Friday, April 21, 2017

Organ Procurement Organizations with Regard to HIPAA Week #6 Blog

This blog is going to contain much more of my opinion than previous blog posts. I was looking for something to write about, and came across a story about HIPAA with regards to Organ Procurement Organizations (OPO). (Healthitsecurity). An ex-employee, Patrick McHahon, claimed that the New York Organ Donor Network, Inc. had removed patient organs before the patients were clinically dead. He claimed he was fired because he "blew the whistle". The company claimed he was fired due to poor performance. Part of Mr. McMahon's evidence he claimed were evident in the patient's case files which showed the patients were still alive. He was requesting the release of the records to prove his case to which the OPO stated due to confidentiality they could not release the records. They also stated that though the organizations are not covered by HIPAA, they need to maintain the patients' confidentiality since they signed memorandums of understanding (MUO) with the hospitals so they can retrieve pertinent information to help the organ donor process. If they released the records "it would defeat the purpose of HIPAA if it were required to comply with plaintiff's request" (McHahon V. New York Organ Donor Network, Inc. 2016). In this case the plaintiff won the case with the court stating that since it is not a HIPAA covered entity it must turn over the records.

This led to me thinking as to why they are not HIPAA protected. First, how can a hospital release records to an entity not covered under HIPAA? This is a little easier to understand. In order for an organ donor group to do its job, it needs vital information about a patient to make sure that the organ goes into a viable recipient. Having to wait for an authorization from a family member would waste valuable time since some organs are only vital for so long. This part makes sense and I completely agree with this. I think this is why you annotate you are on organ donor on your ID. This lets hospitals know they already have your approval.

So why aren't organ donors covered under HIPAA then? This isn't covered too well. From what I have read basically it comes down with the need for them to know the information to do their job. They can also share information with the donor family such as the age, health, gender, and sex of the recipient. With HIPAA they might not be able to provide that information to the donor. This can help the donors feel a little better knowing general info about who is being helped. It could also cause issues though if the OPO started discussing non health pertinent information as it may make the family more reluctant to donate if the recipient were a different religion for example. This is where I am conflicted myself. For myself, I am an organ donor, so I authorize anyone to use my organs. However, someone who may have to decide for another family member may feel reassured it is going to someone who needs it. By making an OPO a protected entity they could not give that information without the recipient family's allowance which may make the family doing the donation more reluctant to donate. Also by having to wait for the recipient's approval you are adding more delay to the process. For example, if the recipient has to say yes then the information is provided to the donor, who then says no, valuable time was just wasted.

With all that being said I agree with the court's ruling that the medical records should be allowed. A health care provider may use or disclose information if and as required by law (42 CFR § 482.45). I believe in a matter of law no information should be kept private, if it is strictly used for purpose of the case and only parts that are required. I.e. in this case only the pertinent info at the time of the patient's death.

References:

Condition of Participation: Organ, Tissue, and Eye Procurement. (2013). 42 CFR § 482.45.
Health IT Security (2017). Judge Says HIPAA Regulations Do Not Apply in Organ Donor Case. Retrieved from: http://healthitsecurity.com/news/judge-says-hipaa-regulations-do-not-apply-in-organ-donor-case
McMahon v. New York Organ Donor Network, Inc. (2016). New York Supreme Court Op 32707. Retrieved from: http://nycourts.gov/reporter/pdfs/2016/2016_32707.pdf



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