University of Virginia School of Medicine
Clinical Medicine Committee
Members: Adams, Reid B; Innes, Allison H; Innes Donald J.; Juel Vern; Maughan, Karen L; ; Owens, Gary K; Rein, Michael F; Short, Jerry G; Squillace, Susan P; Petri, William A; Keeley, Meg M.; Herrington, Pamila; Corbett, Eugene C; Schalet, Benjamin J; Wilson, William G.; Lieb, Darci; Herbert, William; Robertson, Mit; Diallo, Alfa; Guests: Jackson, John; Sidebottom, Marge; Hayden, Joanne; Hodsdon, Beth
The Clinical Medicine Committee met at 4 PM on Thursday, June 6, in the Pediatrics-Pathology Conference Room.
- Privacy Issues: Following introductions, we discussed the issues of patient confidentiality/privacy and the HIPAA regulations as they pertain to medical education, with particular emphasis on the use of electronic devices (PDAs, etc.) for storing and retrieving information. Mr. Jackson provided some background information and a national perspective on this issue. The majority of medical students on clinical rotations are using PDAs, and some medical centers have adopted policies regarding their use. Dr. Maughan stated that PDAs are being used by the Family Medicine residents here, but this use is primarily as a reference source for "evidence-based medicine"; they are not being widely used on that service for patient care. Ms. Sidebottom discussed HIPAA (Health Insurance Portability and Accountability Act 1996), and the upcoming enforcement date of the privacy portion of this act.
A concern is that the electronic devices may be used to store sensitive patient information, and these devices may not be "secure". It was noted that physicians, and physicians-in-training, have been using note cards, notebooks, clipboards, etc. to store and transport patient information and data to facilitate patient care for years, and these modalities are not secure and can be lost, misplaced, or stolen. Mr. Robertson mentioned that it is actually cumbersome to get patient information onto a PDA, and that these devices are currently being used by medical students at UVA for easy access and retrieval of reference information.
Ms. Sidebottom mentioned that there are plans to have HIPAA training for physicians. It was felt that similar training could be adapted for medical students. Dr. Pearson speaks to the students about privacy issues, and some of this information might be included in his message. There is a website at the Health System with information about HIPAA; the address is http://www.healthsystem.virginia.edu/hipaa/.
There was discussion regarding whether policies, regulations, suggestions, or recommendations would be best to help with these issues. It was felt that these decisions should be made by the Health System, and that the clerkships, electives, etc. would then adapt to these decisions. It was recommended that the "cost" of proposed regulations in terms of complicating patient care be considered, and that the regulations be "piloted" to determine if there would be unanticipated adverse effects on patient care.
- Passports: The members of the Committee, particularly the Clerkship Directors, were encouraged to discuss the passports with their faculty members and house staff before the new clerkship year begins. There have been problems on some services with the skills and other items on the passports being "signed off" in bulk, without the observation, feedback, and teaching that is intended. It was emphasized that falsification or misrepresentation of passport information is an Honor System offense.
- Evaluation Forms and Narratives: A prototype of a clerkship evaluation form was distributed to the group. It is hoped that evaluations can go "on line" for the 2003 clerkship year. The need for improved narrative information by evaluators was emphasized, since the clerkship narratives will be used virtually intact in future Dean's letters for residency applicants.
- The meeting adjourned at 5 PM. Another meeting may be held in the late summer, but the date has not yet been decided.
William G. Wilson, MD
Chair, Clinical Medicine Committee