Monday, July 25, 2005

HIPPA Violation?

I think I may have violated the HIPAA law today. Consequently, it's 2:00AM and I'm still up thinking about what transpired and trying to decide if I really violated it or not. Here's the situation... Woman comes to the pharmacy window and tells me her husband was recently started on two anti-diabetic agents. She remembers one medication is glipizide but cannot remember the second. I pull up her husband's profile and ask if she is referring to the metformin and the glipizide. She informs me that she is and that she was a question about them. She wanted to know the side effects of each medication. I printed her an information sheet about glipizide and metformin. She then informs me that her husband has been experiencing depression and she thinks it is directly correlated to the new medications - being as it started roughly around the time the new meds were started. I glance over the sheets and see that glipizide has "mental/mood changes" listed as a possible side effect. Metformin has no such side effects listed. I consulted my trusty Drug Facts and Comparisons reference guide as well as the package insert for metformin - still no mental/mood changes listed. I inform her that the depression could be a side effect of the glipizide but that her husband should check with his doctor. This is where she drops the bomb on me - her husband has left her. He apparently, in a fit of depression, packed all his stuff and moved out of the house. He won't go to work, he won't talk to anyone, and he won't come out of the apartment. She tried contacting his doctor, but the receptionist informed her that they were "too busy" to deal with her husband's problem. Left with no where to turn, she showed up at the pharmacy. She next asked me to tell her when the refill of glipizide is due so that she can talk to her husband. At this point, warning bells were sounding and bright red lights were flashing. I turned to my boss and said, "Um...I can't tell her that." And he says, "I don't think we should." So I tell her I can't release that information and she gets upset - not mad, but very sad. She wants help for her husband. She wants me to call her husband and discuss the situation. I tell her I cannot do that - he has not approached me with a problem. Finally, I agreed to call her husband's doctor and discuss the situation. I told her that I couldn't call until tomorrow - but that someone from the pharmacy would call the doctor tomorrow. I did not release the patient's doctor's name to the wife. Finally, somewhat satisfied, she begged me one last time to help her husband and then walked way from the counter. Tomorrow (well, actually today) my boss will place a call to the patient's doctor to discuss the situation.

My gut tells me that I did the right thing. I know this patient very well. He usually is a jovial guy - always smiling at the counter and talking with the staff. He always picks up prescriptions for his wife and himself. He's just a very nice guy. It's upsetting to think of him in a situtation like this. If it is the medication causing this situation, it's very tragic. And...if he's that depressed, is he suicidal? I truly feel that this man needs help. It's really sad when a federal law prevents you from providing the best care possible for people. My duty to warn far outweighs my HIPAA responsibilities - at least to me personally.

I wonder if my APhA Professional Liability insurance policy covers HIPAA violations? Sounds like it's time for a Prilosec OTC (for stomach ulcer prevention - increased stress = increased ulcer risk) and a Benadryl (for calming and sedation and these Godforsaken hives!!!)

4 Comments:

Blogger ThatIsMeWhat said...

I don't believe that you violated HIPPA, or at least not in such a way that you can be sued. She was merely asking for side effects of a medication. She was aware of all of the medications that her husband was on already. As soon as you determined that the marriage was in effect near termination, no more information was released. I believe you followed a good standard of practice. If you had revealed a medication to her that she was not aware of, then we'll talk Prilosec.

8:34 AM  
Blogger Animesh Singh said...

This comment has been removed by the author.

1:42 AM  
Blogger Animesh Singh said...

That was really informative post. While searching online services for HIPAA Privacy Training I came across your blog. Thanks for sharing all this information. Looking forward to read such informative post in future.

2:07 AM  
Blogger Amarjeet Prasad said...

This was a nice post and I think it is pretty easy to see from the other comments as well that this post is well written and useful. Keep up the good work.
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11:51 PM  

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