[HN Gopher] Why do shared hospital rooms not violate HIPAA?
       ___________________________________________________________________
        
       Why do shared hospital rooms not violate HIPAA?
        
       Author : oatmeal1
       Score  : 112 points
       Date   : 2023-08-30 21:15 UTC (1 hours ago)
        
 (HTM) web link (law.stackexchange.com)
 (TXT) w3m dump (law.stackexchange.com)
        
       | ceejayoz wrote:
       | This is why "code is law" as a crypto meme was a little silly.
       | Law is often intentionally flexible!
        
         | ajsnigrutin wrote:
         | Meh, just one more if() needs to be added :)
        
         | [deleted]
        
         | Quekid5 wrote:
         | I think you can drop the "often". Law _must_ almost by
         | definition be flexible because there are so many things in life
         | that aren 't as simple 'yes' or 'no'.
        
       | talldatethrow wrote:
       | Car dealership customers are always worried about their data. And
       | rightfully so.
       | 
       | The typical car salesman has 15 credit applications in his desk,
       | 5 in his car in some folders he forgot about, 1 in the trash can
       | he accidentally crinkled up instead of putting in the shred box.
       | The managers office is even worse. The finance guys office is
       | even worse. The 'business office' is half decent because the
       | GM/owner is up there often.
       | 
       | On a side note, my friend subleased an office from a medical
       | nurse temp agency/employment agency.
       | 
       | When he arrived (I helped him move in), there were thousands of
       | unsecured files with people's socials and all info needed to get
       | a job in file cabinets.
       | 
       | The office had cleaning service every night from a random
       | cleaning company.
        
       | dahwolf wrote:
       | Because that would be unreasonable and impractical.
       | 
       | Next question please.
        
         | [deleted]
        
       | fardo wrote:
       | The second comment feels closer to the mark. While post-hoc
       | justifications could be made as to why a rule at least in spirit
       | seemingly about patient privacy ignores an obvious and glaring
       | privacy flaw, if the parties involved could be so honest, the
       | real-world answer why it's allowed would probably be
       | 
       | > "It would be extraordinarily inconvenient and expensive for it
       | to work otherwise."
       | 
       | Sprinkle on a little bureaucrat-ese and post-hoc justification
       | and you get the "clarified guidance" the primary comment calls
       | out
        
         | tptacek wrote:
         | It's about the confidentiality of electronic medical records,
         | not about patient privacy.
        
           | fardo wrote:
           | If we're discussing
           | 
           | > What is the motivation behind keeping medical records
           | confidential, why do we actually care?
           | 
           | A respect for the patient's privacy is likely going to be one
           | of the driving reasons, if not the primary reason itself.
        
             | tptacek wrote:
             | No, that's not the actual reason! The reason the rule
             | exists is because, when HIPAA was passed, electronic
             | patient health records were a new thing, and they were
             | desired both for cost savings (electronic records as a way
             | to drive administration costs down were a huge thing in the
             | 1990s) and so the USG could combat Medicare fraud. The
             | confidentiality rule was designed to ease the acceptance of
             | electronic records; that's all. That's why the rule refers
             | to e-PHI.
        
               | fardo wrote:
               | You're correct regarding historical procedure, but with
               | regards to the privacy rule, which was added shortly
               | after its creation and at least online is much of why the
               | act is known and discussed today, the rule exists to,
               | quoting the government's description,
               | 
               | > The Rule requires appropriate safeguards to protect the
               | privacy of protected health information and sets limits
               | and conditions on the uses and disclosures that may be
               | made of such information without an individual's
               | authorization.
               | 
               | We allow a major hole here in that protected health
               | information by willfully careful readings of "appropriate
               | safeguards" and "limits and conditions", essentially
               | because doing otherwise would be a nightmarish expense
               | and pain.
        
         | [deleted]
        
       | pierat wrote:
       | Speaking of that, hospitals still use tons of POCSAG (pagers) and
       | splatter medical everything over those. Course it's illegal to
       | listen due to a bullshit 1987 law... but trivial to do so with a
       | RTL-SDR.
       | 
       | One idea my nefarious side had was to get the med records of
       | individuals and get the address's house cost, and send scary
       | calls/text/messages shaking relatives down with scare-calls.
       | 
       | Obviously I wouldn't do that. But it would be trivial to do.
       | 
       | (Long story short, pager infrastructure needs destroyed.)
        
