Archive for November, 2010

Patient Privacy in the Age of "Social Media"

Thursday, November 11th, 2010

April 14, 2003 is when athletic healthcare entities had to be fully in compliance with  the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  There were a flood of news articles, press releases and discussion in the athletic healthcare community surrounding the impact of HIPAA on disclosure of athletic injuries.
Pre-HIPAA,  it was common practice for an athlete/patients' injury to be discussed openly during a contest, post-game press conference or newspaper article. It seemed there was no assumption of privacy when it related to an athlete's injury.  Every fan had a front-row seat and play-by-play updates on key players' injuries. Unlike the privacy accorded to their private patients, even seasoned physicians and other healthcare providers who worked within the athletic healthcare facilities of many campuses could be found discussing their athletic patient's condition(s) with folks who had no real need to know about an injury or illness.
Fast forward to 2010 and the use of social media. Now the healthcare privacy requirements are complicated with the proliferation of mobile phones that can also take photos and videos and post them to YouTube or any social media site.  Add to this the friend requests received from patients. The topic has even made USA Today.
This topic that has garnered discussion in other healthcare professions. An article in the Spring 2010 issue of the National Council of State Boards of Nursing newsletter Leader to Leader addressed the difficulty of boundary issues and the importance of educating nursing students about boundary violations and the internet.
Do you have policies in place to protect your patients? How have you been able to determine compliance with these policies?

Continuing Education

Tuesday, November 9th, 2010

Continuing Education (CE) is one topic on which  everyone has an opinion whether they are  Athletic Trainers (ATs), consumers or other healthcare providers.  Over 12,000 individuals provided comments  in a BOC survey in May of this year.  The results and comments helped inform the recommendations the BOC Standards Committee is presenting for final comment right now.

A theme throughout both surveys  is the high cost in terms of both time and money,  for obtaining continuing education. In the survey completed in May of this year there were many comments about the difficulty and cost of traveling to conferences, paying for hotel, transportation and the meeting registration itself.  This didn't surprise us, but attending conferences and meetings is just one of many ways a professional can obtain ongoing education.

Armstrong and Weidner published an article in the Journal of Athletic Training 2010;45(3):279–286 titled  "Formal and Informal Continuing Education Activities and Athletic Training Professional Practice." Their results closely matched the BOC's unscientific survey in May of this year. Informal activities are just as valuable as their formal counterpart. More often than not, they are also less expensive, both in terms of time and money.

The Spring 2010 Certification Update had a piece about CE activities and thinking outside of the box- finding CE opportunities close to home. What type of informal and formal activities do you engage in that may not be a part of the current BOC requirements?

Take the CE Requirements Part 2 survey before it closes on November 15, 2010.

Protecting Patient Privacy

Thursday, November 4th, 2010

I was scanning recent posts on a discussion thread and came across a post asking for suggestions about methods for reporting the status of injured high school athletes to physical education teachers, school nurses and coaches. Later in the post it asked if anyone used a "disabled list or a white board/chalk board.”

I was shocked. The first thing that came to mind was whatever method is used it must protect the patient’s rights under HIPAA, (the Health Insurance Portability and Accountability Act of 1996) and that can’t happen with a white board/chalk board! In addition someone pointed out that FERPA regulations (Family Educational Rights and Privacy Act) would pertain to student information. Protecting any patient’s confidentiality is a cornerstone for all healthcare professionals and it’s the law of the land.

To complicate things, in the secondary school environment you are dealing with minors. I’ve heard similar comments before and thankfully they are not common. Just because a patient is also an athlete, they do not give up their right to privacy or allow caregivers such as Athletic Trainers, school nurses, or coaches the option of breaking the law.

I can remember in the pre-HIPAA days when we had our patients sign-in for treatments and rehabilitation in a notebook that was out in the open for anyone to review. Those days are long gone. As it is stated on the HIPPA web site “At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes.” Implementation and education about patient confidentiality and HIPAA and FERPA is an ongoing and difficult job and it doesn’t come without push-back from those you work with. How have you implemented and educated those you work with?

Work-Life Balance: Part 2 Looking at Life from Both Sides

Tuesday, November 2nd, 2010

In a previous blog post, we asked if AT students see themselves as health care providers. The July issue of issue of the NATA News reported on the life of the Athletic Trainer in the College/University environment.  The goals of the survey they reported on were to answer three questions:

• What are the differences between collegiate settings in regards to salary, workload, position titles, job responsibilities, and other variables?
• Are collegiate Athletic Trainers overworked as commonly stated?
• Are collegiate Athletic Trainers generally dissatisfied with their jobs and lifestyle - so much so that they've considered leaving the profession?

807 Athletic Trainers representing all three NCAA, NAIA and Junior College/Community College levels responded.  The survey asked Athletic Trainer to rate, (similar to the question asked by the AT Student at the Ohio AT Meeting) how often they miss the following activities:

• Holidays
• Social
• Family

The summary of the report in the NATA News was interesting but as I read it I asked myself "what other health care profession establishes a staffing schedule for its professional staff in the way most collegiate athletic training programs do?" I assume most had a model of one AT per team - responsible to the team for all their activities, practices, games - home and away and off-season workouts.  The NATA provides guidance and benchmarks for appropriate staffing in two documents: Appropriate Medical Coverage for Intercollegiate Athletics (AMCIA) document and the Appropriate Medical  Care for Secondary School Athletes.

Some Athletic Trainers are using different staffing models; assigning athletic trainers to schedules, to specific venues or to shifts (such as 7:00am – 3:00pm) rather than to activities or teams. Some have moved their clinics to student health services. How is that working? What ideas can you share that can enhance both patient and athletic trainer safety?
“When you change the way you look at things, the things you look at change.” – Wayne Dyer