Intentional Privacy

A member of my family has recently been having some medical issues, and has been making the rounds of doctors and other medical practitioners. It is bad enough when someone doesn’t feel well, but what can make it worse? A medical professional being careless with our personal health information in spite of the medical privacy laws (HIPAA and HITECH). A visiting nurse called to make an appointment for a home visit, which turned into a SMS text dialogue. A question from the nurse left me speechless, “Have you received your {INSERT PRESCRIPTION BRAND NAME HERE} yet?”

Really? She really put part of the treatment plan in an unencrypted text message?

Text messaging by a medical professional should be limited to location and time of appointment.

I informed her that in my opinion putting a prescription name in an unencrypted text message was a violation of HIPAA, especially since the patient had never met the nurse or signed any HIPAA disclosures. She said she deleted the messages from her phone and gave me the name of her supervisor. I called the woman, who wasn’t available. I left a voice mail message, saying that I was concerned because putting treatment details in an unencrypted text message was a violation of HIPAA.

Strike two: A week later, no one from the nursing service has called me back.

I called the company that ordered the nursing service, explained what happened and asked that the service be cancelled. I took the patient to the doctor’s office—much less convenient—but a better option in this case. I was concerned that the nurse might be using a personal phone that did not have encryption on it, that she might have games installed (a common source of malware), that she did not use a pass code to lock her phone or that her phone did not automatically lock, or any of 100 different bad scenarios. What further concerned me is that I did not receive a call back from the nursing company. They are supposed to have a HIPAA Privacy Officer, who should have returned my call and explained what they were doing to protect the patient’s information in the future. At the very least, the nurse should have been required to re-take HIPAA Patient Privacy training (which is mandated to occur yearly anyway by the Office of Civil Rights).

Why is this such a big deal?

When you consider that your medical record is worth more to an identity thief than your credit card, it is a very big deal. A CNBC article published on March 11,2016, “Dark Web is fertile ground for stolen medical records,” stated:

While a Social Security number can be purchased on the dark Web for around $15, medical records fetch at least $60 per record because of that additional information, such as addresses, phone numbers and employment history. That in turn allows criminals to file fake tax returns.

Your credit card might be worth one or two dollars at most.

Another informative article, “Is Texting in Violation of HIPAA?,” appears in The HIPAA Journal.

If you feel that your medical privacy has been violated, you can file a complaint with the Office of Civil Rights.

I’m going to call the nursing service again on Monday and ask to speak with their HIPAA Privacy Officer and try to explain my concerns.

The Bottom Line: They lost a client!