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  • SC/HIPPA double bill

    Technically, HIPPA doesn't apply to this, since it's a U.S. law and this happened in Canada, but here goes:

    Exact change only please
    I was at the walk-in clinic, and a woman walked up to the registration desk. This clinic handles a number of non-OHIP issues, and doesn't take plastic for those (listed fees are all a multiple of $10). She was rather upset that the desk staff wouldn't make change, expecting exact change only (staff told her to go to the pharmacy/convenience store in the same building). She asked if anyone in the room could make change for her (no takers), and finally left to get change. When she was gone, I commented that with the fees being a multiple of $10 it would not be unusual to expect exact change, and that only taking exact change would allow for a fairly common security measure - payments dropped through a slot in a lock box that nobody on the premises had keys to. The receptionist replied "That's exactly what we do".

    That could leak information
    Another patient came back to the reception desk after seeing one of the doctors, and asked for an explanation of their prescription. In a normal conversational voice, the receptionist told them to take 4 pills now, and the other 4 in 12 hours. IANAD, but it seems to me that an unusual dosage and frequency would narrow down the list of treatments, so that someone with a bit of medical knowledge would have a good chance of guessing the patient's condition. After the patient left, I asked the receptionist (seemed to be new - he kept asking co-workers how to do things) whether he realized that what he had said could leak information that would be covered by doctor-patient confidentiality (as opposed to a common dosage like "1 pill 3 times per day", which could be any one of hundreds of treatments). He hadn't realized that.

    Any medical staff, how serious a breach would giving the dosage information (medication not stated) have been in this case, i.e. roughly how many conditions would have a treatment that involves 8 pills taken in 2 batches of 4, 12 hours apart?
    Any fool can piss on the floor. It takes a talented SC to shit on the ceiling.

  • #2
    It depends. That could have been anything: steroids, an anti-viral, lots of things.

    There are some drugs if I heard the frequency I might guess what it is, like Acyclovir which used to be taken five times a day (they've fixed the dose so it's not that frequent anymore).

    If I heard the name of the drug, I could easily guess the patient's condition. But I don't know that many people know drugs as well as I do, excepting other health care workers of course
    They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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    • #3
      I have an entirely different, non contagious and non std recurring viral infection, that can be treated with the same medication one would take for HIV. When I've gone to emergency and handed in the medication I'm on I've had the reception nurse loudly exclaim 'Oh, have you got HIV'. More than once. By more than one different nurse. Want to see a group of people who stare at you in the waiting area?

      I really don't like the nurses at emerg very much, and they don't seem to have to follow any of the health care privacy rules.
      Pain and suffering are inevitable...misery is optional.

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      • #4
        Quoth NecessaryCatharsis View Post
        I have an entirely different, non contagious and non std recurring viral infection, that can be treated with the same medication one would take for HIV. When I've gone to emergency and handed in the medication I'm on I've had the reception nurse loudly exclaim 'Oh, have you got HIV'. More than once. By more than one different nurse. Want to see a group of people who stare at you in the waiting area?

        I really don't like the nurses at emerg very much, and they don't seem to have to follow any of the health care privacy rules.
        If you're in the U.S., report them. That is unacceptable.
        When you start at zero, everything's progress.

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        • #5
          Canada. I'm not sure but I don't think it is an actual law or anything that they can't talk so loud, just humiliating.
          Pain and suffering are inevitable...misery is optional.

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          • #6
            I expect medical privacy laws to exist in most (if not all) Western cultures: it seems to be a general expectation in Euro-derived cultures.

            (As for cultures of other derivations, I simply claim lack of knowledge. Maybe it's a universal, I just dunno.)
            Seshat's self-help guide:
            1. Would you rather be right, or get the result you want?
            2. If you're consistently getting results you don't want, change what you do.
            3. Deal with the situation you have now, however it occurred.
            4. Accept the consequences of your decisions.

            "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

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            • #7
              Quoth Seshat View Post
              I expect medical privacy laws to exist in most (if not all) Western cultures: it seems to be a general expectation in Euro-derived cultures.
              I'd expect Canada to have a medical privacy law as well, but since it's highly unlikely to carry the same name (HIPPA) as in the U.S., that's why I said that technically HIPPA wouldn't apply. Just like in the past 10 years no truck has undergone a DOT inspection in Ontario - we don't have a Department Of Transportation, we have the MTO (Ministry of Transportation for Ontario).
              Any fool can piss on the floor. It takes a talented SC to shit on the ceiling.

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              • #8
                Quoth NecessaryCatharsis View Post
                I have an entirely different, non contagious and non std recurring viral infection, that can be treated with the same medication one would take for HIV. When I've gone to emergency and handed in the medication I'm on I've had the reception nurse loudly exclaim 'Oh, have you got HIV'. More than once. By more than one different nurse. Want to see a group of people who stare at you in the waiting area?

                I really don't like the nurses at emerg very much, and they don't seem to have to follow any of the health care privacy rules.
                They do have to follow the privacy rules. HIPAA: Health Insurance Portability and Accessibility Act. The law specifically says that confidential health care information can only be shared with those involved in your health care, excepting some very limited circumstances for law enforcement. Talking too loud is a HIPAA violation.

                Complain. In detail, explain what happened, and demand changes to the triage system so that any looking over of medical information happens in an enclosed room that can't be overhead in the waiting room. The reception "nurse" (if she was a nurse) should not be looking at your medication list unless you are in the triage area, and that area should be cordoned off from other patient care areas to ensure privacy. If it's not, the administration needs to reconfigure the area.

                Demand this.

                Shit like this is why I don't like hall beds in the ER. There is no way to ensure privacy. If patients would just complain about the lack of privacy to administrators, they would get rid of hall beds and actually renovate and expand their ERs.

                Quoth NecessaryCatharsis View Post
                Canada. I'm not sure but I don't think it is an actual law or anything that they can't talk so loud, just humiliating.
                See above. Because it is humiliating . . . and wrong.
                They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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                • #9
                  What about when patients are sharing a hospital room together? A friend of mine just had surgery and was in the hospital for a couple of nights, and shared a room with another woman for part of her stay. While visiting my friend, her husband and I got to overhear her neighbor's doctor come in and talk to her about her condition, treatment, medication, etc. There was no privacy aside from a curtain between the two beds, which certainly didn't block the doc's voice and he was not keeping his voice down and did not offer to take her to another (private) area to discuss anything with her. Same with my friend when her nurses/doctor came in to talk to her.

                  Also, at one point, my friend's neighbor made a phone call to make a doctor's appointment (she as being discharged with orders to see a specialist of some kind the next day) and proceeded to give her full name, DoB, and SSN, all in front of us. And this woman was in the air force (we were in a military hospital and her branch/rank were posted outside the door to the room.) That wasn't the hospital's business/fault, but I would've thought she, especially being in the military, would have had a little more concern for her own personal security with three complete strangers less than 5 feet away from her.

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