Privacy Officer's Roundtable

  • 1.  Physical Therapist's Access to Schedule/Chart

    Posted 07-23-2018 09:26 AM
    ​​Please review the following scenario:
    • A Physical Therapist works in the same building as an Orthopedic surgeon and accesses the same EMR (they are both employed by the same hospital).
    • The PT looks at the doctor's schedule daily (which includes Medical Record #, Patient Name, and reason for appointment, e.g., wrist fracture, back pain, etc.).
    • The PT looks for diagnoses that may need his services so he can better schedule the patient that day in case the patient needs a splint, etc. or in case the patient needs post op therapy in a few weeks after surgery he can put a hold on his schedule.
    • If the PT sees a diagnosis that may need his services, he opens the chart. If the patient lives in the next town over, the PT says he then closes the chart and does nothing. If the patient lives in the same town, then the PT has the office staff schedule the patient with him, even before receiving an order from the physician.
    • The PT says he and the ortho team work together and this improves the quality of patient care.
    • I say the PT should not be looking at the doctor's schedule ever because that is not his department.  In addition, he  should not be looking in the patient's chart until he receives an order from the doctor.
    • I would love to know your thoughts, Contrast & Compare!  Is this a HIPAA violation, does it go against minimum necessary?

    Thank you!


    Compliance/Ethics & Privacy Director
    SCCE Membership

  • 2.  RE: Physical Therapist's Access to Schedule/Chart

    Posted 07-23-2018 12:25 PM
    Hi Cinda.  I would agree that the PT should not be looking in the chart until there is a referral.  S/he has no idea if the patient even wants to see them for their PT or if the ortho doc will even want PT care.  Plus, looking at a chart and then closing it because the patient lives in another town kind of sounds like snooping.  I'd say an impermissible use.

    David Garrison CHC,CHPC
    Compliance/Privacy Officer

    SCCE Membership

  • 3.  RE: Physical Therapist's Access to Schedule/Chart

    Posted 07-23-2018 02:48 PM
    I think David worded things well.  The other thing to keep in mind is even if the Ortho orders PT, the patient would have the right to select another physical therapy practice, so not necessarily get all the PT referrals anyway.  Looking at way too much information on patients that PT may not ever have a treating relationship with.  My opinion only.

    Marie Wagner CHC,CHRC
    Sr. Corp Compliance Coord
    The Queen's Health Systems

    SCCE Membership

  • 4.  RE: Physical Therapist's Access to Schedule/Chart

    Posted 07-25-2018 09:11 AM

    Thank you to those who responded!  The director does agree with me and will put a stop to this practice!



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  • 5.  RE: Physical Therapist's Access to Schedule/Chart

    Posted 07-24-2018 07:17 AM
    ​I would say that even before you get to minimum necessary, I would doubt whether there is even a treatment relationship established between the PT and the patient. The patient came in to see the doctor and established that treatment relationship with a covered entity.  The PT wouldn't have established a treatment relationship until the doctor made the diagnosis and referral.  Without the exception of access to PHI for a treatment relationship, the PT (under the circumstances) should only get access to PHI with a signed consent.

    Lee Braem
    Sr Corp Counsel & Chief Comp Ofcr
    Evonik Corporation

    SCCE Membership