Brenda, thank you so much for your reply!
Scenario #1 – I agree that since the husband isn't there as a patient, it isn't right to search to see if he is a patient and flag his chart. Flagging the wife's chart should be sufficient.
Scenario #2 – I also agree that this seems extreme. As you said, a patient may act differently toward different providers. I've talked about this scenario with our Security – they said their priority is to keep patients and employees safe. They want to be able to flag the patient's chart and to notify the providers whom the patient is scheduled to see.
Scenario #3 – I know what happens in the parking lot isn't PHI, but let's say the patient gets violent in X-ray's waiting area and Security is called. Of course Security is going to get the patient's name either from the patient, or the X-ray department for their internal report, and they will request the patient's chart be flagged. But they also want the provider notified directly, and they want to be present at the patient's next appointment.
One thing I suggested is that when Security has an aggressive patient incident, we send the patient a letter telling them about our zero tolerance for violence policy, and letting them know that one more episode of aggressive behavior may result in dismissal from the health system.
Since I couldn't find any rules or regulations about dealing with aggressive patients, I am suggesting we have a policy outlining our procedure – whatever it is – and then consistently follow it.
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Dec 17, 2021 6:25 AM
Scenario #1: The husband is not there as a patient so it's not appropriate in my opinion to search to see if he is a patient. The wife is the patient, so wouldn't a better alternative be flagging her chart noting that the person accompanying her may present a danger? Scenarios #2: Yes I think that's fine if staff think safety is an issue, but it seems extreme. I've seen cases like that where the patient only had a beef with one physician and was charming to everyone else. Scenario #3: Yes I think that's fine and falls under TPO. Yes you can tell the doctor about it. Activities like this that occur in the parking lot are not PHI and even if they were the doctor is his treating care provider. ------------------------------ Brenda Manning J.D., C.H.C., C.H.P.C. Privacy Director Privacy Officer Carilion Clinic The views expressed herein are my own and do not represent those of my employer. They are not meant to constitute legal advice or create an attorney-client relationship. ------------------------------
Original Message: Sent: 12-16-2021 03:15 PM
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