What information can hospitals give over the phone?

As healthcare providers, patients, and families understand the complexities of hospital communication, a common question arises: what information can hospitals disclose over the phone? The answer to this query depends on a variety of factors, including the purpose of the call, the identity of the recipient, and the patient's own preferences and authorizations.

Understanding HIPAA regulations

The Health Insurance Portability and Accountability Act (HIPAA) serves as the guiding framework for hospitals regarding patient information disclosure. HIPAA's privacy rule outlines the specific circumstances under which hospitals can share protected health information (PHI) over the phone. Compliance with these regulations is necessary to ensure patient privacy and avoid potential penalties.

Directory information

At the most basic level, hospitals can provide directory information about a patient over the phone. This includes the patient's name, location within the facility, religious affiliation, and general condition. However, the extent to which this information can be shared may be subject to the patient's own preferences and restrictions.

Authorizing disclosures

While HIPAA's privacy rule sets the baseline for information sharing, patients have the right to authorize additional disclosures beyond what the rule permits. Patients can grant permission for hospitals to share more detailed PHI with specific individuals, such as family members or caregivers, over the phone.

Restrictions and limitations

Conversely, patients also have the right to restrict the information that hospitals can disclose. This may include limiting the disclosure of certain medical history details or preventing the sharing of information with specific parties. Hospitals must respect these patient-initiated restrictions, even for treatment, payment, and healthcare operations (TPO) purposes.

Read also: What is the HIPAA Privacy Rule? 

Verifying identities

To protect patient privacy, hospitals may implement additional safeguards, such as requiring the verification of a caller's identity before disclosing any information. This step helps ensure that the person requesting the information is authorized to receive it, even if the patient has not explicitly restricted the disclosure.

Telephone system considerations

The type of telephone system used by the hospital can also impact the information that can be shared over the phone. Hospitals using Voice over Internet Protocol (VoIP) systems must have a valid business associate agreement with the software vendor before disclosing PHI, a requirement that does not apply to traditional public switched telephone network services.

Read more: VoIP Providers and HIPAA Compliance: The Ultimate Guide 

Permissible disclosures 

Hospitals can make disclosures of PHI over the phone for treatment, payment, and healthcare operations (TPO) purposes. However, the amount of information that can be shared may vary depending on the specific context of the call. For example, when requesting authorization from a health plan, the minimum necessary standard applies.

Additionally, according to §164.510 of the privacy rule, “If the individual is not present, or the opportunity to agree or object to the use or disclosure cannot practicably be provided because of the individual's incapacity or an emergency circumstance, the covered entity may, in the exercise of professional judgment, determine whether the disclosure is in the best interests of the individual and, if so, disclose only the protected health information that is directly relevant to the person's involvement with the individual's care or payment related to the individual's health care or needed for notification purposes.”

Balancing transparency and privacy

Understanding the complexities of hospital phone communication requires a delicate balance between providing transparent and informative responses to callers while also upholding the patient's right to privacy. Hospitals must carefully consider the nuances of each situation to ensure compliance with HIPAA regulations and respect the individual preferences of their patients.

Developing policies

To mitigate the risk of HIPAA violations and patient complaints, hospitals should develop policies and procedures for handling phone inquiries. These guidelines should clearly outline the types of information that can be disclosed, the verification processes for callers, and the steps to be taken when a patient has requested privacy protections or authorizations.

Empowering patients and families

By educating patients and their families about their rights and the hospital's policies regarding phone communication, hospitals can foster a more transparent and collaborative relationship. This, in turn, can help reduce misunderstandings and ensure that all parties are aligned on the appropriate sharing of information.

Navigating challenging scenarios

There may be instances where the appropriate course of action is not immediately clear, such as when a patient's capacity to make decisions is in question or when there are conflicts between family members. In such cases, hospitals should have protocols in place to escalate the decision-making process and consult with legal or ethics experts to determine the best course of action.

Read more: Can you share PHI over the phone or text? 

FAQs

What makes a phone HIPAA compliant?

Put simply, a phone system that's HIPAA compliant meets all the requirements that HIPAA lays out for safeguarding patient data, specifically, the aptly named privacy and security rules, which together lay out the standards for protecting ePHI.

What is directory information?

Directory information consists of the name of the patient, the location of the patient in the healthcare facility, the patient’s religious affiliation, and the patient’s condition, which are described in general terms that do not communicate specific medical information about the individual.

Why it is important to know what information hospitals can give over the phone?

• Healthcare providers want to make sure they comply with HIPAA,
• Patients want to know if their privacy rights have been violated, and
• Families want the maximum information possible about a loved one.

Learn more: HIPAA Compliant Email: The Definitive Guide