       | paxys wrote:
       | It is legal because you are agreeing to it. Otherwise get up and
       | leave.
        
         | ceejayoz wrote:
         | You can't agree to OHSA violations, or to a sub-minimum wage. A
         | hospital conditioning treatment on a HIPAA waiver having been
         | signed will quickly find itself the subject of regulatory
         | scrutiny.
         | 
         | I went to war with a doctors' office that claimed their non-
         | compete clause meant I couldn't transfer my medical records to
         | a doctor who'd left the practice I wanted to follow.
        
           | paxys wrote:
           | A paper that says "I agree to a sub minimum wage" is illegal.
           | 
           | One that says "I agree to share my medical info with XYZ" is
           | not. Every hospital already makes you sign this when you are
           | admitted, otherwise they wouldn't be able to function.
        
             | ceejayoz wrote:
             | Such a _voluntary_ waiver is legal, yes.
             | 
             | Refusing to treat you if you want to keep your rights, less
             | so.
             | 
             | The thing they have you sign is an agreement that you
             | received a notice of their privacy practices (laying out
             | your HIPAA rights). It isn't a waiver.
             | 
             | Hospitals don't need a waiver to operate. HIPAA already
             | permits them to share internally, with billers, etc.
        
           | robbiep wrote:
           | That a doctors office can have a non-compete boggles the mind
        
             | jonas21 wrote:
             | I assume the non-compete agreement was between the doctor
             | and the practice, which seems somewhat reasonable.
        
               | [deleted]
        
               | ceejayoz wrote:
               | Yes. They took the position that their non-compete (and
               | our general "we agree to clinic practices") with their
               | doc took precedence over our HIPAA rights, which NY...
               | disabused them of.
        
       | ShakataGaNai wrote:
       | Because health privacy is not ALWAYS HIPAA. In fact, it's almost
       | never HIPAA... except for the fact that some Karen's learned the
       | term HIPAA and now they think it's always HIPAA [1].
       | 
       | Unless it's digital health record-related, then it's probably
       | HIPAA.
       | 
       | If you're really curious, you can read HIPAA [2] and HITECH [3].
       | Combined, they are about 600 pages of dense dense legalese.
       | 
       | [1] https://www.hipaajournal.com/is-it-a-hipaa-violation-to-
       | ask-... [2]
       | https://www.govinfo.gov/content/pkg/PLAW-104publ191/pdf/PLAW...
       | [3]
       | https://www.govinfo.gov/content/pkg/PLAW-111publ5/pdf/PLAW-1...
        
         | lolinder wrote:
         | > some Karen's
         | 
         | As an aside: I wish this meme would die.
         | 
         | > For the same reason, the Karen meme divides white women
         | themselves. On one side are those who register its sexist uses,
         | who feel the familiar tang of misogyny. Women are too loud, too
         | demanding, too entitled. Others push aside those echoes,
         | reasoning that if Black women want a word to describe their
         | experience of racism, they should be allowed to have it.
         | Hanging over white women's decision on which way to jump is a
         | classic finger trap, familiar to anyone who has confronted a
         | sexist joke, only to be told that they don't have a sense of
         | humor. What is more Karen than complaining about being called
         | "Karen"? There is a strong incentive to be cool about other
         | women being Karened, lest you be Karened yourself.
         | 
         | https://www.theatlantic.com/international/archive/2020/08/ka...
        
         | owenmarshall wrote:
         | One of the easiest questions to ask of someone who shouts
         | "HIPPO violation!" is "covered entity or business associate?"
         | 
         | "Yes, Dunkin Donuts can give you a free donut if you show your
         | Covid vaccination card. No, the donut shop is not a covered
         | entity or a business associate, so they aren't bound by HARPO."
        
         | kstrauser wrote:
         | From https://www.hipaajournal.com/what-does-hipaa-cover/
         | 
         | > The HIPAA Privacy Rule applies to all forms of health
         | information, including paper records, films, and electronic
         | health information - even spoken information.
         | 
         | HIPAA is not as limited as you state.
        
