less than whole emotionally when vulnerable), man possibly appears =5. (of course the sexes can be combined other ways/orders) She's seen him with the hosemonkeys, he's got flashing, shiny machines that to the lay person (No pun intended) can look exotic, has a fancy, heroic ambulance. It's no longer a level playing field.

Also, the Doc beat me to it, but I don't believe that this is a HIPAA violation either. Can one of you that claims it to be a violation quote the language from HIPAA that makes is so?

Dwayne

[systemet]

I agree that it's unethical to use information from the patient care record to contact a patient after an event. The information wasn't disclosed to you for personal use, but was given with the implicit understanding that it was to be used for treatment follow-up +/- billing purposes. Most jurisdictions have some sort of privacy disclaimer (I assume in the US this is part of HIPAA?), that describe why information is being collected, for what use, and how privacy is to be safeguarded.

I also think it's unprofessional for a medic to initiate any conversation about a potential date (with the patient or a family member / random bystander) while treating a patient. It doesn't exactly promote the idea that you're focused on the patient's care at that point. There's also an issue as to whether the patient is in a situation where they can freely refuse here, if they are worried about upsetting the EMT / Paramedic, and the potential changes in their treatment that might result. I imagine a professional college would have issue with this.

Dating a patient after meeting them in a non-work setting seems fine to me though. And I don't think it's unreasonable to give your number to the patient if they ask for it. But the dialogue needs to be steered back to patient care, to prevent an impression that you're no longer doing your job.

I also don't think it's a problem to treat your girlfriend or wife. It's not something I would choose to do --- I know from experience that if a family member or friend is injured / sick my judgment goes out the window, and I become very aggressive in terms of treatment therapies. I'd far rather pass the call onto someone else, if it's a possibility.

Just my opinion.

[Just Plain Ruff]

From a summary of the HIPAA rule website

Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another

Here is the website

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

So we have the medic with her information in the course of treating her. But that information is to be used solely for just that. You don't use the protected patient information to get a silly date.

So I would think that it is indeed a hipaa violation.

And here's more

Permitted Uses and Disclosures. A covered entity is permitted, but not required, to use and disclose protected health information, without an individual’s authorization, for the following purposes or situations: (1) To the Individual (unless required for access or accounting of disclosures); (2) Treatment, Payment, and Health Care Operations; (3) Opportunity to Agree or Object; (4) Incident to an otherwise permitted use and disclosure; (5) Public Interest and Benefit Activities; and (6) Limited Data Set for the purposes of research, public health or health care operations.¹⁸ Covered entities may rely on professional ethics and best judgments in deciding which of these permissive uses and disclosures to make. Nothing here about asking for a date so I think violation

So where in that summary does it say that you can use the information you got while treating the patient to call her up and ask her for a date?

And here's even more info

Authorized Uses and Disclosures

Authorization. A covered entity must obtain the individual’s written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.⁴⁴ A covered entity may not condition treatment, payment, enrollment, or benefits eligibility on an individual granting an authorization, except in limited circumstances.⁴⁵

An authorization must be written in specific terms. It may allow use and disclosure of protected health information by the covered entity seeking the authorization, or by a third party. Examples of disclosures that would require an individual’s authorization include disclosures to a life insurer for coverage purposes, disclosures to an employer of the results of a pre-employment physical or lab test, or disclosures to a pharmaceutical firm for their own marketing purposes.

All authorizations must be in plain language, and contain specific information regarding the information to be disclosed or used, the person(s) disclosing and receiving the information, expiration, right to revoke in writing, and other data. The Privacy Rule contains transition provisions applicable to authorizations and other express legal permissions obtained prior to April 14, 2003.⁴⁶

Still nothing in this summary as I'm reading it allows the use of the patients phone number or information for purposes of getting a date.

And even more info

Access and Uses. For internal uses, a covered entity must develop and implement policies and procedures that restrict access and uses of protected health information based on the specific roles of the members of their workforce. These policies and procedures must identify the persons, or classes of persons, in the workforce who need access to protected health information to carry out their duties, the categories of protected health information to which access is needed, and any conditions under which they need the information to do their jobs.

Note the carry out their duties, sure he needed her information but once she was dropped off at the hospital is duties ended so he should not have used her info as he did.

I'm not sure if this proves it's a HIPAA violation but it sure is pointing to a very slippery slope that the medic probably cannot climb and give a justification of his actions if he was pressed .

[paramedicmike]

I found the same info as did Ruff. The actions demonstrated by the medic in question are certainly improper and not keeping with the spirit, and quite possibly the letter depending on how it is viewed, of the legislation.

[Just Plain Ruff]

I asked one of my former clients HIPAA person. She is the one who is in charge of investigating HIPAA complaints and infractions for my client.

She said once the call was over the medic had no business keeping her private information, the medic had no need to have that information and by using that information for personal gain was subjecting his service to significant fines and penalties.

She said that the service if they do not have a HIPAA policy that they better get one and fast.

She said the service as well as the medic could be penalized. The medic could be fired and the service could face fines of 25000 per occurrence and even higher fines if the medic was found to be doing this for personal or financial gain.

I have one question to all of you on this thread.

How much training did you receive on HIPAA when you were hired or how much training per year do you get in HIPAA and patient privacy education?

My suspicion is minimal training at best. I know all the services that I've worked for had minimal training.

I also find that most services are reactive and only provide the training when a HIPAA fine or violation was set against the company.

[DwayneEMTP]

That mentions 'protected information' several times but you don't list the definition of what that protected information is...I think that, though I've not read it in ages, it's referring to specific health, and primarily insurance information...

Using her phone number for non medical purposes? I don't think anyone here will argue that that's horseshit. But as he didn't transmit any of her personal and/or insurance information (making that assumption of course) to anyone else, I don't see the HIPAA issue. Though I'd can his stupid ass in a second as his professional judgement is obviously off in the ditch in my opinion.

Just trying to make the point that many state 'HIPAA violation" because they're unable or unwilling to differentiate between patient privacy issues and HIPAA issues.

Though I don't believe it's a HIPAA violation, am I making it clear that I think this guy is a douche...?

Dwayne

Actually, I can't find any way that this is a HIPAA violation, after reviewing much of the document, as it is concerned only with the electronic transmission and protection of medically/financially sensitive data.

As he was not transmitting ANY data, in any form, or so it appears to me, this can not possibly be a HIPAA violation. I suppose that it could be argued that he transmitted her number to her in some way, but the best that I can tell, that is not protected data, and even if it was he was not transmitting it to a 3rd party.

Douchie? yeah. HIPAA? Nearly impossible in this scenario unless you all come up with something significantly different than what I'm seeing...

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

Dwayne

[paramedicmike]

Dwayne,

In the link Ruff provided you'll find this:

"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,
  

and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.¹³ Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number)."

No. A phone number isn't listed as an example. But it would not be a far stretch to argue that a phone number could be used as identifiable information. And it isn't a matter of whether he transmitted her information to anyone. It's the responsibility of the facility or organization and its employees to protect the information. By taking this woman's phone number with the intention of asking her for a date it can reasonably be argued that her information was not protected. He had no business taking the info with him upon completion of the call.

Ruff's colleague has given her opinion. It'd be interesting if Ruff could convince her to join in the discussion so she could address some of these topics first hand.