mobey

Double patient transfer - HIPAA breech?

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Just wondering if anyone knows the latest on this. Can we transfer 2 patients, unrelated in the same ambulance without breeching HIPAA?

I have researched it and cannot find much info.

We are buying a new ambulance and it "Must" be dual cot for double transfers, but I think that they are highly inapropriate.

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I agree that getting them for transfer purposes is not appropriate. Also because there is no safe way for two people to use two stretchers and you can't leave a patient unattended.

What I DO like them for though is those scenes where you have multiple patients. More than once I have had two serious traumas in the back and wished I didn't have to strap one to the bench seat.

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Well, since HIPAA is an American law, I do not see how you could violate it in Canada.

Did you guys adopt a similar law??

However, two unrelated pts is not a violation of HIPAA here in the US. Its been done many, many times out of necessity. Hell I had 5 patients once during an MCI. Talk about a chicken minus its head...

HIPAA applies mostly to the rules of billing practices. It means we will not share information with outside agencies.

Now as far as privacy concerns, yes two patients is an issue, but in an emergency situation I believe it may sometimes be overlooked as you have to do what you can do with what you have on hand.

Notice I said emergency situations. To routinely transport interfacility patients together is bad juju in my book. I strongly disagree with that practice. Is the service billing two transports when only one actually took place? Reeks of fraud my friend.

It is rude and disrespectful to the patient as they deserve complete privacy when it is available. They also deserve the one on one care while in transit.

I think this is a silly idea and just plain wrong.

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Well, since HIPAA is an American law, I do not see how you could violate it in Canada.

Did you guys adopt a similar law??

I am known to post things that are completly freeking WRONG!! And yes this may be one of those things. :oops:

I am going to look into this further to find out exactly what I am dealing with, but yes we do have a similar system.

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I have my own gut feeling about taking a double IFT. It feels wrong to me. It especially feels wrong to me when I'm forced to double haul psych patients. That spells a recipe for disaster to me. I can just see patient number 1 giving the beat down to patient number 2 because Jesus came to him on a cloud with a ukelele and made him do it.

Now when it comes to multiple patients at a scene, I've hauled two criticals, one on the stretcher and one on the bench. If I have to do this, I make sure I grab one of the firemen that I know is a paramedic (a paramedic I trust) and we handle it. I've hauled up to four 20 year olds from a fender bender with various complains such as "I can't bend my wrist this way anymore," or "it really hurts behind my knee, do you think it's broken?" Let me add that all of these kids were much more interested in cell phoning their friends and telling them all about their near-death experience, than talking to me. Perhaps I'm just boring.

I digress... I don't know how HIPAA feels about this double transport thing. I can only say that if it feels wrong, it just might be wrong. Good luck with finding answers, the government can be mighty elusive at times. When you find out, let us know.

Cheers,

K

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Like AK described it is an insurance issue. Surely, everyone has seen hospital rooms with two beds in them. Yeah, that curtain is real privacy getter :D ..

R/r 911

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As far as the abandonment issue, I don't think transferring two emergency patients in the same ambulance would qualify, since you're staying with both the same time. You're dividing your attention, but it's a triage situation. You're partner gets one out on the gurney, transfers care to the ED, then returns with an empty gurney for the one you stayed with. Routinely done here for patients in the same car on TC's (family type situations) and MCI's (bus accidents, etc)

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I have had as many as 6 patients in my ambulance. Once had an OB in active labor, a chest pain with s/s of MI, and a dog bite victim all at 1 time. Every time the OB screamed thought my cardiac patient would code. 30-45 minutes into transport met mutual aid and shuffled patients.

As far as transfers back to nursing home only reason I can think of for not doing it is you can not bill both for transport, so you would be costing your service money.

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Patient confidentiality rules for your company and regional statutes apply to those situations. Many confuse these with HIPAA. Most U.S. states have patient's Bill of Rights statutes that includes a patient's expectation and right of privacy. Each medical service also adopts those and expands on them for their own purposes for employees to follow.

The Canadian version of the U.S. HIPAA does apply to insurance and electronic records which we do a lot of transactions with Canadian "snowbirds" in Florida. They sign our form with the understanding that the privacy with PHI and insurance should also be observed in Canada through their personal information and electronic data security laws. There are similar electronic security rules and laws in many other countries also.

http://aspe.hhs.gov/admnsimp/pl104191.htm

PUBLIC LAW 104-191

AUG. 21, 1996

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996

Public Law 104-191

104th Congress

An Act

To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes.

If more than one patient is transported, your billing office must be made aware so they can pro-rate the charges. If this doesn't happen, your service can be set up for an investigation for violations of billing practices which can result with an unflattering fraud headline in the news. That pertains to the U.S. companies.

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I agree that getting them for transfer purposes is not appropriate. Also because there is no safe way for two people to use two stretchers and you can't leave a patient unattended.

Tell that to the transfer company I work for LOL

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