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HLT 162 - Selected Topics in Health Science : Hiller: Patient Confidentiality

Courseguide for HLT 162

Confidentiality and HIPAA

Health care practitioners have a duty to keep personal medical information confidential. Communication between the patient and doctor is strictly confidential. For example, doctor-patient medical discussions should occur in private, or a patient might ask a doctor to call their cell phone rather than home. Even well-meaning family members are not necessarily allowed to have information about a person's medical condition. All people are entitled to confidentiality unless they give permission for disclosure or they clearly can no longer express a preference (for example, if they are severely confused or comatose). A federal law called the Health Insurance Portability and Accountability Act (HIPAA―Health Information Privacy) applies to most health care practitioners and sets detailed rules regarding privacy, access, and disclosure of information. For example, HIPAA specifies the following:

  • People should normally be able to see and obtain copies of their medical records and request corrections if they find mistakes.
  • Health care practitioners should routinely disclose their practices regarding privacy of personal medical information.
  • Health care practitioners may share the person's medical information, but only among themselves and only as much as is necessary to provide medical care.
  • Personal medical information may not be disclosed for marketing purposes.
  • Health care practitioners should take reasonable precautions to ensure that their communications with the person are confidential.
  • People may file complaints about privacy practices of health care practitioners (directly to the health care practitioner or to the Office for Civil Rights in the United States Department of Health and Human Services―see How To File a Complaint with the Office for Civil Rights).

At the same time, HIPAA rules should not be read to create barriers to normal communications with a patient's family or friends. The rules permit doctors or other health care practitioners to share information that is directly relevant to the involvement of a spouse, family members, friends, or other people identified by a patient. If the patient has the capacity to make health care decisions, the doctor may discuss this information with the family or others present if the patient agrees or, when given the opportunity, does not object. Even when the patient is not present or it is not practical to ask the patient's permission because of emergency or incapacity, a doctor may share this information with family members or friends when, in exercising professional judgment, the doctor determines that doing so would be in the best interest of the patient.

Health care practitioners are sometimes required by law to disclose certain information, usually because the condition may present a danger to others. For example, certain infectious diseases, such as human immunodeficiency virus (HIV) infection, syphilis, and tuberculosis, must be reported to state or local public health agencies. Health care practitioners who notice medical signs of child, adult, or elder mistreatment (elder abuse) or neglect normally must report such information to protective services. Conditions that might seriously impair a person's ability to drive, such as dementia or recent seizures, must be reported to the Department of Motor Vehicles in some states.

Source: Merck Manual Home Edition Online

Patient Confidentiality Defined


Confidentiality is the right of an individual to have personal, identifiable medical information kept private. Such information should be available only to the physician of record and other health care and insurance personnel as necessary. As of 2003, patient confidentiality was protected by federal statute.


The passage of federal regulations (the Health Insurance Portability and Accountability Act of 1996) was prompted by the need to ensure privacy and protection of personal records and data in an environment of electronic medical records and third-party insurance payers.


Patient confidentiality means that personal and medical information given to a health care provider will not be disclosed to others unless the individual has given specific permission for such release.

Because the disclosure of personal information could cause professional or personal problems, patients rely on physicians to keep their medical information private. It is rare for medical records to remain completely sealed, however. The most benign breach of confidentiality takes place when clinicians share medical information as case studies. When this data is published in professional journals the identity of the patient is never divulged, and all identifying data is either eliminated or changed. If this confidentiality is breached in any way, patients may have the right to sue.

The greatest threat to medical privacy, however, occurs because most medical bills are paid by some form of health insurance, either private or public. This makes it difficult, if not impossible, to keep information truly confidential. Health records are routinely viewed not only by physicians and their staffs, but by the employees of insurance companies, medical laboratories, public health departments, researchers, and many others. If an employer provides health insurance, the employer and designated employees may have access to employee files.

Read more:

Books and Media in the Library

Title:Confidentiality & patient privacy [videorecording] : basic principles for staff education / Medical Consultants Network Inc.
Edition:Version 1.0.
System Requirements:DVD.
Physical Description:1 videodisc (ca. 20 min.) : sd., col. ; 4 3/4 in.

This program covers JCAHO and CMS requirements for confidentiality of patient information and privacy rights. It explains how to maintain confidentiality of verbal, written, and electronic information; considers security issues and common breaches of information; and outlines ways to avoid privacy pitfalls. The DVD also introduces the basic HIPAA compliance requirements for healthcare workers.

Films on Demand

Protection: Privacy, Safety, and Standards—Ethical Issues in Nursing
Exploring the third provision in the American Nurses Association Code of Ethics, this program looks at confidentiality standards mandated under the Health Insurance Portability and Accountability Act (HIPAA) as well as the role of ethics in medical research. The video also addresses the proper methods for reporting unethical, illegal, or impaired practices. With help from illustrative scenarios and expert interviews, viewers learn about the importance of patient privacy and confidentiality and various ways that nurses can successfully advocate for their patients, including those who might participate in research. Also covered: review mechanisms and the role of an ethics committee. A part of the series Ethical Issues in Nursing. Run Time: 21 minutes

Health Information Management
Compiling and retrieving up-to-date information on patients’ illnesses, injuries, and medical history is more important than ever for effective medical care. This video focuses on opportunities in the field of health care information management and technology. Examples of HIM-related positions are covered—including medical billing specialist, diagnostic and procedural coder, and privacy officer—along with the two main types of schooling that precede a HIM career: an associate degree leading to work as a Registered Health Information Technician, and a baccalaureate degree required for employment as a Registered Record Administrator. Patient confidentiality is an important subject in the video. A viewable/printable instructor’s guide is available online. A Meridian Production. Run Time: 15 minutes

How do I access from home?...

One of your first duties as a student is to "activate" your accessBCC card...aka...student ID.  Why?  Well, once activated, the back of your library card, the barcode (22777...) becomes your accessPass to the libraries resources from home, or for that matter wherever you are that has a internet connection and a device to load it.

If you are trying to access books or online books, please type in the barcode from the back of your activated accessBCC card.  This will ensure remote access.

To access Films on Demand

BCC Libraries provide access to a collection of streaming videos specific for anatomy topics. Below is a brief description of the selected titles and instructions on how to access. Please visit the database Films On Demand for further streaming videos on your topic.

Films On Demand videos are accessible on campus and off campus with a valid AccessBCC ID activated at the library. If the barcode on the back of your ID is not working (22777...) please visit the Library at any of the three campuses to activate.

Any questions please email me @ Melanie Johnson.