I am a registered X-ray Technologist just recent terminated from employment based on the following.

An audit report was ran on our patient x-rays. In review of the x-rays, the supervisor noted that these exams had been view by myself; a registered x-ray tech, not all the films were imaged by byself. Some were imaged by fellow x-ray techs, but within our department (modality).

Human Resources is stating that this is a violation of HIPAA, as I did not have direct contact with this patient and did not have reason to acces the images/report. However, our department staff have always view images associated with other techs.

None of the images viewed were copied, printed or have any relationship to me on a personal basis, or discussed with any employee outside of the hospital. Only to view for learning / educational purposes.

Sorry to tell you this, but this is indeed a HIPAA violation. If you did not have direct contact with the patient you had no right viewing the films. Whether other people do or not isn't the point. The point is that whoever views films not associated with their patient is violating HIPAA.

As an x-ray tech are you responsible for interpreting x-rays? Were you asked to view the films as a consult? If not, J_9 is right.

X-ray techs do not interpret Scott, a licensed radiologist does.

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Originally Posted by J_9

X-ray techs do not interpret Scott, a licensed radiologist does.

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That's what I thought. Just making sure.

So why do you as a TECH view them ? What in doing your job required you to view them.

Next if this is common, did the other TECH's do this and are they being fired also ?

Our Radiologist (Rpa) will sometimes submit a QA on a view, Quality Action notice that indicates something was improperly done. So, for learning or educational purposes viewing to see what the Quality is. Some of these QA's may or may not be your films, and may belong to another technologist.

Other films that have been viewed, that did not have a QA, were films of interest, such a film that you may think had a fracture, something of interest to view for learning. This is not related to the patient "name", but the image and outcome of the image.

And yes, other techs have viewed images and were not fired. In addition, x-ray tech have also shared there images with other techs "saying... you should see this fracture or see this tumor, mass.

Unfortunately, it is still a HIPAA violation. I work in labor and delivery and frequently we review the electronic strips of fetal heart tones and contraction patterns. However, we must be treating the patient in order to sign on and review them. If we are not treating nurses it is a HIPAA violation. We had a similar issue in our department that you are having now.

If it is not a QA, and you are not the treating tech but your electronic signature is captured, you are in violation of HIPAA.

So your defense is that you were assigned to view these films as a training exercise. Do you have proof of that?

As I understand it there are films that are used for a peer review and others that are not but the techs tend to look at the films that are not considered for peer review, kind of like rubbernecking at an accident scene... "wow! would you look at the size of that tumor!" sort of thing.

If the films viewed were not for peer review/QA, then it is most definitely a violation.

I know none of this is what you hoped to hear, but now in the age of nursing informatics there is a virtual fingerprint on everything we do, in every area of the hospital, whether it be radiology, L&D, med-surg or respiratory therapy, for example.

If you are not treating a patient, and were not asked (written not orally) to review a chart/film/strip, you are in violation of HIPAA whether you know the name/demographics of the particular patient.

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Originally Posted by ScottGem

So your defense is that you were assigned to view these films as a training exercise. Do you have proof of that?

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No, not necessary were these films assigned to me as training. The films however, did have QA assigned. Now, is the QA assigned to the film or the Employee.

But, still bottom line QA is Quality.

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Originally Posted by ymbrown

Now, is the QA assigned to the film or the Employee.

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That is facility specific. Meaning, at my facility the QA may be assigned to the film, but at your facility the QA may be assigned to the employee.

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Originally Posted by J_9

That is facility specific. Meaning, at my facility the QA may be assigned to the film, but at your facility the QA may be assigned to the employee.

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Yes, nothing that identifies our facility as the QA being specific to employee or films. There is a QA filter on the system; that being said, I am going to determine the QA's to be film related. What do you think

All of which proves that the HIPAA regulations were written by imbeciles.

I agree with AK, a big bunch of nut cases wrote HIPAA. Here is my question or thought. You looking at an image is not a violation in my book. The person who had control of those images and allowed you to see them committed the violation. Who gave or allowed you access?

