Wednesday, December 21, 2011

Ouch! That Hurts!

"TRIAGE Nurses sort emergency room patients according to the urgency of their condition, and            Blackbaud sees no reason hospital fund-raisers, for instance, shouldn’t behave similarly.."

That end  note appeared in a story by Ron Lieber in last Saturday's New York Times.The gist is that "Blackbaud helps hospital fund-raisers sniff out your net worth at the same time the doctors are evaluating your chest pain" and  they “take advantage of the captive audience by sending hospital admissions lists to the development office for a wealth screening within hours of when the patients are admitted. 


 As Lieber  points out this  not  illegal. There is a  lot  in the public domain. But there is a  lot not in the public domain and, one hopes, your health records, the reason you're  in the hospital, your illness and so on are among the items one cannot find  on a search engine - or through improper communication between a medical staff member and the development office. In my opinion the very fact that someone has been admitted to the hospital deserves a cloak of confidentiality. Why is  your face lift or my prostate any of the development office's business?

The federal government's Office for Civil Rights enforces the HIPAA Privacy Rule, which is supposed to protect the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety. 

We live  in a time in which friendship has been commoditized (Facebook etc.), trivialized (Twitter ) and privacy subjugated to smart phone content and "wealth engines." There's  not a lot left to steal.Which doesn't mean that we shouldn't try to redeem what's left.

Having been a consultant to many hospitals and health care systems I know the question of proper and ethical behavior with regard to patients' privacy is always of concern.The hospital grapevine functions more efficiently than the development office in most places so stuff  gets around.

I  know Blackbaud and their senior people. It is a remarkable company whose services I always recommend to clients with the simple remark that "they are the industry standard." There is  no doubt that their people are ethically committed to good corporate citizenship. For that reason I asked them to respond to this blog beofre I  posted it. Here's what, Marc Chardon, their CEO, wrote:

    "We agree that that the development office should not know a patient’s condition or other medical information -- that should be off limits. We and our customers support this by being active members of associations like AHP, AFP, and APRA, and following their codes of ethics.  First any information is scrubbed via HIPAA, and then whatever can be communicated legally is subject to one or more codes of ethics.

    "Information passing through this scrubbing can be used to identify potential donors, which are a growing source for healthcare funding. With insurance reimbursements declining, government funding decreasing, and patients without coverage increasing, hospitals rely more and more on fundraising to provide the standard of healthcare we all value.  

   "Sensitive fundraising practice can bring patients to welcome the opportunity to ‘pay it forward’ because they value the services that have been funded by previous donors"

A patient's right to privacy and confidentiality should always trump any institution's perception that there is  no privacy. 

 Only prospects.