Watch Out for HIPAA!


HIPAA . . . or did you say Hippo?

When hearing the acronym HIPAA, I often imagine a hippo.

A hippopotamus (meaning water horse from the Greek) is the third largest land animal. Cumbersome and thick-skinned, it appears to have been created by a committee forced into decisions before a deadline eliminated funding. Remarkably, the massive mammal is fast, whether running or swimming. Don’t linger if a hippo suddenly veers toward you for a meet and greet!

Maybe I think of hippo and HIPAA for another reason: The Health Insurance Portability and Accountability Act (HIPAA) could also be labeled big and cumbersome.

Don’t get in its way either!

HIPAA irks me. I rarely remember the acronym’s letters: HIPPA, HPPA, or HIPAH? And I usually fail to correctly identify what each of the letters represent. Doesn’t the “I” mean Information and shouldn’t the “P” be for Patient? Why, please, was the awkward “portability” ever considered as a useful word for the average consumer?

And HIPAA was designed with the average consumer in mind. The simplest way of understanding HIPAA is that it protects an individual’s medical and health data. (If you want a more complicated official explanation, you can look here.) Every health-related agency, including hospices, must follow HIPAA guidelines. If HIPAA is the Pied Piper, health care agencies are the ones trailing right behind. Every consumer—a.k.a., you the citizen, you the patient, you who accumulates massive amounts of health-related data from birth—is guaranteed privacy because of the 1996 act passed during President Clinton’s administration.

My dislike of HIPAA has other reasons.

In the late 1970s and into the 80s, as a pastor serving in my first churches, I could phone a nurse’s station at a hospital and get dirt on a church member. Was Ms. Jones still there? What room was she in? When is Mr. Smith’s surgery scheduled? Who is his doctor? Much of the time, I’d get answers!

Not now.

Back in the day, I’d stroll into hospitals and nursing facilities and chat with RNs or administrators. Eventually, I’d mention being a person’s pastor and the staff would often tell me details about the patient. As a minister, shouldn’t I be trusted with information? (Well, we could have a long discussion about today’s perceived trustworthiness of clergy . . .) Nonetheless, once it was easy to learn a few essential facts about how a patient—like a scared-about-surgery, frightened-to-be-alone church member—was doing.

Not now.

All of your information is protected.

My current work at hospice gives access to medical records. Prior to becoming paid staff, I was a volunteer. The background check on me as a volunteer was the most extensive ever undertaken in my professional life. When involved with the “hippo,” you better be well trained, reliable, and able to keep confidences.

Staff can be fired for breaching HIPAA confidentiality.

A hospice—and other medical agencies—can face steep fines for breaking HIPAA guidelines.

You, as a patient, should be giddy about this.

When you enter into hospice care, you will be asked who can receive information about you. Who is your DPHA, or durable power for health attorney? Who is the person(s) you’ve officially designated to speak for you about health-related issues if you can’t speak for yourself? You may want others, like your adult children or dearest friend, to be listed on the official medical chart as people entrusted with your information. No one other than those designated by you will have access to your records. If your gossipy Aunt Junebug from Happy Trails, Florida calls the hospice to ask about you, she will be told, well, nothing. Good news, eh?

After death, HIPAA rules continue to protect your records. Whether it’s a family member with all of the proper IDs or a best friend who was the official DPHA, they can no longer examine your records without taking multiple legal steps.

Why? To protect your information.

Before California’s End of Life Option Act (EOLOA) began in 2016, the hospice where I work discussed scenarios for future patients. With the EOLOA, terminally ill adult patients able to make their own decisions can choose a medically assisted death. If hospice patients take this path, they can choose to inform only their doctor about their plans. Their cause of death will officially be the terminal illness, without any reference to the EOLOA. However, the patient’s medical records could mention the EOLOA. What if a patient’s surviving family wants to “know” the details of a loved one’s death? In simplest terms, viewing the records will be difficult. If the interested parties go through various legal procedures, they may eventually access the protected information.

But the process will not be easy.

HIPAA may be hippo-like in its bloated, cumbersome ways. And it’s an acronym hard to remember and with more small print than you can shake at with a stethoscope. The “Portability Act” also means that, as a pastor, I can’t enter a hospital and learn any “innocent” details about . . . anyone. As someone that uses medical records at a hospice, those rigorous guidelines make my current job very responsible.

All of that is darn good for you.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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