           | dekhn wrote:
           | but it only applies to covered entities and business
           | associates.
        
             | kstrauser wrote:
             | True. That covers the hospital rooms in this article. It
             | doesn't mean that your barber can't ask to see your
             | vaccination card.
        
       | vidanay wrote:
       | Why do the paper thin walls between exam rooms at my doctor's
       | office that allow me to hear entire conversations while I am
       | waiting (and waiting) not violate HIPAA?
        
         | supertrope wrote:
         | Clinics that deal with the most sensitive medical needs tend to
         | be more careful. HIV testing, reproductive health, psychiatry,
         | hospice.
        
         | burnte wrote:
         | Reasonable precautions. I've been top IT management in
         | healthcare for 8 years, I'm very well versed with this concept.
         | HIPAA isn't "PHI is Eyes Only Secret!" it's "you have to take
         | reasonable precautions to safeguard data from bad actors." I
         | have a wall between the rooms, each room has doors, and when
         | the doc is talking with you, you can't hear a lot from the next
         | room over. We don't have to make walls soundproof and doors
         | sealing airlocks.
        
       | amelius wrote:
       | Because by walking into the hospital, you already gave away the
       | info to any bystander. And all variations thereof.
        
         | ceejayoz wrote:
         | If you're coming in for a disembowlement, sure, but even then
         | you're only really revealing the condition; your name, history,
         | insurance details etc. are still private information. (The
         | hospital would also still be forbidden from, say, publishing
         | "amelius came in today with with a minor disembowlement"
         | without your permission, no matter how public it was in the
         | waiting room.)
        
           | Quekid5 wrote:
           | In the waiting room they usually don't shout out "Geoff,
           | who's here for the cock wart, the doctor will see you now"...
           | they just say "Geoff, the doctor will see you now."
           | 
           | Btw, my name's not Geoff.
           | 
           | (Just to be a bit more plain.)
        
       | macksd wrote:
       | The top comment here is very reasonable, but I still think the
       | application of HIPAA has been a giant mess, reflecting a disdain
       | toward patients similar to everything else in the US healthcare
       | system.
       | 
       | I've ranted on here plenty about how often I've dealt with
       | incorrect bills, and HIPAA plays into that as well. My private
       | information can be shared to "traveling doctors", it can be
       | shared with woefully incompetent contractors who handle billing
       | (or, pretend to), and I received a notice last year that my
       | information had been involved in a data breach and I'm not
       | expecting any compensation. When I had to get a very private and
       | sensitive part of my body imaged, they'll gladly announce to the
       | waiting room my name and what procedure I'm there for, even
       | though it's a rather private and sensitive part of my body - very
       | similar to the shared room concern. I don't care that the people
       | in that room aren't likely to misuse my healthcare information, I
       | don't want them knowing where I found a lump anyway.
       | 
       | And yet HIPAA is often cited to me over the phone as the reason
       | why we can't seem to get incorrect bills figured out for my
       | dependents. It doesn't seem to me that HIPAA actually does much
       | to protect my privacy, but it sure gets used to obfuscate things
       | when there's a problem.
        
         | jancsika wrote:
         | > And yet HIPAA is often cited to me over the phone as the
         | reason why we can't seem to get incorrect bills figured out for
         | my dependents.
         | 
         | That's actually a great reason to refrain from discussing
         | someone else's medical data with you. That it is inconvenient
         | for you is certainly bad, but that is a non sequitur.
         | 
         | > It doesn't seem to me that HIPAA actually does much to
         | protect my privacy, but it sure gets used to obfuscate things
         | when there's a problem.
         | 
         | If we allowed Bill Handler, Inc. try their hand at securely
         | implementing "for the purposes of this call, pretend I'm
         | someone else," you're going to have TWO_PROBLEMS *
         | NO_OF_DEPENDENTS
        
         | [deleted]
        
