The HIPAA privacy rule allows healthcare providers, known as covered entities, to share patient information with other covered entities for treatment, payment, or healthcare operations. Doctors working within the same covered entity or those with a pre-existing relationship can freely exchange patient data to facilitate the patient's care.
Exceptions and restrictions
While sharing information for treatment is generally allowed, there are exceptions. The HIPAA privacy rule outlines several exceptions and restrictions that impact a doctor's ability to share patient information. For instance, if a patient has explicitly requested a restriction on the use or disclosure of their PHI, doctors are generally prohibited from sharing that information, even with other covered entities, except in emergency situations. Additionally, certain types of sensitive information, such as psychotherapy notes, may require the patient's explicit authorization before they can be shared.
The role of business associate agreements
When a doctor, who is a covered entity, needs to share patient information with a healthcare provider who is not a covered entity, such as an independent counselor or a paper-based fax service, a business associate agreement (BAA) must be in place. The contractual agreement ensures that the non-covered entity implements appropriate safeguards to protect the privacy and security of the shared PHI.
Navigating non-covered entities
The HIPAA privacy rule's definition of covered entities can be confusing. Doctors who are not covered entities, either because they do not conduct electronic transactions or because they do not bill insurance directly, are still subject to state confidentiality laws and may need to take additional steps to protect patient information when sharing it with covered entities.
Patient consent and authorizations
In certain situations, even when the sharing of patient information is permitted under the HIPAA privacy rule, doctors may still need to obtain the patient's explicit consent or authorization. This is particularly true for the disclosure of sensitive information, such as mental health records or substance abuse treatment details. Doctors must carefully review the specific requirements and obtain the necessary approvals before sharing such information.
Unauthorized access
HIPAA violations can also occur when healthcare professionals access patient records without proper authorization, even if the information is not used for personal gain or shared with others. The case of Doctor H, an immigrant from China, illustrates this point.
During his notice period, Doctor H, who had access to patient records for research purposes, accessed the state healthcare system's records out of curiosity, unaware of the strict HIPAA rules governing such activities. Despite not using or sharing the information, Doctor H was charged with a HIPAA violation and sentenced to four months in jail, along with a $2,000 fine. Unauthorized access to ePHI, regardless of intent, can have severe legal consequences.
Documenting compliance
Maintaining thorough documentation is necessary for ensuring HIPAA compliance when sharing patient information. Doctors must document any agreements to lift patient-requested restrictions, as well as any instances where patient authorization was obtained. Such documentation serves as evidence of the provider's adherence to HIPAA regulations and can be beneficial in the event of an audit or investigation.
Navigating the minimum necessary standard
When sharing patient information for purposes other than treatment, such as healthcare operations, the HIPAA privacy rule imposes the minimum necessary standard. Doctors must make reasonable efforts to limit the amount of PHI disclosed to only necessary information.
Leveraging technology for secure communication
Healthcare providers have access to multiple technological tools that can facilitate the secure exchange of patient information. From encrypted email and secure messaging platforms to cloud-based storage solutions, doctors can use these technologies to streamline communication with their colleagues while maintaining data protection.
Seeking guidance from privacy officers and compliance professionals
Given the complexity of HIPAA regulations and the potential consequences of non-compliance, doctors who are unsure about their obligations or the appropriate procedures for sharing patient information should seek guidance from their organization's privacy officer or consult with external compliance professionals. These experts can provide invaluable insights and ensure doctors adhere to the necessary protocols.
FAQs
Does HIPAA apply to the sharing of patient information between doctors?
Yes, HIPAA's privacy rule governs the sharing of patient information between healthcare providers, including doctors. The rule establishes guidelines for when and how covered entities can disclose PHI to other covered entities or business associates.
Do I need patient consent to share information with other doctors?
Generally, doctors can share patient information with other doctors for treatment purposes without obtaining the patient's explicit consent. However, there are exceptions, such as when the patient has requested a restriction on the use or disclosure of their PHI, or when the information being shared is sensitive. In these cases, the doctor may need to obtain the patient's authorization before sharing the information.
What can I use to share patient information with other doctors?
Healthcare providers have access to multiple secure communication tools and technologies that can be used to share patient information, such as encrypted email, secure messaging platforms, and cloud-based storage solutions.
Learn more: HIPAA Compliant Email: The Definitive Guide
Farah Amod
