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SALT LAKE CITY (AP) -- Two years after enactment, the patient privacy provisions of HIPAA -- the Health Insurance Portability and Accountability Act -- are getting mixed reviews.
Critics say it creates confusion about patient privacy and everyone applies it a little differently.
Early on, hospitals operated heavily on the side of caution, but some are re-evaluating how they interpret the law.
"People are starting to understand there are both good aspects and challenges," Stephanie Argoitia, manager of University Hospital's privacy office, told the Deseret Morning News.
Before HIPAA, you could call the hospital and find out about your neighbor's condition. Now, information about a patient's condition and location may not be released to anyone unless the patient "opts in" to allow disclosure.
Most hospitals consider a patient opted-in unless he asks to opt out or is too ill to indicate preference. In those cases, the patient's family usually would be asked to make the decision.
"Nothing that happens in a hospital any more is a matter of public record," said Bonnie Midget, Primary Children's Medical Center spokeswoman.
During Grand Rounds, the discussion among doctors is more cautious as individual cases are reviewed. It is held in a patient's room, never in the halls. In tight spaces like intensive care units where conversation could be overhead, relatives might be asked to leave because talk involves someone else.
And a mother can't stay and watch a CT scan being done on her child because charts and scans from other patients could be seen.
Under, HIPAA information still is supposed to flow freely among those directly involved in a patient's current care. But that does mean every doctor taking care of a patient will know what every other doctor is doing.
Doctors complain that information flow only works within a practice or facility.
Being more sensitive when handling patient records is a good thing, said Dr. Zell McGee, emeritus professor of internal medicine at the University of Utah. But it can get in the way of communicating information back and forth between doctors.
"You have to get all kinds of paperwork done just to get a lab value" when you might ordinarily call and ask, McGee said.
Initially, many patients were opting out, but that has lessened as patients get more used to HIPAA and know what it means, said Doug Boudreaux, spokesman for Iasis, which owns several Utah hospitals.
HIPAA rules mean that since a patient is either "in," or "out," with no picking and choosing between individual queries, not only are friends sometimes unable to call or write, but the flower deliveries stop and even relatives are denied updates.
From the hospital administration standpoint, one of the biggest consequences has been a strain on relationships with the media and with law enforcement.
Dave Gessel, vice president of Utah's hospital association, said a state HIPAA task force is very close to simplifying the forms and guidelines to provide relevant information to law enforcement. But the media remain frustrated with their inability to get even a condition report on a crash victim.
"It has paralyzed us with regards to information to the media," said Boudreaux. "Even when (media) has information -- even if we know it's wrong information -- we can't say anything."
(Copyright 2005 by The Associated Press. All Rights Reserved.)