         | motohagiography wrote:
         | Agreed, the individual records are not specifically secret. The
         | regulations are to prevent unauthorized disclosure and misuse.
         | 
         | Unfortunatly that leaves a _lot_ of leeway. The major EMR
         | vendors are all aggregating patient data in cloud services and
         | taking it across borders to where there is no transparency for
         | what is being done with it. The regulations were written with a
         | 90 's understanding of technology.
         | 
         | A more appropriate regulation today would be to create a
         | category of legally privileged PHI that is strictly
         | inadmissable in legal proceedings and with heavy fines for
         | unauthorized use and disclosure. However, I don't see privacy
         | legislation getting any better as the people inside govt and
         | academia absolutely hate privacy as a concept because they are
         | the specific targets of limiting their discretion about whose
         | data they can snoop. We're in an era of institutional capture
         | by people without ideals or principles, and it's probably
         | unwise to expect altruistic public interest policy like
         | 90's-style privacy legislation from any of them anytime soon.
        
         | jliptzin wrote:
         | I once went to the dermatologist, the doctor left the room
         | briefly and had the computer screen open with everyone's full
         | name and reason for the visit that day...could see who was
         | there for genital warts, Botox, etc. I don't think anyone
         | should expect that their health info remains private at any
         | point
        
           | catchnear4321 wrote:
           | two seconds to clear the screen. a few dollars for a privacy
           | shield.
           | 
           | your doctor was more than a little careless and, knowingly or
           | not, relied on you to not cross any lines.
           | 
           | if that's not concerning to you, fantastic... but for some
           | reason you didn't name the doctor, perhaps because you know
           | others disagree. nor did you name the patients.
           | 
           | huh.
           | 
           | guess your doctor made a safe assumption about you. who else
           | saw the warts list that day?
        
           | DoreenMichele wrote:
           | What your doctor did is actually a HIPAA violation. He's a
           | covered entity and securing computer screens is a standard
           | precaution for such.
           | 
           | In reality, a lot of doctor's offices are not well versed in
           | HIPAA because many are de facto small businesses. Large
           | hospitals and insurance companies generally have better
           | knowledge of HIPAA and HIPAA compliance.
        
         | meetingthrower wrote:
         | Had an emergency room visit for a somewhat bloody mishap with
         | my son (he's ok.) The resident texted the on call surgeon
         | pictures of the problem from his personal phone to determine if
         | the surgeon should come in for a surgery. The pictures I saw on
         | his phone of other patients as he set up the text were a
         | hellscape of blood and gore!
        
       | 1-6 wrote:
       | I have a domain name that's similar to a medical facility.
       | Sensitive medical data gets emailed to the wrong recipient all
       | the time and it's usually operator error.
        
         | _jal wrote:
         | Ditto, only my domain is unfortunately similar to a major (non-
         | us) airline.
         | 
         | The tarmac reports can be oddly entertaining sometimes. I still
         | wonder how an alcohol bottle became embedded in a runway a few
         | years back.
        
         | RajT88 wrote:
         | I used to work for a company which made EHR systems, and there
         | was one product which distributed client software updates via
         | email. As in, they would attach an *.msi file and send it.
         | 
         | It was a weird conversation, where we both ended up looking at
         | each other like the other one was a total moron.
        
         | [deleted]
        
         | vasco wrote:
         | My name and domain is similar to a huge transportation company
         | so I frequently get quotes for big jobs, plus times and dates
         | for large truck shipments.
        
           | dylan604 wrote:
           | This might be advantageous if you are also receiving
           | inventory for these shipments if you're the type to make that
           | information available to interested parties
        
       | anonu wrote:
       | HIPAA is sort of a joke to me. My perspective being that of a
       | patient. Any doctor's office just blindly asks you sign a HIPAA
       | authorization release form. Most patients don't realize that you
       | have a choice to "opt out" and not sign it. But even then it
       | doesn't matter because under HIPAA the provider may still choose
       | to share your personal information for their own reasons.
       | 
       | Sure, I am doing a lot of "hand waving"- I'm not an expert on the
       | law. I'm merely sharing my perspective on this. Would love to
       | understand more about this specific authorization...
        
