Hep C investigation at Exeter puts HIPAA to the test

State requests broad access to thousands of patient records
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A hepatitis C outbreak originating at Exeter (N.H.) Hospital pits patient privacy against public health. The state Department of Health & Human Services is asking for broader access to Exeter Hospital's medical records in investigations. However, Exeter Hospital says doing so would violate Health Insurance Portability and Accountability Act (HIPAA) rules, Seacoast Online reported.

The hospital, which could lose its Medicare status for noncompliance, says it already has turned over information on 32 patients and is worried about sharing the thousands more requested, according to Scott O'Connell, an attorney for Nixon Peabody, which represents Exeter Hospital.

"They want us to set them up at a computer terminal and let them surf," O'Connell said. "We are the custodians of our patient records, and patients potentially involved have asked us to protect their information."

However, the state says it is a public health issue. Associate Attorney General Anne Edwards said the state is not asking to surf Exeter Hospital's entire record system, but it may need to look at a group of patients, such as those associated with the cardiac cath lab department.

"Exeter Hospital can't tell us how to investigate, who or even what to investigate," she said. "We are not required by law to inform them of the specifics of our investigation or for them to determine if we can take certain actions. We are not talking about releasing names publicly, but we do need to determine the scope of this case, which is an infectious disease investigation."

A superior court judge last week said the state may have a limited right to the records with some minimization of its request, according to another Seacoast Online article.

Assistant Attorney General Jeanne Herrick also suggested the hospital was tampering with the records, a claim that O'Connell called "outrageous."

Herrick said, "Exeter Hospital is a business, and there are good business reasons for them not to want any new patients (infected) or further investigation into this matter."

Meanwhile, the hospital failed to meet standards for the second time, according to a Centers for Medicare & Medicaid Services survey, NECN reported. Exeter Hospital can submit a corrective action plan and undergo a third survey. If it fails to pass the third survey, the hospital may lose its Medicare status by the year's end.

Exeter Hospital President and CEO Kevin Callahan responded in a statement, "We take quality and patient safety extremely seriously, and we will continue to make all necessary improvements to further improve the health system. Hospitals across the country and regulators who oversee them continue to learn from this tragic event that was created by an alleged criminal who circumvented some of the best systems and protocols at leading institutions across the nation."

For more information:
- here's the Seacoast Online article on the hearing and the article on HIPAA
- read the NECN report
- read the hospital statement (.pdf) on the CMS results and the conference remarks (.pdf)

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