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AIS's Health Business Daily
Featured Story August 7, 2008 Hospitals See Attention to Patient Privacy as Competitive Advantage; Breaches Can Harm Patient Satisfaction Reprinted from REPORT ON PATIENT PRIVACY, the industry's most practical source of news on HIPAA patient privacy provisions. Consumers naturally assume that their banks will not reveal secret passwords and account information to any ole Joe who walks in the door. Likewise, they have come to expect that hospitals will protect their health records from prying eyes. And ensuring privacy is an important factor on the minds of compliance officers and others aiming to boost patient satisfaction — a key goal in the increasingly competitive hospital marketplace. Some hospitals, in fact, closely track patents' opinions of privacy in an effort to monitor and improve the quality of their facilities. And one hospital sees its intense focus on privacy as giving it a competitive advantage. Patient privacy — including privacy that falls outside of HIPAA-regulated protected health information (PHI) and electronic medical records — has a direct impact on how hospital patients perceive their visits, says one expert. "In a general sense, we've always known that privacy improves satisfaction, to the extent that patients in shared rooms always had lower satisfaction than patients in private rooms," says Dennis Kaldenberg, Ph.D., senior vice president of research, knowledge management and strategic planning at Press Ganey Associates, an independent research firm that measures patient satisfaction in various health care settings. "The patients like to be in a setting where they feel like there's no one else listening to the details of their condition," he tells RPP. "They like to be in a place where their family can be with them in private, without other people overhearing." Recognizing how such situations affect satisfaction, most hospitals with the means moved to private rooms a long time ago, Kaldenberg says. But other situations remain ripe for compromising privacy, he adds. Most notably, these include conversations that health care providers (i.e., physicians, nurses or lab technicians) have about their patients in public places such as elevators or hallways. "They may not realize there may be other ears in the room or hall that are picking up on that information," he says, adding that such conversations are a very common occurrence. These overheard conversations can stoke unease in a patient and ultimately lower their satisfaction. "If they're talking about someone, are they talking about me, and who might hear it?" is the typical response that a patient might have when eavesdropping, Kaldenberg says. "Any conversation about a patient is best made not in a public space, but in a space where only the care providers can hear one another." But when it comes to safeguarding medical records, most patients take for granted that the hospital is keeping their records private, Kaldenberg asserts. "The guarantees that are now promised in the documents that they have to sign at the beginning of their care probably are viewed as a confirmation of something they had expected to have happened already," he adds. To be sure, recent news stories about breaches of celebrities' PHI, such as actor George Clooney and singer Britney Spears, have raised concerns among patients. This is especially true because medical records are now frequently stored electronically, making them easier to access than paper records, Kaldenberg says. "But I don't know if there is any more concern in health care than there would be in dealing with your bank or the places that share your credit card numbers as you buy things off of the Internet." Focus on Privacy Improves Satisfaction One hospital sees its focus on privacy as a top organizational priority and a key factor in generating patient satisfaction. Children's Health System in Birmingham, Ala., conducts random surveys of families to gather a "patient privacy satisfaction score," says Kathleen Street, privacy officer and risk manager at the hospital. The survey, which has been in place for a decade, also queries patients' satisfaction levels on such things as patient care, staff courtesy and facility cleanliness, she adds. Satisfaction around privacy improved "quite significantly" following implementation of HIPAA in 1996, Street tells RPP. "For several years in a row since implementation of HIPAA privacy guidelines, patient privacy was one of our top statistics as far as a percentage of satisfaction — along with patient safety and customer service," she says. The definition of "privacy" at Children's Health System includes whether computer programs are logged out after each use, and confidential information is shredded when appropriate, Street explains. It also includes whether patients were examined privately, and how well the medical staff, nurses and clinicians protected that information. "All of those factors weigh into parents' levels of satisfaction," she says, noting that these parents also are becoming more privacy savvy. "Most recently, we have found that more and more parents are wanting to have an audit trail of who has accessed their records," Street adds. This development could stem from consumers' growing awareness of how to manage electronic information from their own home computers. "They realize that they can have different access controls on their computers, so that they want to ensure that we have appropriate access controls on ours," she says. Privacy is but one factor that affects patient satisfaction. Kaldenberg points out that the relationship between the patient and provider is still the most important factor for a patient in a health care setting. But this relationship also centers on privacy, he adds. "When we think about relationships, you want to believe that the people you're interacting with treat you with some level of respect, and that level of respect is based in part on whether they talk about you or keep your information private, or whether in some sense, keep secrets," he says. Patient privacy
is one of the central factors, along with patient safety and quality
of services, that Children's Health System uses in its measurement of
"pediatric excellence," says Street. She also views the hospital's
focus on privacy as providing a competitive advantage, especially as
it builds a new facility that will use only electronic health records.
"We want to be a facility where parents say, 'We know that our
child's privacy is going to be respected here.'"
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