Hi Folks

Beth are you saying that if I’m in a center and the person next to me starts to to talk to me. And we talk small talk at first then find we want to share our story " That “HIPPA” stops two people from talking about there own life history. I understand that medical people can not talk to others unless given the ok, but when a person signs that paper it leaves the door open for medical people to talk to who they want if they can say the person needed to know for this reason or that?

[QUOTE=bobeleanor;11408]Hi Folks

Beth are you saying that if I’m in a center and the person next to me starts to to talk to me. And we talk small talk at first then find we want to share our story " That “HIPPA” stops two people from talking about there own life history. [/QUOTE]
NO. You are free to share your OWN medical history with anyone you choose. But OTHERS can’t share your history without your permission.

As Dori said, you can share what you want to about your personal health information with anyone that you choose to share it with. One of the reasons why the Health Insurance Portability and Accountability Act (HIPAA) includes privacy provisions is because in the past, although most medical professionals maintained confidentiality of medical records, there was concern in Congress that others who had a reason to have your health records like your health insurance company (or its personnel) might share your health information with an employer, lender, and others who could use that information against you. Congress wanted to prevent that. I’m sure Congress had no idea how far some people would take HIPAA.

If you want to read what the Office of Civil Rights has published about HIPAA, including 13 pages of FAQs, see:


Thanks Beth and Dori


HI Fol;ks

I would like to have comment on HIPAA. Example, At drug stores , drive thur windows. Sign reads that the persons (person working for drug stove or person picking up Rx) must not be on cell phone. While in drug store they have a a window set up for the person picking up drugs and the druggist to talk,if either person has questions on Rx. Do the same rules on HIPAA apply for dialysis parties? In other words when I talk to nurse , DR, social worker, unless the person waives his/her rights said person has the right to have questions and answers talked about in a secure setting?

Bob O’Brien

The new Conditions for Coverage that became effective October 14 state that the patient has the right to privacy and confidentiality in all aspects of treatment. The interpretive guidance provided to surveyors to explain what this means states:

[I]Patients have the right to privacy and confidentiality in both the verbal and physical aspects of their treatment.

Patients have the right to privately discuss their condition and treatment. Staff should allow the patient to direct where discussions of sensitive topics should occur, and ask the patient if he/she wants to schedule a time to discuss a sensitive issue away from the treatment area. Any staff-patient interactions that require privacy should be conducted in private. To allow for private conversations between patients and staff members, there should be ready access to a room in the facility where patient and/or family meetings can be held in private. Plan of care conferences may be conducted chairside rather than in a private location if a patient grants permission.

Patients have the right to privacy during activities that expose private body parts while in the dialysis facility. This includes activities related to use of vascular access sites located in the groin or chest and physical examinations. Options for ways to comply with this requirement include the use of privacy screens, curtains, or blankets. Staff must be able to observe the patient’s vascular access, bloodline connections, and face at all times. Refer to V407 under the Condition for Physical environment. [/I]

The new regulations encourage facilities to invite patients to attend meetings where the plan of care is developed. The regulations recommended that the meeting include the patient (in-person or by phone) and all members of the “interdiscipinary team” (physician, nurse, dietitian, and social worker). This allows everyone to hear assessments from each discipline and the patient of how well he/she is doing, to review any problems as a group, and jointly to develop a workable plan with timelines for resolving any issues.

HIPAA does not prevent communication among healthcare team members to provide care to patients. It is intended to prevent those who do not have a “need to know” (like other patients or visitors) from hearing or reading about someone’s personal health information.

Hi Folks
Hi Beth
So if I’m in center and the Dr, is making rounds or soical worker etc. When they come to talk a person that is on the machine, they can’t talk to the person if the other people in center are so close in a normal talk voice the dialouge between the two parties can be heard? Unless said person on dialysis has given his/her OK? And if the DR etc say to me, if I want to talk one on one without people not around. They must agree to a reasonable time frame? And are you saying that before 10/14/08 these rules were not in place? In my example, the drug store has had these rules in plain view for the past couple of yrs. I talked to people at the drug store and they said it was law. Like I said this went back a couple yrs.

Bob O’Brien
PS this is country wide not just state?

It is hard to have much privacy when you’re doing HD in a dialysis clinic where dialysis machines and chairs are a few feet apart. Staff members talking with patients should do their best to keep their voices low. The new regulations that apply to all facilities in all states (unless state regulations or facility policies are more stringent) are much more specific about ways to protect patient privacy than the prior regulations which were effective 20 years before HIPAA was enacted. If one or more staff want to talk with a patient or vice versa and the patient prefers not to have that discussion in the treatment area, as the new regulation says, he/she can ask to have the discussion in a private place. Facilities should have a a private place for meetings like this…probably a conference room or a private office. If an in-center HD patient chooses to meet privately with his/her doctor or any or all team members, it will need to be before or after dialysis or on a non-dialysis day. Some patients may be willing to do this, but many may choose to have those discussions where they happen because they of their preference to only be at dialysis on dialysis days at their scheduled time or because of limited transportation. One option to protect privacy is to “meet” by teleconference. In fact, the regulations suggest the option of meeting by teleconference for patients or staff who cannot attend the team meeting for developing the plan of care.

Greater privacy is another advantage of being a home dialysis patient. Much of the communication with staff is done by phone where no one is listening in. In my experience, when home dialysis patients came to clinic and saw staff and/or their doctor, they met in a private room separate from other patients. Some patients met with their doctors at the office and came to the dialysis clinic to meet with staff in their offices.

Incidentally, when a state surveyor comes to the dialysis clinic and wants to interview the in-center or home dialysis patient, the patient can ask to meet somewhere outside the dialysis clinic or to talk on the phone instead of talking at the dialysis clinic.

Hi Folks BOO Got all you lurkerrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr

Hi Beth or Dori

So what is happening anymore web chats?

You know that if every dialysis consumer ""in center " asked to talk one on one with the Dr, social worker. I’m told that it would put these big companies out of the dialysis game. That there is no way that the DRs /social workers could possible make the time to see each one in a proper setting. But who cares about what people strapped to a chair think. They are not going anywhere for at least 5 hrs. And we have time to break them of free will with threats of death, if they don’t play the game. My first formal complaint went out today. I now cross my fingers and wait too see if the whole set up is just a scam…

The next big scam pulled on the people to break, the medical scam stay turned…

Thanks Beth, Dori…
Bob O’Brien

Hi Bob,

We switched webinar vendors, and then found out that my laptop had some issues that made it impossible to take part in a webinar. My new laptop just arrived, and is having the software loaded up. So, we’ll do some more practices and should be up and running soon!