All health information isn't protected equally, and understanding the nuances of the Health Insurance Portability and Accountability Act, or HIPAA, is important for providers and caretakers, particularly in an emergency situation — like an opioid overdose.
HIPAA prevents health professionals and organizations from sharing protected information without a patient's consent, but it also permits sharing information if a patient is incapacitated, unconscious or in imminent danger. However, some health care providers don't share that information over fear of violating privacy rules, which could inhibit essential treatment.
Dr. Elinore McCance-Katz, who leads the federal Substance Abuse and Mental Health Services Administration, addressed this concern during a U.S. Senate Health Committee hearing on Wednesday.
"Just last week, I was at a national meeting of substance abuse treatment providers, and the issue of sharing information was one of their main issues," she said, adding that often information is withheld because practitioners mistakenly think it is covered by 42 CFR, a separate regulation that applies to records related to treatment of patients in substance abuse programs.
Substance abuse records are "the most protected records in the land," and this concept has been "drilled into" most health care providers, said Sharie Kitzmiller, health information management director and privacy official at Parkridge Valley Hospital.
"They just hear, 'Oh my gosh, it's substance abuse. Those fall under those real strict guidelines,'" she said. "I think probably some education needs to take place, especially seeing more and more people come in with opiate overdoses."
Kitzmiller emphasized that as soon as the patient is capable of consent, the decision to release records goes back to the individual, and all communication that's protected under the federal substance abuse treatment laws remains tightly sealed to encourage people to seek help.
"They need to know that they can open up and be honest and be able to not worry about losing their kids, their job or everything they have. Otherwise, they are going to stay out on the street and not get treatment," she said.
The U.S. Department of Health and Human Services' Office for Civil Rights recently released new guidance to further clarify for providers when it's appropriate to release health information in crisis situations.
"Use your judgment – if you think this is needed for this patient to save his life and he can't say otherwise, then it's your job to say, 'this is what needs to be done,'" she said. "The hospital will stand behind them."
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