HIPAA Question
I was visiting with an esthetician educator earlier this week, and we were discussing client intake and health history forms, and how essential they are for client safety. She said she recently heard that under HIPAA, clients do not need to list certain medications they may be taking as it violates their privacy, even though the Privacy Rule is supposed to permit disclosure of personal health information needed for patient care and other important purposes. I haven't had a chance to research this yet, but wondered if any other estheticians had heard anything about clients NOT having to tell them what medications they are on. Thanks!
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Replies to This Discussion
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Permalink Reply by Beth on
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As a patient or client you absolutely have the right to refuse disclosure and care if you so choose. That is your right period. However, you can consult with your client about whatever treatment you are doing and go over contraindications of certain medications. If they then sign something and omit use or don't disclose the meds then it isn't your liability...they signed it. Have it in writing that if all pertinent medications and treatments aren't specified that your are not liable for adverse reactions. Always CYA!
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Permalink Reply by ASCP on
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Thank you for your response and the good advice. I wonder sometimes if clients just aren't aware how serious some product reactions can be if the medication they are taking is contraindicated. I like your idea of putting on the intake form that if they choose not to disclose what medication they take, you're not liable for adverse outcomes.
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Permalink Reply by James Mason on
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I don't think HIPAA addresses this directly. The purpose of HIPAA is to tell you what YOU, as a licensed professional or other person who may run across Personal Health Information, are supposed to behave, and how you're supposed to deal with the info. It doesn't relieve the client of any responsibility to disclose important information; in fact, the idea is to GET them to release all relevant information so that they can make informed decisions, and that people "treating" them (in whatever context), can have the information they would need to best undertake that treatment. Failing to disclose is a problem, both for YOU and also for your client. This was really bad advice, and I urge you not to follow it.
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I don't know if you were directing the last comment towards me or not? The point of any consent form is to first inform the client of what will take place and possible outcomes both positive and negative. I don't feel like adding the use of oral and topical medications can alter your results would be out of line on a form. Stating use of retinoids and waxing is already there, so I think we should just be more clear. The general public doesn't understand that some medications can affect skincare treatments negatively. However, it is important to inform them of this before the treatment and give them any opportunity to list medications. However, I guess my main point was that yes it would be optimal for them to disclose all pertinent information, but it is their right not too. If you feel they aren't being honest and upfront or they refuse then you too can refuse the service. I am not advocating doing a treatment on someone by just having them sign a waiver. I think it is our role to inform them of all potential outcomes.
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Permalink Reply by Karen Hurley on
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Jesse: I think your best option is to make sure you making decisions within your scope of practice and be sure to use intake forms designed by industry professionals. As estheticians, we are limited on how we correlate Rx or OTC meds to our treatments. I find the best designed intake forms don't ask for meds specifically, but categories of meds, such as antihistamines, hormone therapy, etc. that may affect immediate treatment or home care use.
As far as HIPAA privacy rules, the patient controls what they provide to you, the rules keep you from disclosing it to other sources by managing internal processes and external ones. A copy of HIPAA privacy rules is easily obtained by Googling on the Internet.
Our esthetician laws keep you from using information in a way that's outside of your scope of practice. So, it's probably best to go back to your school textbook and see what advice is provided there in regards to medication, which would be an industry standard. Better yet, getting your hands on the newest version is probably best.
Good luck,
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yes, being a nurse injector as well, I have to ask on my forms if they take fish oil, asa, st, john's wort, etc, as many cause bleeding.... flax seed, so many. if they won't list anything, i will always assume they are taking something. just like when people go into surgery............ very important.
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Permalink Reply by Lauren Snow, ASCP on
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I'm not a lawyer, but I would think that if a client comes to you and does not disclose particular medications they are on by their choice- not by your intake form negligence, you would not be liable for any sort of violation of HIPAA. HIPAA is to protect patients. It is a privacy act that the medical profession must obide by. They must protect our information and records.
It sounds like her client is confused, as there is no privacy violation by asking about medications. It would be a violation if I called her doctor and her doctor told me what meds she was on- but it is a concern that she is not willing to share what medication she is on. There are many medications that cause sun-sensitivity that is important for an esthetician to know about. Not to mention other countless medications that could allow the esthetician to properly care for the client's skin without causing harm or a law suit.
If I had a client that refused to offer this important information, I would not continue to see her. However, you could always warn of contraindications verbally and by signed written statements if she chose to keep her as a client- maybe she would be more forth coming or have the courage to say no to a treatment.
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I agree with you, Lauren, that HIPAA should actually encourage the client to disclose everything because its purpose is to protect the client's privacy. I also agree that if a client refuses to tell you this important information, you might question whether you should continue to treat them. There are some unethical people out there just looking for a reason to sue, and this may just give them an avenue to try to do so. Thanks for the great posts, everyone!
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They don't have to tell you, however I do warn my client in regards to complications that can arise. Then they seem to come forward..............so far it works.................... Same as in hospital setting, when I was administrator, I always informed my nurses that in pre-op with them and anesthesia, they took meds. be it illegal or not!
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Let me clarify my position. When I talked about it being bad advice, I meant the suggestion that we allow our clients NOT to list their meds. No, we can't force them to disclose, but we should make sure we explain that HIPAA is designed to PROTECT their Private Health Information. I didn't suggest that everyone flock to their google-o-meter because I didn't think it was necessary to tell licensed professionals how to search for information on something they needed to know at this late date (I'm writing in 2012).
I ran this by one of my trusted beagles and he absolutely assures me that failing to properly explain HIPAA, or NOT pursuing needed medical information MIGHT NOT be enough to protect one from a lawsuit (actually, anyone can file a lawsuit for darn near anything; whether or not they prevail is the issue). So you COULD be liable for their not disclosing if you don't make a point of asking for full disclosure. I am in full agreement with the idea of not continuing to see someone who doesn't want to give their medical information. Excuse me, Private Health Information. BTW, you don't need to necessarily explain HIPAA point for point, and there is suggested language all over the web for how to present this information, but the idea that we can blithely accept that our clients aren't disclosing pertinent health information, and do nothing about it is wrong, dangerous, and could cost us, both professionally and financially.
Finally, I agree with the idea of perhaps asking about "categories" if a specific agent isn't a particular concern. It's important also to remember that we're not physicians, so we want to be sure that we're not representing that we know anything about pharmaceuticals and all of their various issues. . .just that there are things that are contraindications, and areas where caution is warranted. I think we're all better-served when we proceed with modesty and caution, staying within our scope of practice, and insuring as well as we can that we're watching out for client health and safety.
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