A 40-year-old woman comes to the office due to new-onset genital lesions. On examination, she is found to have several genital warts in her vaginal area. Testing for sexually transmitted infections is otherwise negative. The patient admits to having a brief extramarital affair while traveling for business. The following week, the physician receives a phone call from the patient's husband, who is not a patient in the practice. He knows his wife was recently seen and would like information regarding her health as he is concerned about his physical symptoms. Which of the following would be the most appropriate response by the physician?

Question

A 40-year-old woman comes to the office due to new-onset genital lesions.  On examination, she is found to have several genital warts in her vaginal area.  Testing for sexually transmitted infections is otherwise negative.  The patient admits to having a brief extramarital affair while traveling for business.  The following week, the physician receives a phone call from the patient's husband, who is not a patient in the practice.  He knows his wife was recently seen and would like information regarding her health as he is concerned about his physical symptoms.  Which of the following would be the most appropriate response by the physician?

Quizplus · Accepted Answer

The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule provides instructions on management of protected health information (PHI). The main goal of HIPAA is protection of patient privacy and confidentiality. A physician can respond to a family member's request for information only if the patient has specifically provided verbal or written authorization for release of information to the family member. Due to public health concerns, notifiable infections (eg, HIV, chlamydia, tuberculosis) are an exception to the Privacy Rule and should be reported to the Centers for Disease Control and Prevention (CDC); many states offer partner notification services by local health departments (rather than individual clinicians) to protect patient privacy. However, human papillomavirus infection (eg, genital warts) is not a notifiable infection, and PHI disclosure without patient consent (eg, partner notification) would be a violation of HIPAA. (Choice A) Asking the husband to put his wife on the phone to obtain a verbal release of information may inappropriately pressure the patient to consent to disclosure of her personal health information. The patient should be approached privately regarding release of information, which preferably should be obtained in writing. (Choice B) Requesting proof of the caller's identity is irrelevant as information cannot be released without the patient's authorization. Although HIPAA does not require proof of identity to respond to callers, providers may establish their own rules for verifying identity. (Choice D) Asking whether the patient's wife is aware that he is calling does not address the issue at hand, which is the requirement for a release of information prior to disclosure of medical information. (Choice E) It would be inappropriate for the physician to ask the patient's husband about his physical symptoms as they do not have a patient-doctor relationship at this time. Furthermore, discussing these symptoms may inadvertently violate the patient's confidentiality. Recommending that the husband seek medical evaluation for his symptoms would be reasonable. Educational objective: The Health Insurance Portability and Accountability Act protects health information by requiring verbal or written authorization for release of information. Family members who contact the physician for information about their relative should not be given any information about the patient without the patient's consent. __________ References: Sexually transmitted disease: a private matter? (http://www.ncbi.nlm.nih.gov/pubmed/12387448)

A 40-Year-Old Woman Comes to the Office Due to New-Onset