Home Forums Discussions Problems Lab interface confidentiality issues

Hello everybody.
I just realized (maybe too late) that lab interface allows any lab "to see" every patient. I am contracted with LabCor and Quest. Everything was working well. Then I signed with Spectrum and they installed their software too. So I am waiting to be trained on lab input etc, and then I am getting a phone call today from their IT people. They are concerned that "they are not getting updated demographics on my patients in the last few days" and want to go in remotely and "fix it". I said I have not sent any labs to you yet and that is when they told me they are getting info on all of my patients regardless of my use of Spectrum. Turns out LabCor and Quest are doing the same. I talked to AC support and person told me that is how AC interface works. Is there a liability issue? Why does Quest need to know about Spectrum patient and vice versa? What do you think? I am actually planning to call my malpractice risk management people.

doesn't seem right to me either that a lab would need all patient demographic data. I thought it was need to know basis.

Welcome to HIPAA 2010! Anyone who expects to be paid for patient services has full access to patient info, without prior patient authorization. HIPAA privacy regulations do not require you to obtain patients? consent to use their PHI for routine disclosures, such as those related to treatment, payment or health care operations (TPO).

You should have a Business Agreement with them that requires them to keep confidential all information they may get from you.

It probably has something about only using the information for appropriate patient care.

Thus, if they were going through your data to figure out which lab you used the most, that would be outside of the scope of patient care and should be a violation.

I need to review the business agreements I have signed in the past. I usually do not pay a great deal of attention to them, other than to skim them for agregious variations in terms.

I think the way the interfaces work is that to import the patient's results into your EMR, they need to see your database to find the matching patient. I suppose the question is what data the lab can extract and use? As Wendell says, the answer should basically be "none" but that may not be the case. This is definitely one for the lawyers...
Of course if we were using a "cloud" EMR (Athena, Practice Fusion) we would have even less ability to determine who accesses our patient data.

Now that our maintenance costs are raising to $1000 per year, does that mean that our Lab interfaces will automatically be working? I don't know about you guys but QUEST and other labs are refusing to pay for an interface if we do not conduct a "worthy" amount of business with them.

According to the MEANINGFUL use criteria, this information must be freely flowing. Has anyone looked into this?

Dr. Perry S.

I send almost all my labs to PAML and they did not bat an eye at paying for this interface, but I can see if I lived in the big city and my pt. chose different ones how that would be an issue. Unfortunately I cannot imagine an EMR not charging someone for the interface since they had to develop and support it - as things tend to change with time.

I do wish I could afford all the interfaces but $500 for a lab which only rarely sends me data. I don't think Meaningful Use can expect us to interface all labs.

Quest and Labcorp didnt bat an eye when I asked for them to pay the fee. Its a one-time $250---much much less than with other EMRs, which is why they didnt mind. Sounds like a change in mgmt. Also, they have been losing business to small, regional labs. I use one for uninsured patients. I want to send them more, but they wanted me to guarentee a certain amount of business. Frankly, at a onetime $250 fee, thats just the cost of them getting into your stadium. Other emrs are much more expensive and its an annual, not one-time, fee.

Quest has consistently refused to pay the fee. I am at the point where I'd like to send a letter to all my patients asking them to use Labcorp, since they paid for their interface.

Some insurance companies leave little choice, but when I have the choice....Labcorp was helpful and Quest was not, so guess who I use.

Ironically Quest paid for our interface and labcorp did not(and still has not), they need to justify their cost by verifying the amount of volume an our office produces for them($) in other words they do not want to waste their money($). Typical healthcare bureaucracy...

So as it stands now we only get quest results but not labcorp