Iowa hospitals have spent millions of dollars to comply with new federal privacy laws, but patients say the expense is worthwhile.
Changes, too, in the amount of information hospitals now release about patients has also triggered some inventive ways to communicate with clergy, law enforcement and relatives, privacy officers say.
Federal regulations that went into effect April 14 curtailed the amount of patient medical information hospitals, clinics, insurers and pharmacies can release.
To meet criteria set out in the Health Insurance Portability and Accountability Act of 1996, or HIPPA, Iowa hospitals big and small have trained thousands of staff, changed policies, redesigned admission desks and bought new software to maximize patient privacy.
In practice, patients are now informed how their records will be used and their rights under the act. No longer can hospital employees provide information to media _ or relatives _ without consent. The new rules also require permission before providing information to marketing companies. There are tighter restrictions on maintaining files, submitting bills to insurance companies and each hospital has an officer assigned to investigate breaches in policy.
Generally, hospital officials say the new regulations have been embraced by doctors and nurses, patients and their families.
"Overall we're finding that people, both patients and staff, like it," said Tina Sander, privacy officer at Waverly Municipal Hospital. "We haven't had any complaints from patients. It is a little bit more protection for them."
It's also been a little more burdensome on hospital budgets.
Just the cost of providing paid work time training to more than 8,000 workers at the University of Iowa Hospital and Clinics is estimated to exceed $1 million, said Debbie Thoman, compliance officer.
Sander said the Waverly hospital spent more than $200,000 on training, planning and other costs linked to implementing the new rules.
The result at some facilities could be slightly higher medical bills or insurance premiums, officials said.
"Everything you do that adds more regulations is going to raise the cost of care," said Patty Armstrong, privacy officer at Iowa Health Des Moines, which began training staff of more than 8,000 more than three years ago.
But there are also changes yet to come that Armstrong predicts will save hospitals money. In the next year, hospitals will switch to an electronic billing system with insurance companies.
The system will standardize billing forms, reduce paper costs and use encryption software to improve medical record privacy, Armstrong said.
But the security restrictions have frustrated some professionals who once relied on freer access to patient information.
When patients have not signed a release, no information is released, not even the patient's name. There are exceptions for police investigations or cases when life is at risk.
The hardest hit may be members of the clergy. In the past, some hospitals had long-standing policies to grant pastors, rabbis and priests restricted access to patient directories to help coordinate ministerial and spiritual services. Not any more, compliance officers say.
"In general it's caused a lot of concern among clergy," said F. Larry Shostrum, coordinator of spiritual services for the University of Iowa Hospital and Clinics. "They understand why it's being done this way now, but it sure is an inconvenience."
To help clergy, some hospitals are working within the rules to improve communication to church officials.