Confidentiality, HIPAA and the Correctional Nurse
An RN calls the hospital for discharge information on a patient transported back to the prison infirmary from the local hospital after his jaw was wired following an inmate brawl in the exercise yard. The emergency room nurse refused to provide any information stating it would be a violation of HIPAA. She instructs the prison RN to obtain any information she needs from the patient himself.
An NP is reprimanded for telling a housing officer that one of the inmates is a severe diabetic and needs his evening snack on time.
Confidentiality of patient health information has always been a concern for nursing. Valuing patient privacy is an ethical imperative, even in the correctional setting. In recent years the Health Insurance Portability and Accountability Act (HIPAA) has moved healthcare information confidentiality to a legal concern for nurses. In particular, HIPAA regulations ensure that private health information is not released to any third party without the patient’s permission .
Disclosure of medical information may be necessary for the health and safety of both the patient and the large patient community within a security facility. Officers may need to know about medical conditions or disabilities that require special equipment or scheduled appointments. Some medication side effects require additional attention or changes in work duty. Joint surgery may limit movements or abilities that security needs to be aware of. Foruntately HIPAA regulations take into account the need for some information sharing within the correctional setting and have spelled this out is the 45 C.F.R. 164.512 (k) (5) (i) section of the code.
HIPAA Permitted Disclosure to Correctional Institutions
If the correctional institution represents that such protected health information is necessary for:
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According to this section of HIPAA regulations, an ER nurse can confidently share health information with the receiving nurse in the prison infirmary and a nurse practitioner can alert an officer to a health need of an inmate in his charge.
Many in corrections are confused about how to implement HIPAA regulations and the boundaries of patient privacy and confidentiality of medical information. Share your experiences in the comments section.
Photo Credit: © mirabile – Fotolia.com
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This law certainly leaves much room for interpretation by the wrong people. Although we feel it important to protect the health and well being of people incarcerated, confidential information should be protected and those on the receiving end of other peoples medical information should be screened and held to stricken standards of NON-Disclosure of prisoners. Unfortunately prison staff share information regarding prisoners among themselves and with other prisoners out of malice. Take for example a mentally ill inmate that was raped and taken to the hospital. The Department of Corrections is responsible for that individuals safety and welfare and is liable. Does the hospital release the rape kit information or other details to the DOC? What if the family of the victim brings a lawsuit against the DOC? The victims legal rights have been jeopardized and violated. What really needs to change is the law in NC that denies any prisoner the right to have and/or received their own medical records. This is outrageous as it precludes the prisoners, their families and the right to advocate for their medical needs and treatment. To date we have identified thousands being denied medical treatment and medications. HIPAA serves one purpose (which is not to protect the patient) they protect insurance companies and medical providers, i.e. BIG BUSINESS.
I sooo wanted to agree with you..BUT….
You started of on point then drifted, then drifted more into an opinion with no grounds to substantiate an All prison staff approach which as you indicate is malice in itself. Then you tried to get back on valid points.
A rape inside of a prison is a crime, regardless of the offenders desire to prosecute. Just as if someone witnessed a child being abused. It has to be reported, regardless if the parent or the child disagrees. And yes, I did make the comparison to a child because an offender is a ward of the state, his crime was committed against the state.
Then ended with nothing but a complaint against an invisible source..”Big Business”..