HIPA and Appointments

Question: Are we allowed to speak with anyone but the patient regarding patient appointments? For example, can we leave reminders with a patient's family?

Answer: The Privacy Rule states that you are allowed to speak to the patient directly or to other healthcare professionals about billing and care-related issues. If your patient is present and alert, ask him if you can talk to his family. If he agrees or doesn't object, you can. If your patient is not able to agree - in an emergency, for example - exercise professional judgment and determine whether disclosure is in the best interest of the patient. If so, disclose only information that is directly relevant. The Privacy Rule grants you authority to "make reasonable inferences of the individual's best interest in allowing a person to act on behalf of the individual (patient) to pick up filled prescriptions, medical supplies, X-rays, or other similar forms of protected health information."

Regarding appointment reminders, the Office for Civil Rights' Privacy Guidance explicitly states that covered entities can "communicate with their patients at their homes, whether through the mail or by phone or in some other manner. In addition, the Rule does not prohibit covered entities from leaving messages on answering machines ... A covered entity may also leave a message with a family member or other person who answers the phone when the patient is not at home."

That said, you should notify the patient in your Notice of Privacy Practices that they will be contacted with reminders. Make every effort (and have a policy) to comply with patient requests concerning calling only at home, not at work, or mailing to a P.O. box rather than a home address. Also do whatever you can to further safeguard privacy.

For example, the message you leave with another party should contain only the minimum information; leave a provider name instead of the clinic name, since this will eliminate the release of potential diagnostic information. Here is a sample message: "This message is for Jane Doe. You have an appointment with Dr. Jones on Tuesday at 2 p.m." Similarly, consider slipping postcard reminders into an envelope or using a format that allows you to at least fold and seal the reminder.