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The Department of Health and Human Services (HHS) has released the first of what’s expected to be a series of guidances on how the new rule governing privacy of patient medical records and information will work. Stating that "we . . . understand that overheard communications are unavoidable," the HHS guidelines clarify that the new rules are not intended to stop physicians from talking with other health care professionals about a patient’s treatment.
According to the guidance, when physicians and nurses talk to each other or with a patient about providing care, they should use privacy safeguards that are "reasonable" without getting in the way of rendering appropriate medical treatment. For example, doctors are not prohibited from speaking loudly in a busy emergency area where they could be overheard talking about a patient’s condition if that is necessary to provide appropriate care. Also, physicians are not prevented from discussing lab test results with a patient or another health care professional in a joint treatment area.
These practices would be "permissible, if reasonable precautions are taken to minimize . . . inadvertent disclosures to others who may be nearby (such as using lowered voices, talking apart)," notes the guidance.
Scheduled to go into full effect in April 2003, various physician advocacy organizations are lobbying to extend the compliance deadline and change various provisions in the final rule.
HHS has already agreed to some changes. These include permitting pharmacists to fill prescriptions phoned in by a patient’s doctor before getting the patient’s written consent, and allowing "direct treatment providers" receiving first-time referrals to schedule appointments, surgery, or other procedures before obtaining the patient’s signed consent.
To review the HHS guidance on medical records privacy regulations, go to: www.hhs.gov/ocr/hipaa/.