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Archive for Accounting of Disclosures

Q: I suspect that my relative, who is a registered nurse at the local hospital, accessed my medical records without my consent while I was in the hospital. The hospital refuses to disclose any access that results from treatment and healthcare operations. However, from a patient’s perspective, it is important to know who has accessed your PHI during treatment. When will patients be able to see who accessed their PHI during treatment?

A: This hotly debated issue and gets to the heart of the “accounting of disclosures” right granted patients under HIPAA. Most organizations interpret this to mean that patients have the right to an accounting of disclosures for reasons other than treatment, payment, or operations. If your relative was also providing or involved in your care (and there are many ways a staff member can be involved in treatment, payment, or operations without providing hands-on care), access would be appropriate, assuming the relative accessed only the minimum necessary to accomplish his or her job. You have the right to request an investigation and can specifically ask the hospital to look into an individual staff member’s access. If, after investigation, the hospital determines that there was no access or that the access was appropriate, you have no real recourse. You can file an official complaint with the Office for Civil Rights if you remain dissatisfied.

Editor’s note: This question was answered by Chris Simons, MS, RHIA, director of health information and privacy officer at Cheshire Medical Center/Dartmouth-Hitchcock in Keene, N.H. This information does not constitute legal advice. Consult legal counsel for answers t j o specific privacy and security questions. Send your HIPAA questions to Associate Editor Jaclyn Fitzgerald at jfitzgerald@hcpro.com.

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