         | appleflaxen wrote:
         | > Any doctor's office just blindly asks you sign a HIPAA
         | authorization release form.
         | 
         | You are incorrect. You are being asked to acknowledge that you
         | received a copy of their privacy policies. You can decline and
         | it doesn't change very much (if anything), because they will
         | still document that they informed you of them... which they
         | did.
         | 
         | It's understandable that people don't read what they're
         | signing; I often don't have time, either. But you are posting
         | _about_ that form having not paid much attention to it, which
         | is less common, in my experience.
        
         | ceejayoz wrote:
         | > Any doctor's office just blindly asks you sign a HIPAA
         | authorization release form.
         | 
         | I've never been asked to waive my rights. I have been asked to
         | sign that I received their notice of privacy practices. (Almost
         | always having not been actually given any to read, which is
         | fairly infuriating.)
         | 
         | > But even then it doesn't matter because under HIPAA the
         | provider may still choose to share your personal information
         | for their own reasons.
         | 
         | Only in certain specific situations.
        
         | kemotep wrote:
         | Any HIPAA authorization form I have signed has had me spell out
         | who is allowed to have access to my records, like my wife or
         | another Doctor's office. Did you read what you signed?
        
         | dangle1 wrote:
         | HIPAA was never meant to prevent direct communication between
         | clinicians regarding a shared patient's healthcare needs and
         | issues in order to provide the best and safest care possible.
        
         | [deleted]
        
       | swayvil wrote:
       | My friend spent the night in the hospital recently, for
       | observation.
       | 
       | She didn't sleep a wink. With all the beeping and alarms and
       | periodic checks and procedures. Mostly involving her roommate.
       | 
       | The next morning she was mentally and physically wrecked. the
       | first thing she told the nurse was, "I want to go home so I can
       | get some sleep.
       | 
       | The nurse laughs and replies, "I hear that all the time. Nobody
       | ever sleeps here".
       | 
       | Now that's messed up. Sleep is the great healer. No sleep is the
       | great destroyer. Is this intentional or institutional insanity or
       | what?
       | 
       | I mean why don't they just put strychnine in the water supply
       | while they're at it?
        
         | morkalork wrote:
         | Likewise, l hospitals serve food portioned nutritionally for a
         | healthy adult when people who are sick or healing from injury
         | may very well need more calories and protein to fuel their
         | bodies healing.
        
         | bigmattystyles wrote:
         | Ricky Gervais had a line that stuck with me back on the podcast
         | with Steve Merchant and Karl Pilkington - `How do people sleep
         | in hospital? They'll wake you up to give a sleeping pill`
        
         | ceejayoz wrote:
         | The beeping and alarms and periodic checks and procedures are
         | there to prevent worse things than a night's worth of lost
         | sleep.
        
           | swayvil wrote:
           | Yeah I get the obvious theory. But it's like putting a
           | tourniquet around your neck to stop a nosebleed.
        
             | tekla wrote:
             | No its not. One bad night of sleep won't kill you. You are
             | more than welcome to reject an overnight stay.
        
         | tekla wrote:
         | An overnight stay is for observation not comfort. The hospital
         | wants to gather as many metrics as possible to keep you alive,
         | respond ASAP to issues and dis-chargable to free up room for
         | other sick patients. not give you a hotel bed.
        
           | swayvil wrote:
           | Go to the hospital healthy, come out sick.
           | 
           | I don't have a medical degree or anything but that's crazy.
           | 
           | (Also, the nurse said _nobody_ sleeps here. Not just the
           | people under observation.)
        
             | tekla wrote:
             | > Go to the hospital healthy, come out sick.
             | 
             | This isn't whats happening. Being sleep deprived for a day
             | is annoying, but hardly a health issue. I bet most people
             | would rather have doctors respond to you suddenly dropping
             | blood O2 levels to under 90% than not.
             | 
             | > (Also, the nurse said nobody sleeps here. Not just the
             | people under observation.)
             | 
             | Yes, nobody sleeps because nurses and doctors are all
             | working >14 hour shifts with on-call rotations trying to
             | keep people ALIVE. I have many medical professionals in my
             | family, all of them are rest deprived, trying to keep track
             | of the myriad of patients all demanding personal constant
             | attention.
        
