Thursday, November 08, 2007
Medical privacy rules taken to extremes
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Shanna Flowers is The Roanoke Times' metro columnist.
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You've probably read a story in this newspaper in the past month or so about someone shot, or stabbed, or injured in a bad car crash, and that story contained the all-too familiar phrase, "a hospital spokesperson declined to give [injured person's] condition."
Or maybe, you have experienced the roadblock at a personal level when you called a nursing home to check on a loved one's condition: No information is available.
The latest example is William Byrd High School, where officials this week told an auditorium full of hysterical parents to stand down because there isn't a problem, but golly, if there is, they can't tell you all the facts. Just trust them -- they're doing everything they can.
Welcome to the overzealousness of the Health Insurance Portability and Accountability Act, the beast of a law known as HIPAA.
Implemented in 1996, the law was designed to protect health insurance coverage for people who lose or change jobs, with provisions to keep medical information confidential.
But it has become the latest catchall excuse for not releasing information for anything medically related.
Consider a few HIPAA-induced frustrations reported in The New York Times:
n A Kentucky husband and his wife met with a human resources manager at the wife's job to discuss an insurance issue. The HR director told them she couldn't discuss the matter with the husband because it was a violation of HIPAA.
n Birthday parties at nursing homes in New York and Arizona were canceled for fear that revealing a resident's date of birth could be a HIPAA violation.
n Patients in doctors' waiting rooms were assigned code names such as "Zebra" or "Elvis" so they could be summoned without identification.
The broad law has given way to rigid interpretations that have stymied everyone from family members to caretakers to law enforcement authorities seeking health care information.
Even worried Byrd parents were subject to the law's weird application. And the ensuing hysteria was unleashed at a meeting school officials called Monday night.
During an interview Tuesday, Roanoke County School Board Chairman Mike Stovall said he wanted to be more forthcoming with parents about the mysterious twitching some students have experienced.
But the school system's lawyer and public health officials, citing HIPAA, told him he couldn't be.
"All I'm doing is being a steward and taking the advice of the professionals, and they're saying, 'You can't do that,' " Stovall said.
"If it wasn't for HIPAA, I would have told it."
Don't school officials get it? Don't they understand that the absence of authoritative and factual information is a breeding ground for rumor, innuendo and fear mongering that spreads like wildfire?
On Monday night, outraged parents demanded to know the symptoms so they could monitor their children's health.
But school officials wouldn't budge.
Eventually, officials relented after getting the permission of the parent of an afflicted child to discuss the symptoms.
When asked why school officials didn't divulge the symptoms, Stovall said doing so could unwittingly identify the victims.
By telling the public that the twitching was a symptom, Stovall said, everyone would be on alert for students doing that, thereby identifying them and ostensibly violating HIPAA.
That's the rationale for sending an entire student body and its parents into a panic?
Some issues require rational judgment. Roanoke County school officials didn't use it when they refused to communicate with parents who justifiably felt like they weren't getting answers.
In the heat of their fear, parents called for officials to close the school. About 20 percent of the students didn't show up for classes Wednesday.
Shutting down Byrd isn't necessary. So far, fewer than 10 students in a school of 1,200 students have manifested symptoms.
Tests have not shown an environmental cause.
I genuinely believe school officials are trying diligently to discover if something's going around William Byrd. To their credit, they've called in an expert from the Centers for Disease Control and Prevention.
But they've bombed on the public relations front. Instead of being open about what they were doing, they hid behind HIPAA.
