HIPAA and blogging

Along with my slightly revised design and new about page, I thought it would be a good idea to revisit my anxiety over this blog--especially that associated with HIPAA regulations, which could get me thrown out from school or de-licensed. The blog Clinical Cases and Images has a good post that lays out the 18 patient identifiers that a doctor must remove from a case report in order to be in HIPAA compliance. I would assume that these apply to nursing as well.

Most of the 18 identifiers are no-brainers (like a patient's name) or wouldn't normally apply to a nurse wanting to blog (like a medical device serial number). However, two gave me pause: you can't say a patient's age if the patient is over the age of 89; and you can't mention a geographical subdivision smaller than a State.

The first of these makes sense to me--there are so few people over the age of 89 that I suppose it would really be quite simple to sift through those patients and identify someone from a description of their medical condition. The second of these really doesn't make sense, though, unless it applies only to a patient's personal addresses. Consider for a moment that you are a doctor who is writing a case report. If you have to obscure the location of the patient's treatment, how hard is it to find out where a doctor has a practiced? In fact, articles usually mention an author's institutional affiliation right at the top of the page. This rule would be so constricting as to make case reporting impossible in many situations. Therefore, I have to assume that the rule only applies to a patient's personal home or business addresses.

There is a third identifier, which is dates specific to the patient, that I am a little leary of as well. Say you have a clinical rotation and come home and blog about it. You haven't mentioned a specific admission or discharge date, but does a "date during a period of care" count? I choose to think not.

Anyhow, be careful, student nurse bloggers, for there are overzealous instructors around every corner, and you have no power!

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