               | watwut wrote:
               | > I have many medical professionals in my family, all of
               | them are rest deprived, trying to keep track of the
               | myriad of patients all demanding personal constant
               | attention.
               | 
               | That is not exactly defense of medical system. If it
               | keeps workers sleep deprived they will make mistakes.
               | This just means system itself sux.
        
               | swayvil wrote:
               | Actually, sleep deprivation, even for one night, is
               | definitely a health issue. And the only reason it's
               | accepted is because it's so common. It's the modern
               | equivalent of drinking out of lead cups.
               | 
               | (And of course a sleep-deprived medical professional is a
               | health hazard to everybody involved. Only a fool thinks
               | otherwise.)
        
               | emerongi wrote:
               | Sleep deprivation is not as dangerous as dying from an
               | acute condition. If you're in the hospital for one night,
               | you're being treated by doctors who want to make sure
               | you're not going to die for the night. If you get
               | admitted for a longer period, it's a different
               | environment altogether. At least this has been my
               | experience.
               | 
               | You get used to the beeping after one night anyway. If
               | not, you can ask the nurse for earplugs or even sleeping
               | pills (although sleeping pills are harder to get).
        
               | tekla wrote:
               | Then leave. They're not forcing you to stay. Generally no
               | one puts you on observation unless you need it, and by
               | "need it", it means "needs to be disturbed to take tests"
               | 
               | If you think sleep is a higher health factor than the
               | reasons that the hospital want to put you under
               | observation, then just refuse treatment.
               | 
               | If you don't want to be disturbed by patients in the same
               | room, you can pay for that.
        
               | [deleted]
        
       | lifeisstillgood wrote:
       | my favourite part of the "reasonable precautions" explanation is
       | the possibility that if you are a known PHI leaker, the hospital
       | might have to segregate you - (or even be able to refuse
       | treatment)
       | 
       | weird
        
       | tptacek wrote:
       | It's easier to make sense of when you remember the original
       | purpose of HIPAA, which was cost control and portability (that's
       | what the 'p' stands for!).
       | 
       | The confidentiality rules in HIPAA are part of (IIRC, I think,
       | etc?) the "Administrative Simplification" section, which was
       | about standardizing electronic health care records and making
       | them available to the government for combating Medicare fraud.
       | The law wasn't a sweeping medical privacy bill; it added privacy
       | rules to mitigate concerns people had about centralizing medical
       | records as part of its major purpose.
        
       | armchairhacker wrote:
       | How does HIPAA compare to FERPA?
       | 
       | My understanding is that FERPA is similar to HIPAA, except for
       | college scores and enrollment information instead of medical
       | records.
       | 
       | But there's a rule in FERPA where you explicitly can't leave a
       | stack of exams and let students pick them, because it exposes
       | students to others' scores. Another rule is that you can't
       | associate a students exam with their student ID even if it's a
       | sequence of numbers, because the id is public information, but
       | you wouldn't expect someone to remember someone else's id.
       | 
       | (I specifically remember some professors not following the exam
       | rule, probably because they didn't know or perhaps it didn't
       | exist yet. I don't know if anything happened to them but I
       | suspect if anything, they were simply asked to not do that in the
       | future.)
        
         | vasco wrote:
         | I recently learnt on HN that some countries don't publish
         | grades to ALL students at once and still can't think why. It's
         | such an amazing gift to be able to see how much everyone got
         | and the academic competition in its most pure form, while
         | removing some awkwardness of getting results of your work (good
         | or bad) early in your life.
         | 
         | People are too focused on hiding results because someone might
         | feel bad.
        
           | armchairhacker wrote:
           | Most classes. publish grade distributions, so you know if you
           | were in the top or bottom 10%. Or at least the mean, median,
           | highest, and lowest.
           | 
           | But you don't get the grades of individuals.
        
           | kube-system wrote:
           | While things like FERPA broadly protect most student
           | information in the US, it doesn't exist so that people don't
           | feel bad about their test scores. It limits schools and their
           | staff to using student data for legitimate academic purposes
           | and prohibits other uses that could be bad. That data goes
           | beyond just test scores and could be things related to the
           | students health, social life, behavior, etc. This kind of
           | data doesn't need to shared with anyone that doesn't need to
           | know it.
        
