UCLA Medical Center is taking steps to fire at least 13 employees and has suspended at least six others for snooping in the confidential medical records of pop star Britney Spears during her recent hospitalization in its psychiatric unit, a person familiar with the matter said Friday.
In addition, six physicians face discipline for peeking at her computerized records, the person said.
Questioned about the breaches, officials acknowledged that it was not the first time UCLA had disciplined workers for looking at Spears' records. Several were caught prying into records after Spears gave birth to her first son, Sean Preston, in September 2005 at Santa Monica-UCLA Medical Center and Orthopaedic Hospital, officials said. Some were fired.
"It's not only surprising, it's very frustrating and it's very disappointing," said Jeri Simpson, the Santa Monica hospital's director of human resources, who handled the discipline in the first instance.
"I feel like we do everything that we possibly can to ensure the privacy of our patients and I know we feel horrible that it happened again."
Simpson said UCLA treats celebrities "all the time and you never hear about this."
"I don't know what it is about this particular person, I don't know what it is about her," she added, referring to Spears.
Hoping to head off such problems, UCLA officials sent a memo the morning Spears was hospitalized Jan. 31, reminding employees that they were not allowed to peruse records unless directly caring for a patient. Spears, 26, was not specifically mentioned.
"Each member of our workforce, which includes our physicians, faculty, employees, volunteers and students, is responsible to ensure that medical information is only accessed as required for treatment, for facilitating payment of a claim or for supporting our healthcare operations," chief compliance and privacy officer Carole A. Klove wrote in an e-mail to all employees.
"Please remember that any unauthorized access by a workforce member will be subject to disciplinary action, which could include termination."
Such prying is also considered a violation of state and federal laws governing medical privacy. The laws allow for fines of up to $250,000, although such penalties are uncommon. Under different laws, separate fines are allowed if patients are receiving treatment for mental illness or substance abuse.
The state Department of Public Health said late Friday that it had opened an investigation of the hospital.
Klove declined to discuss specifics of the most recent incidents, citing privacy protections for patients and workers. But she did say the hospital began taking disciplinary actions immediately upon discovering each breach.
"Right from the minute she came in, audits were continually being done," she said. "We watch this all the time. We have people dedicated to looking at records to monitor access."
When employees look at a patient's records electronically, they leave an electronic trail. "We advise all of our workforce that their password is their PIN for lack of a better analogy, and it is their signature," Klove said. When it is used, the systems track which screens they view and for how long.
Those with access to clinical records include healthcare workers and others -- such as billing and admitting staffers -- who need such information to perform their jobs, she said. Housekeepers, for instance, would not have access.
Klove said that all workers must sign statements pledging to adhere to confidentiality rules when they are hired. The hospital is now considering having them sign such statements annually.
Most employees who looked up Spears' data during her most recent hospital stay were unable to review her psychiatric records. The neuropsychiatric hospital, in which Spears was a patient, has tight record security and blocks access to all but those with appropriate credentials.
Instead, what the disciplined employees found were non-psychiatric records from her previous treatment at UCLA, a source familiar with the matter said.
Medical and nonmedical employees are set to be disciplined, although no doctors were targeted for firing, the person said. There is no evidence that any employee leaked information to the media or sold it -- something that hospitals in a celebrity culture have reason to fear.
Nicole Moore, whose union represents three of the non-physician workers involved, said she is trying to determine whether the discipline was administered fairly. Workers are entitled to contest their proposed termination before it becomes final.
"We believe that the university has a responsibility to their patients but also their employees to administer fair and consistent discipline to everybody, regardless of their position, whether it's a doctor who violated it or a certified nursing assistant," said Moore, lead organizer for the American Federation of State, County and Municipal Employees, Local 3299 at UCLA.
Klove said doctors are overseen differently than other employees. By law, they report to a medical staff governing body, which has the authority to limit, suspend or revoke their practice privileges.
In January, Spears was admitted to UCLA under Section 5150 of California's Welfare and Institutions Code, which allows patients to be held against their will for up to 72 hours for evaluation if they are deemed a danger to themselves or others. Her hold was extended and she was released Feb. 6.
Snooping has landed hospital staffers in trouble around the country.
In October, Palisades Medical Center in New Jersey suspended more than two dozen employees without pay for accessing George Clooney's medical records after he was injured in a motorcycle accident.
Also last year, Tri-City Medical Center in Oceanside fired nine people, including nurses, secretaries and technicians, for attempting to take pictures of a patient and circulate images of an X-ray.
Cedars-Sinai Medical Center in Los Angeles, which has also treated Spears, said its electronic medical records of high-profile patients are flagged so that access is "highly restricted."
Even so, employees can be -- and have been -- terminated just for attempting to access those records. Hospital spokesman Richard Elbaum said three or four workers are terminated each year for trying to look at records of high-profile patients.
Lois Richardson of the California Hospital Assn. said hospitals do "everything they possibly can" to educate workers about patient confidentiality.
"People still gossip," she said. "They're nosy; they're curious. They want to be able to tell their friends, 'I saw Britney's records.' Their friends are asking. That's just how people are."
When discipline is imposed, maybe employees will think twice the next time, she said. "Maybe they won't peek as often."
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Instances in which hospital workers were disciplined for inappropriately looking at patients' records:
September 2004: Columbia Presbyterian Medical Center in New York suspended 17 workers for trying to access the medical records of former President Clinton, who had undergone heart surgery there.
July 2005: Kootenai Medical Center in Idaho disciplined four workers for looking at the medical records of an 8-year-old girl, Shasta Groene, who was admitted after she was found with a man who later pleaded guilty to murdering members of her family
September 2006: New York City Health and Hospitals Corp. said it would suspend 39 workers without pay for looking at the records of a 7-year-old girl whose death from beatings led to major changes in the city's child welfare system.
May 2007: Tri-City Medical Center in Oceanside fired nine workers and suspended another for attempting to take a photo of a patient in a psychiatric unit, looking at another patient's X-ray or failing to report the breaches.
July 2007: Park Nicollet Clinic in Minnesota said it had suspended more than 100 workers that year, mostly for looking into electronic records of relatives or friends.
October 2007: Palisades Medical Center in New Jersey suspended 27 workers for a month without pay for looking at the medical records of actor George Clooney, who was injured in a motorcycle accident.
March 2008: UCLA Medical Center takes steps to fire 13 workers and suspend six others for snooping in Britney Spears' medical records. Six doctors also face discipline.
Source: Times research