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View Full Version : HIPPA and MCI's



paramark210
12-04-2003, 01:10 AM
Theres been a rumor floating around my service concerning multiple pts. Is it a HIPPA violation to transport two pts. in the same rig who are not family members. Example: An MVA where each of the drivers are injured. Can they they both be treated and transported together?

kghemtp
12-04-2003, 06:58 AM
Excellent topic to discuss! Some cities will dictate 2 patients per truck to avoid calling more ambulances or mutual aid (and 2 status 3's can both be charged for the ride & treatment). The severity is also a good point-- some have policies that a status 1 or status 2 goes alone, no other patient. You may also be able to use the idea "same car, same ambulance" where people from different cars might be taken in different trucks. We do want to keep peace, so sometimes we have to think that a crash where someone was at fault, arguments could start in the back of our trucks. We can often get people settled down with the idea that "insurance companies fight over these things" and it makes sense to most patients. In terms of violation of HIPAA, we get past that by telling the patients we'll be transporting together and will have to treat both of them. One thing I can't stand is an incident commander sending occupants of the same car to different hospitals. When we have 6 or 8 people, ok maybe we need different hospitals for half of them, but it just gets confusing & aggravating to family members & patients when they're separated. This topic should do well! Take care

IAMedic
12-04-2003, 07:20 AM
Patient care before privacy. This question was asked in one of the workshops I attended. Pretty much the idea is that you can not prolong patient care because of privacy. If you have time to get another ambulance, then do it. But, if they are family members, people in the same vehicle at the time of the collision or if all of the patients need immediate care then they should be taken by whatever transport available.

Now on a personal note, I will try to transport family together. Especially if I have a child that is hurt (not critical), I will try to have a parent or older sibling ride with us. This helps me with any history I may need, calms the patient and if there is separation you have someone else there who can help track down friends and family.

I am lucky because we usually transport to our hospital and there isn't much of chance that everyone will get separated. Unless of course, one gets flown to a trauma center before the others know what's happened.

Dalmatian90
12-04-2003, 11:18 AM
Think of the logical continuation of "Well, we can't transport 2 patients 'cause it'll violate HIPAA..."

What about Hospital rooms with 2 (or more) beds seperated by curtains if they're pulled?

For that matter, our local ER has "letter" bed -- when they run out of Beds 1-10 in either double or single rooms, you get letters that are along the hallway!

The "urgent care" room is 3 or 4 beds in one big room to handle the non-"emergency" patients.

I don't think you'll see American hospitals convert to all private-rooms anytime soon!

btroutm
12-04-2003, 01:52 PM
I believe that this situation would be considered an Incidental disclosure, meaning that it is the health care provider's responsibility to attempt to safeguard protected health information, but under certain circumstances (as in an MCI) disclosure may still occur. Like IAMedic said, treatment always comes before privacy.

DrParasite
12-04-2003, 04:20 PM
I don't believe it's a HIPPA question, becaused hippa deals primarily with billing. now patient confidentiality might be an issue, but i don't think it's HIPPA.

that being said, I've transported 4 patients to the ER in one ambulance, 2 of whom where backboarded.

the bottom line is that you need to do what you got to do. which is better for the patient? taking 2 in one rig, or waiting on scene until you get a second rig to transport the other patient? especially at an MCI, when you got more patients than ambulances, take as many as you can to get treated at the hospital.

oh, as a side note, my personal rule is to take 2 (or more) from an MVA if they are stable, but any that need ALS treatment get their own rig.

btroutm
12-04-2003, 08:13 PM
Originally posted by DrParasite
I don't believe it's a HIPPA question, becaused hippa deals primarily with billing. now patient confidentiality might be an issue, but i don't think it's HIPPA.Patient confidentiality is HIPAA.

"The U.S. Department of Health and Human Services issued the Standards for Privacy of Individually Identifiable Health Information ("Privacy Rule") to implement the requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Privacy Rule standards address the use and disclosure of individuals’ health information." (http://www.hhs.gov/ocr/hipaa/)

If it's a patient confidentiality issue than it's a HIPAA issue.

Weruj1
12-04-2003, 10:37 PM
thanks Btr for that ! it is all about confidentiality ! and I agree with otehr posters on this topic.