EMS providers are patient advocates and voices for the sick, injured, and sometimes, even the deceased. During such events as the unfortunate mass shooting at the movie theater in Aurora, Colo., providers are often tasked with ensuring family members and relief agencies know about the status of the victims. Thankfully, Health Insurance Portability and Accountability Act (HIPAA) makes the sharing of critical patient information a little easier during a mass casualty incident (MCI).
Disaster Relief Entities: HIPAA allows EMS providers to share information about a patient’s location, general condition or death with an agency that’s authorized to assist in disaster relief efforts. This information can be shared with the disaster relief agency for the purposes of notifying a family member, a personal representative of the patient or another person responsible for the patient’s care. So EMS providers can release patient information to such entities as the Red Cross, a state emergency management agency or another similar type of entity to enable that organization to contact someone who’s responsible for the patient’s care.
Family Members and Friends: HIPAA also permits EMS providers to disclose information about a patient’s location, general condition or death to a patient’s family member, relative, close personal friend or any other person who might be involved in the patient’s care. Bystanders, however, are a different story. Even if a bystander is truly concerned about a patient’s welfare, or may have even assisted the patient before you arrived on the scene, you may not share patient information with them, unless the patient agrees.
There are two rules that you must follow when providing patient information to relief agencies or family and friends:
1. If the patient is competent and able to make healthcare decisions, you should first obtain the individual’s agreement to share the information, or at least give him/her an opportunity to object. The patient’s verbal agreement is enough. You can also infer from the circumstances that the patient doesn’t object to you sharing the information. For example, if you ask the patient if there’s anyone you can contact and they say “my spouse,” you can infer that the patient is OK with giving information to the spouse.
2. If the patient is incapacitated, which is often the case in MCIs, then providers can disclose patient information if they believe that disclosure is in the best interests of the patient. HIPAA permits providers to use their best judgment here in gauging how much information they should share. Just remember to keep the patient’s best interests in mind and to not disclose more than the patient’s location, general condition or death.
Finally, there’s always the concern about others overhearing discussions between two crew members or radio transmissions. But these types of inevitable disclosures are called “incidental disclosures” under HIPAA and generally don’t pose a HIPAA violation. In addition, if it’s necessary to ask a bystander, police officer, news reporter or other non-medical person to assist you in treating, moving or transporting a patient in a mass casualty situation, you may do so. HIPAA always permits you to share patient information for treatment-related purposes with any party who’s also involved in the treatment of the patient. And it isn’t a HIPAA violation to transport multiple patients in an ambulance or other vehicle. Sometimes, an emergency simply overwhelms the available resources, and HIPAA recognizes that incidental disclosures will occur.
All of us at Page, Wolfberg & Wirth would like to express our deepest sympathy for the victims and everyone affected by the tragedy in Aurora, Colorado. We also express utmost gratitude to all of the responders who answered the call on that fateful morning, and those across the U.S. who continue to answer that call every day. We’re honored to represent an industry that’s solely committed to the care of others in need.
The authors are all attorneys with Page, Wolfberg & Wirth, a national EMS law firm. Visit the firm’s website at www.pwwemslaw.com for more information on a variety of EMS law issues.