If you are looking to start a career as a member of a care team or as a solo caregiver, you have probably heard the term HIPAA tossed around. However, what are all the things that HIPAA covers, and how do they affect you as a caregiver?
Caregiving as a Position of Trust
One of the main tasks of every caregiver is to establish trust with the person in their care, as well as their family members. Being in somebody's care, or putting a family member in somebody else's hands, is an extremely vulnerable position and it requires an enormous amount of trust.
There are many ways in which a caregiver can foster and nourish that trust: by being kind, reliable, and patient, doing their job in an efficient manner, and treating both the client and their family members with respect.
One of the most important aspects of this trust is keeping the client's personal health information private. Patient data is something that only the patient has the right to share or not share with whomever they wish. A caregiver who shares patient information without the patient's consent is violating that trust and breaking the HIPAA law.
Client Privacy and Protected Health Information
In simple terms, to respect confidentiality means to keep private things private. Caregivers, family members, and healthcare providers are in a unique position in which they have access to sensitive medical records and protected health information about their clients.
In the course of their work, a caregiver inevitably learns confidential medical information about their clients' physical as well as mental health.
Caregivers are also likely to learn other personal information about clients’ financial situations and details of their relationships with others.
Caregivers should never talk about any of this information unless it becomes necessary. When in doubt, keep it private. Only people directly involved in healthcare for the client should have access to this information.
Caregivers should, of course, keep chart notes and client records up to date with any changes, but they should never be shared with others outside the care team.
What Is the HIPAA Privacy Rule?
When it comes to things like medical records or protected health information, it is not enough just to rely on the personal moral code of individual healthcare providers and members of the care team. That is where HIPAA comes in.
HIPAA is short for Health Insurance Portability and Accountability Act. When we talk about this federal privacy law, we usually refer to the HIPAA privacy rule which defines how a health plan or a health care provider has to protect patient privacy.
The agency that oversees HIPAA is called the US Department of Health and Human Services Office for Civil Rights. The HHS Office enforces these privacy rules and handles complaints.
One of the main reasons for the existence of this law is to keep health information, especially individually identifiable health information, private and secure. All healthcare organizations must take special steps to protect a person's health information.
If this law is broken, consequences include hefty fines and possibly prison time, depending on the circumstances. This is why some healthcare organizations hire a HIPAA compliance officer to help make sure this is honored.
Who Does HIPAA Apply To?
HIPAA applies to everyone who is a so-called covered entity. This term describes everyone involved in a person's health care, including doctors, nurses, nursing assistants, home health aides, and all care team members.
According to HIPAA's rules, if a member of a care team wishes to share information about the client with someone, they need to check if this person has HIPAA authorization. Without written authorization, they are in danger of committing a HIPAA violation.
A family caregiver is not a covered entity.
However, the client does have the ability to name a family member as a personal representative if they want to. According to HIPAA rules, an individual's personal representative is allowed to have the same rights regarding access to information about the person who authorized them, which would then make them a covered entity.
A personal representative can also make medical decisions for the patient.
For children and minors, their personal representatives are their parents or legal guardians.
No one else has the automatic right to know anything about a client’s condition or other details unless the patient chooses to share it with them. It doesn't matter if they are a family member, a friend, or a member of the clergy; only the client can share the details with the people they choose.
Even with personal representatives, healthcare providers are expected to use their professional judgment and act in the best interest of the patient.
If they suspect, for instance, domestic violence, or have any other indication that the named personal representatives' might be a danger to the patient, they can (and should) refuse to share patient data and follow up by reporting the concerns to DSHS.
What Information Does HIPAA Cover?
HIPAA covers all personal health information (PHI). PHI includes the patient's name, address, telephone number, social security number, e-mail address, and medical record number. It also includes information about diagnoses, mental or physical conditions, medications, and treatment plans.
Only those who must have information for care or to process records should know this information. Covered entities are also not allowed to disclose protected health information to others outside the care team and named representatives.
Steps a Caregiver Can Take to Protect Client Information
Sometimes a caregiver finds themselves revealing information from a client's health records or mental illness by accident. Here are some steps you can take to ensure this doesn't happen.
Make sure you are in a private area when you listen to or read your messages.
Know with whom you are speaking on the phone. If you are not sure, get a name and number. Call back after you get approval.
When talking to a care team member or the doctor's office on the phone, use landline phones, not cell phones. Cell phones can be scanned and hacked.
Do not talk about residents or clients in public places. Public areas include elevators, grocery stores, lounges, waiting rooms, parking garages, schools, restaurants, etc. Use confidential rooms for reporting to team members or when discussing medical records.
If you see a resident's or client's family member or a former resident or client in public, be careful with your greeting. He or she may not want others to know about the caregiving relationship, so keep it neutral.
Make sure nobody can see health or personal information on your computer screen while you are working.
Log off when you are not on your computer.
Do not give confidential information in e-mails. You do not know who has access to your messages and they can also easily be hacked. Make sure fax numbers are correct before faxing information. Use a cover sheet with a confidentiality statement every time.
Do not leave documents or medications out where others may see them.
Store, file, or shred documents according to your facility policy.
If you find documents with a resident's or client’s information, give them to the nurse or care team manager to file appropriately.
If a family member or friend is concerned for your client, encourage them to talk with the client themselves and make sure they are aware of your professional limitations.
Everyone deserves to have control over what happens with their personal information. Clients especially are in a vulnerable position when multiple different types of care providers have access to their personal details.
Understanding how this law applies to people in service to the client is very important for maintaining professional boundaries. Trust is one of the most important aspects of the client-provider relationship.
By following these rules carefully, you can work confidently, knowing that you are providing quality care while keeping their information safe and secure.