       | andrewguy9 wrote:
       | Because that would be expensive.
        
         | [deleted]
        
       | dtnewman wrote:
       | From the HHS.gov website:
       | 
       | The Privacy Rule permits certain incidental uses and disclosures
       | that occur as a by-product of another permissible or required use
       | or disclosure, as long as the covered entity has applied
       | reasonable safeguards and implemented the minimum necessary
       | standard, where applicable, with respect to the primary use or
       | disclosure. See 45 CFR 164.502(a)(1)(iii). An incidental use or
       | disclosure is a secondary use or disclosure that cannot
       | reasonably be prevented, is limited in nature, and that occurs as
       | a result of another use or disclosure that is permitted by the
       | Rule. However, an incidental use or disclosure is not permitted
       | if it is a by-product of an underlying use or disclosure which
       | violates the Privacy Rule.
        
         | bigmattystyles wrote:
         | I mean, they usually have a little curtain - I suppose that
         | counts as reasonable.
        
         | [deleted]
        
         | mzs wrote:
         | guidance to the question itself: https://www.hhs.gov/hipaa/for-
         | professionals/faq/197/must-fac...
        
       | buildsjets wrote:
       | The P in HIPAA stands for Portability, not Privacy. The primary
       | purpose of HIPAA is not to prevent the sharing of confidential
       | patient data, it is to ENABLE the sharing of confidential patient
       | data with anyone who has the right to see it. The issue is the
       | number of entities who claim that they have right to see the
       | data, and the lack of a mechanism for the individual to prevent
       | their information from being shared.
       | 
       | Should Facebook have a right to access your health data? Your
       | opinion does not matter, they wanted it, and they got it. What
       | about the US Department of Transportation? They maintain the
       | right to access the electronic medical records of any person who
       | falls under their regulation, such as pilots and truck drivers.
       | They have been know to go on fishing expeditions trolling through
       | medical records in search of violations. Search for Operation
       | Safe Pilot. I know several people who have either avoided medical
       | treatment because of this issue, or obtained treatment in a
       | foreign country.
        
         | deathanatos wrote:
         | I work in healthcare; these views are my own, and IANAL.
         | 
         | > _The P in HIPAA stands for Portability, not Privacy._
         | 
         | ... sure, that P stands for that. But one of the key sections
         | is literally called the Privacy Rule: "The HIPAA Privacy Rule
         | establishes national standards to protect individuals' medical
         | records and other individually identifiable health information"
         | 
         | > _Should Facebook have a right to access your health data?
         | Your opinion does not matter, they wanted it, and they got it._
         | 
         | No. Wantonly sharing PHI with Facebook would almost certainly
         | be a violation of HIPAA ... and literally, it's already
         | happened, this year even[1]: "The office warned that entities
         | covered by HIPAA aren't allowed to wantonly disclose HIPAA-
         | protected data to vendors or use tracking technology"
         | ("Vendors" here included Facebook and the like.) 1
         | 
         | Now, HIPAA only applies to covered entities. In the context of
         | the OP however, a hospital is a covered entity. Whether
         | eavesdropping is permissible is a good question.
         | 
         | [1]: https://www.politico.com/news/2023/04/17/health-industry-
         | dat...
         | 
         | 1I think regulatory agencies across the board have been giving
         | pittances for fines, and these are no exception. There's a real
         | question as to whether enforcement is actually _meaningful_ ,
         | but that's separate question from whether there is a _right_.
        
           | tptacek wrote:
           | It's only "key" in the sense that it's the part technologists
           | and people building PHI-encumbered products have to care
           | about. It's not a key section in the bill itself; in fact, I
           | don't even think it's a key part of the _section_ of the bill
           | it 's in (which, I think, is about Medicare fraud).
        
             | deathanatos wrote:
             | Okay ... sure. "Key" if you're like me, and working in
             | healthtech, I suppose, as it's one of the sections they
             | repeatedly try to cram into your head in the mandatory
             | training sessions. (...and for good reason.) In the
             | intersection of Facebook and PHI.
        
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