The HIPAA right to an accounting of disclosures generally applies to disclosures outside the covered entity for purposes other than TPO (Treatment, Payment, and Healthcare Operations). Internal accesses by workforce members performing their jobs are usually exempt. The correct first step is to clarify this distinction for the patient.

A signed Business Associate Agreement (BAA) is a non-negotiable HIPAA requirement when a vendor will have access to PHI. The BAA contractually binds the vendor to safeguard the data and outlines responsibilities. Without a BAA, the covered entity is likely in violation, regardless of the vendor’s other security claims.

This is a classic example of an incidental disclosure. HIPAA recognizes that in a healthcare setting, limited exposure of PHI may occur incidentally during otherwise permissible activities. Since the nurse accessed the information as part of her job (viewing the patient board) and did not further disclose it, this is generally acceptable under the Privacy Rule, provided reasonable safeguards are in place.

A valid HIPAA authorization is required to disclose PHI to a third party like an employer, even when requested by the patient. The authorization must be in writing, specify the recipient, describe the information, and state the purpose. Simply acting on a verbal request is insufficient and violates the patient’s privacy rights.

Following a security incident, the Breach Notification Rule requires a risk assessment to determine if a breach occurred. The assessment must consider factors like the nature of the data, who accessed it, and whether it was actually viewed. If the assessment demonstrates a low probability of compromise, notification may not be required. One cannot assume no breach based solely on the type of data.

Disclosing an individual’s status as a patient, along with their name, is a disclosure of Protected Health Information (PHI). This was done for a purpose unrelated to treatment, payment, or operations (it was for publicity) and without a valid authorization from the patient. The specific clinical details are irrelevant; the confirmation of treatment itself is PHI.

Using PHI for research generally requires patient authorization or a waiver of authorization approved by an IRB or Privacy Board. A researcher’s preparatory review of PHI to formulate a research question is allowed, but only if the researcher represents that the PHI is necessary for the review and will not be removed from the covered entity. The safest and most compliant course is to require the proper waiver before disclosing identifiable records.

The core issue here is a failure in Workstation Use and Security, specifically the physical safeguard of protecting workstations and electronic media containing PHI from unauthorized access. Leaving printed PHI unattended in a public area is a clear violation of this principle. The solution involves clear policies on handling paper documents and securing them when unattended.

A subpoena alone is not sufficient for disclosing PHI. The Privacy Rule requires specific conditions to be met before complying. The covered entity must receive satisfactory assurances that the individual has been notified of the request (giving them a chance to object) or that efforts were made to notify them, or that a qualified protective order is in place. A verbal statement from the attorney is not sufficient assurance.

The HIPAA right to an accounting of disclosures generally applies to disclosures outside the covered entity for purposes other than TPO (Treatment, Payment, and Healthcare Operations). Internal accesses by workforce members performing their jobs are usually exempt. The correct first step is to clarify this distinction for the patient.0