| Living With HIPAA
If all goes according to plan, this will be a place that sets the standard for patient privacy. Patients treated here get known literally from the isside out, but now, information about them will be disseminated with more care than if they had purchased, say, a bedspread over the Internet, or double A batteries at RadioShack.
Nonetheless, the new regulations will mean a major change in the way Hopkins and its entities do business. Here is a sampling of how HIPAA will affect a few key areas.
The hospital has 4 million medical records. Most of them are in our
archives, of course, but there are still thousands active on this campus.
We get 3,500 requests per month to release patient information. The
requests come from lawyers, insurance companies, patients, doctor's
offices, researchers, the public health department, auditors. We always
demand a written authorization to release records. Our staff is attuned
to not releasing information over the telephone.
Christopher Saudek, M.D.
We've worked hard, here and around the country, to build the public
trust in clinical research. We design good, ethical studies, and then
fully inform people who areinterested in taking part. I think we have
to wait and see whether HIPAA will improve protection of research participants,
and improve their confidence and understanding of research, or just
confuse people. It's hard to tell at the moment.
We have three lines of business-EHP, Priority Partners and U.S. Family
Health Plan. As an insurance company, our perspective is different from
a provider's. First, we must send out privacy statements to our members,
about 150,000 pieces of mail. We have to train 500 employees. Our customer
service representatives will be given scripts to help them answer members'
questions. We expect there will be a lot of confusion at first, because
if a wife calls to inquire about her husband's condition, which happens
every day, we will no longer be able to have those discussions without
a signed release form. Once we get release forms, they'll all have to
be entered into our system. We also have had to put in place about 100
business associate agreements with everyone we interface with-our EHP
employer customers, those who provide our lab, vision, dental and drug
services. HIPAA will have a dramatic impact on us, not only because
of the increased paperwork, but because it won't be business as usual
in the way we serve our members.
We raise $140 million a year from grateful patients, and all but a
tiny percentage of that money comes via major gifts. Typically, a patient
comes here to see a physician, expresses an interest in supporting the
physician's research or program. In turn, the physician calls his or
her development officer or the Fund for Johns Hopkins Medicine to determine
the appropriate follow-up. With HIPAA, the patient will need to sign
an authorization before the physician can have a substantive gift conversation
or give the patient's name to the development office. The authorization
inserts a potentially awkward step, and it will be hard to determine
its impact. Private philanthrophy has a remarkable impact on Johns Hopkins
Medicine-it supports novel research that can't get funding elsewhere,
it sets up endowed professorships, it helps build the buildings on campus
and even supports the School of Medicine's operating margin. So potentially,
HIPAA might have a significant impact on us.
Working with HIPAA experts here, we now have a good consent form for
inpatients to grant permission for us to share their protected information
with the media. We are planning to work with the media as the new rules
roll out. Some reporters and editors know little about HIPAA, which
will change the way we work together.
By and large, I'm not worried. When there are new rules, people tend to think worst-case scenario. But then people relax, and the new becomes routine. If in truth we care about patient privacy, this is a good thing.
-Reported by Mary Ellen Miller