Francis L, Vorwaller MA, Aboumatar H, Frosch DL, Halamka J, Rozenblum R, Rubin E, Lee BS, Sugarman J, Turner K, Brown SM; Privacy, Access, and Engagement Task Force of the Libretto Consortium of the Gordon and Betty Moore Foundation., Crit Care Med. [Epub ahead of print], 2016 Dec 02
Abstract
OBJECTIVE: To review the legal issues concerning family members' access to information when patients are in the ICU.
DATA SOURCES: U.S. Code, U.S. Code of Federal Regulations, and state legislative codes.
DATA EXTRACTION: Relevant legal statutes and regulations were identified and reviewed by the two attorney authors (L. F., M. A. V.).
STUDY SELECTION: Not applicable.
DATA SYNTHESIS: Review by all coauthors.
CONCLUSIONS: The Health Insurance Portability and Accountability
Act and related laws should not be viewed as barriers to clinicians sharing information
with ICU patients and their loved ones. Generally, under Health Insurance Portability
and Accountability Act, personal representatives have the same authority to receive
information that patients would otherwise have. Persons involved in the patient's
care also may be given information relevant to the episode of care unless the patient
objects.
ICUs should develop policies for handling the issues we identify
about such information sharing, including policies for responding to telephone inquiries
and methods for giving patients the opportunity to object to sharing information with
individuals involved in their care. ICU clinicians also should be knowledgeable of
their state's laws about how to identify patients' personal representatives and the
authority of those representatives. Finally, ICU clinicians should be aware of any
special restrictions their state places on medical information. In aggregate, these
strategies should help ICU managers and clinicians facilitate robust communication
with patients and their loved ones.