The Health Insurance Portability and Accountability Act of 1996 was created to safeguard patients’ protected health information (PHI). Two decades later, HIPAA is still one of the most misinterpreted regulations in healthcare. These misunderstandings often lead to improper invocations, especially in emergency care settings where timely access to important information can make a life-or-death difference.
Although HIPAA limits disclosures of PHI to unauthorized entities, it is not supposed to hinder necessary communications between health providers or to interfere with or delay patient care.
Emergency care settings are especially prone to HIPAA misunderstandings. Providers may invoke HIPAA prematurely, fearing the severe penalties associated with violations. However, doing so can hinder medical decisions. HIPAA does not require patient authorization for every instance of PHI disclosure. For example:
Disclosures to physicians: HIPAA explicitly permits the disclosure of PHI from one provider to another for treatment purposes without requiring patient authorization. However, as the regulations state, "professional judgment must be used to determine whether the requested PHI relates to the patient's treatment."
Family member inquiries: If a family member calls the ED to inquire about a patient's status, HIPAA allows the disclosure of directory information (like the patient's location and general condition) if the caller identifies the patient by name. However, patients must have the opportunity to object to such disclosures.
Requesting medical records: Providers are allowed to disclose medical records to other healthcare entities for treatment without requiring a patient's signed authorization.
Additionally, HIPAA requires disclosure only to the patient or the U.S. Department of Health and Human Services for compliance reviews.
This fear has led many health professionals to adopt a better-safe-than-sorry attitude. Such a 'kneejerk response' could result in the misuse of medical resources. Like, when a provider unnecessarily denies sharing previous imaging results and the patient has to redo tests, resulting in inflated patient costs, and undue burdens on hospital resources.
Or, when police officers requesting information about patients in the trauma bay get met with resistance. HIPAA allows providers to disclose PHI to law enforcement if the information is integral to their investigation or immediate law enforcement activity.
Knowing when HIPAA does not apply helps providers maintain the balance between protecting patient privacy and offering effective care. Misapplication of HIPAA can delay treatment, increase costs, and erode trust between patients and providers. So, providers must understand what HIPAA entails to navigate legal issues and make decisions that truly put patients first.
More specifically, using a HIPAA compliant email solution, like Paubox, is a method for sharing PHI while keeping all regulations intact. These systems will be indispensable in emergency care settings where timely communication is required.
For example, in cases where a provider needs previous imaging results or consultation with a specialist, encrypted email allows PHI exchange without violating HIPAA regulations.
These email solutions encrypt PHI during transmission and storage, preventing potential interception or unauthorized access. Additionally, HIPAA compliant solutions can streamline workflow and improve patient outcomes while minimizing the risk of potential HIPAA violations.
Related: Using HIPAA compliant forms in emergency medical services (EMS)
Providers must use a HIPAA compliant emailing platform, like Paubox, which encrypts all outgoing emails, preventing unauthorized access to patients’ protected health information (PHI).
Yes, providers must obtain explicit patient consent before using emails to send PHI.
Read also: A HIPAA consent form template that's easy to share
Professional judgment is the discretion healthcare providers use to make decisions about sharing patient information based on their training, experience, and the specific circumstances of each case.