First, I will agree with the statement that HIPAA was written by imbeciles.

In the age of nursing informatics everyone has the ability to view certain computer files in their particular unit. For example, if we have a patient in our unit L&D, there is a computerized fetal monitor strip showing the fetal heart rate as well as the contraction pattern. Everyone in our unit has the ability to view this computerized strip, but if it is not your specific patient, or you are not related to her care, you violate HIPAA by looking this strip up on the computer.

Now, in the OPs case, in radiology, the films are now computerized and can be viewed on a screen rather than the old fashioned films they put up on a light board. Since the OP has a code, if you will, to access the films that he/she is responsible for, he/she also has the ability to access all films taken by any other radiology tech. This is where the fine line is drawn. If the OP views films of patients not directly in his/her care, then the OP has violated HIPAA whether the OP knows the particulars of the case such as name, etc.

I have been trained in this extensively in the last 2 months as I was also accused of this same situation. In my case, however, it was resolved as a peer review situation as there were 7 other nurses involved in this situation.

From this point further, I as well as the OP, should NEVER view anything other than that which is directly involved in OUR patient's care.

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Originally Posted by ballengerb1

I agree with AK, a big bunch of nut cases wrote HIPAA. Here is my question or thought. You looking at an image is not a violation in my book. The person who had control of those images and allowed you to see them committed the violation. Who gave or allowed you access??

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I have access to our data base (DR PACS) because I am a registered tech in the department that takes x-rays. I never discussed the images with third party. What my employer is stating is that I had no business viewing the x-rays. Funny thing is, one of my PREVIOUS CO-workers today told me that one of the tech had performed a CT and the patient had an anuerysm and they were going around showing everyone.!

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Originally Posted by J_9

First, I will agree with the statement that HIPAA was written by imbeciles.

In the age of nursing informatics everyone has the ability to view certain computer files in their particular unit. For example, if we have a patient in our unit L&D, their is a computerized fetal monitor strip showing the fetal heart rate as well as the contraction pattern. Everyone in our unit has the ability to view this computerized strip, but if it is not your specific patient, or you are not related to her care, you violate HIPAA by looking this strip up on the computer.

Now, in the OPs case, in radiology, the films are now computerized and can be viewed on a screen rather than the old fashioned films they put up on a light board. Since the OP has a code, if you will, to access the films that he/she is responsible for, he/she also has the ability to access all films taken by any other radiology tech. This is where the fine line is drawn. If the OP views films of patients not directly in his/her care, then the OP has violated HIPAA whether or not the OP knows the particulars of the case such as name, etc.

I have been trained in this extensively in the last 2 months as I was also accused of this same situation. In my case, however, it was resolved as a peer review situation as there were 7 other nurses involved in this situation.

From this point further, I as well as the OP, should NEVER view anything other than that which is directly involved in OUR patient's care.

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Can you define a peer review?? Because there were also other tech with the same situation, only they were not terminated. I feel I was singled out because of the relationship myself and supervisor have. We have never had any training in Hipaa. Also, x-ray exams receive QA's and these are distributed for edcuational purposes. In fact, three of the films that I reviewed were x-rays that had received a QA on them. So, it was my understand that these are learning experiences. What do you think based on your extensive training. Thanks

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Originally Posted by ymbrown

Can you define a peer review ??? Because there were also other tech with the same situation, only they were not terminated. I feel I was singled out because of the relationship myself and supervisor have. We have never had any training in Hipaa. Also, xray exams receive QA's and these are distributed for edcuational purposes. In fact, three of the films that I reviewed were xrays that had received a QA on them. So, it was my understand that these are learning experiences. What do you think based on your extensive training. Thanks

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In reality, each of the other techs in the department had the opportunity to meet with our supervisor in her office and go over each questionable noted case. However, when it was my turn... I was told that we were to meet in the HR building with the Organizational Director, who by the way already had my termination letter typed up and signed before I even spoke. I had no access to the computer to even be able to review the images to refresh my memory... it had been 6 days since the audit.