Do Medical Technicians 'Need to Know' Patient Health Information?

Carolyn Buppert, MSN, JD

Disclosures

January 03, 2017

To submit a legal/professional nursing question for future consideration, write to the editor at syox@medscape.net (include "Ask the Expert" in subject line).

Question

Is Information Sharing a HIPAA Violation?

 
Response from Carolyn Buppert, MSN, JD
Healthcare attorney

The latest question for our legal expert, nurse attorney Carolyn Buppert, comes from the only nurse who worked at an inpatient subacute psychiatric treatment facility staffed with non-medically trained technicians. This nurse objected to sharing private client health information contained in the nursing documentation with these technicians.

The nurse's supervisors (social workers) insisted that there was no basis to not share all health information. The nurse maintained that technicians did not need to know clients' private health information to perform their job duties, which involved no physical care and were to observe and manage behavior; lead group activities and talk sessions; and manage day-to-day logistics of the facility, such as serving meals, ordering food, and cleaning.

The nurse observed that technicians regularly discussed clients in an office that was within easy earshot of clients and visiting staff, and asked, "In this situation, would it be a Health Insurance Portability and Accountability Act (HIPAA) violation to share the clients' private health information with the technicians?"

The 'Need to Know' for Medical Technicians

The short answer is no, this would not be a HIPAA violation, because technicians are part of the clinical team. They need information about patients to do their jobs, which includes observing patients and sharing observations about patients with nurses and other clinicians.

For example, if a patient has a trigger, a technician should know what it is, so that the technician can report a trigger response or the observation that a known trigger did not cause the patient to react. If a patient has a history of self-harm, the technicians need to know that. The technicians may not need to know every detail. The nurse in charge should determine what the technician needs to know about any individual patient.

The same privacy principles that apply to nurses, social workers, and physicians also apply to technicians. Patient information may be shared for treatment, payment, or healthcare operations, but not for any other reason. Caregivers may share only the information needed to carry out treatment, payment, or operations, and may share patient information only with individuals who need to know the information to carry out treatment, payment, or operations. For example, caregivers on a psychiatric unit may need to know that a patient was abused as a child, but may not need to know the details of the abuse.

As for the technicians discussing patients within hearing distance of people not involved in the patients' care, that is a HIPAA violation. For more information on HIPAA requirements, visit http://www.hhs.gov/hipaa/index.html.

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