New Privacy Rules to Be Loosened


The federal government will ease its strict new medical privacy rules so pharmacists can keep filling prescriptions by phone and doctors can talk to family members in hospital waiting rooms without fear of violating a patient's rights.

"This will bring common sense and clear up any misconceptions that are out there," said Bill Pierce, a spokesman for the Department of Health and Human Services. He spoke Friday after new privacy guidelines were posted on the department's Web site ("Spotlight on Medical Privacy Guidelines;" http://

The privacy standard was issued in April. Health plans, doctors' offices, hospitals and insurance companies must comply with the rule by April 2003.

It is designed to safeguard patient information in a computerized world where data move instantly. A cornerstone of the policy provides that information cannot be disclosed without written consent from a patient.

But health providers and insurers complained to HHS that essential, routine activities could be jeopardized by a strict interpretation of the rule requiring patients to sign forms in advance giving permission to disclose information about their health, medications and hospitalizations. "Health plans and others made a very big deal out of this," Pierce said.

The 33-page document posted by HHS said the department "and most parties agree that privacy protections must not interfere with a patient's access to or the quality of health care delivery."

The question-and-answer format provided examples of where HHS expects to make changes in the privacy rule:

* A druggist will be allowed to fill a prescription telephoned in by a doctor without getting the patient's written consent.

* Common practices, such as using sign-up sheets in medical offices and keeping patient medical records at bedside, will still be permissible.

* Doctors and nurses will be "free to engage in whatever communications are required for quick, effective, high quality health care." That means talks with family members and discussions with other doctors will not be considered violations of privacy. Nor will calling out a patient's name in a waiting area be considered a violation.

HHS offered examples of privacy adjustments that could be considered reasonable under the new rule. Drugstore customers waiting in line could be asked to "stand a few feet back from a counter used for patient counseling."

Curtains or screens could be added to areas where "oral communications often occur between doctors and patients or among professionals treating the patient," HHS said.

In clinics or other facilities where there are many patients and doctors talking and working, privacy can be supplied through "cubicles, dividers, shields or similar barriers," according to HHS.

The reception or intake area at a clinic "may reasonably use cubicles or shield-type dividers rather than separate rooms," the guidance document said.

The information posted Friday is designed to allay fears that the government's enforcement of privacy protections will interfere with the reasonable activities of the health care system, Pierce said. "Hospitals won't have to have all private rooms, and you are going to be able to pick up a prescription for your wife or sister or daughter or neighbor," he said.

Friday's document, HHS said, "is only the first of several technical assistance materials that we will issue to provide clarification and help covered entities implement the rule."

The single federal privacy standard is needed to replace a patchwork of laws covering the movement of personal information, HHS said. "Personal health information can be distributed--without either notice or consent--for reasons that have nothing to do with a patient's medical treatment or health care reimbursement," it noted.

A health plan's information about an individual, HHS said, "may be passed on to a lender who may then deny the patient's application for a home mortgage or a credit card--or to an employer who may use it in personnel decisions."

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