Patient Threats of Violence

  • 1.  Patient Threats of Violence

    Posted 08-10-2020 05:15 PM

    I'm curious if anyone would be willing to share their thoughts or policies with respect to patient threats of violence, trespass, verbal abuse or other similar altercations and preemptively notifying staff.  We're considering development of an account flag that would refer one to a database with name, photo, level of risk and summaries of previous altercations and how to proceed to notify staff if a patient with a history of such behavior presents, so that staff can be prepared, however, I'm not certain this is permissible from a HIPAA standpoint.  My concern is not all these situations would amount to "a serious and imminent threat" based on the individual's prior acts, such as verbally abusive patients.  This use does not fall under a permitted use for Health Care Operations.

    OCR HIPAA FAQs:  "What constitutes a "serious and imminent" threat that would permit a health care provider to disclose PHI to prevent harm to the patient, another person, or the public without the patient's authorization or permission?"  Answer: HIPAA expressly defers to the professional judgment of health professionals in making determinations about the nature and severity of the threat to health or safety posed by a patient. OCR would not second guess a health professional's good faith belief that a patient poses a serious and imminent threat to the health or safety of the patient or others and that the situation requires the disclosure of patient information to prevent or lessen the threat. Health care providers may disclose the necessary protected health information to anyone who is in a position to prevent or lessen the threatened harm, including family, friends, caregivers, and law enforcement, without a patient's permission."

    There is also state law discussing this:  ARS 36-509.

    I would appreciate any input you could offer.  Thank you, in advance, for your time and help.

    Natalie Roehlk, CHC, CHPC
    Privacy Officer
    Summit Healthcare
    Show Low, Arizona
    The opinions expressed herein are my own, and do not necessarily represent those of my employer.
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