There is a crisis in Alabama hospitals. Here’s why you can’t see it
The surge in COVID-19 cases has pushed some hospitals in Alabama to the brink, and health officials have used the crisis to urge vaccinations and school masks.
The leaders are making their case through press conferences and statistics, but have not shown the public what is happening on hospital floors. One of the worst emergencies in Alabama history was mostly behind closed doors, due to a combination of federal privacy laws and hospital policies.
“It has overwhelmed our staff and our doctors,” said Susan Boudreau, president of Mobile Infirmary, where 41% of the hospital’s 480 patients have COVID-19. “They see people suffering and dying. We don’t feel like the world understands what’s going on behind our walls and our hospitals.
Alabama’s overall vaccination rate of 35.9% is the lowest in the country. But as reporters demanded access, they came up against a Clinton-era law that protects the privacy of inpatients: the Health Insurance Portability and Accountability Act – also known as HIPAA.
Federal law, approved in 1996, protects patients and their privacy, and the COVID-19 emergency has not been the subject of any notable exceptions. On the contrary, the dire health conditions faced by many hospitalized COVID patients prevent them from physically granting permission for the media to film their story.
“HIPAA privacy rules prohibit hospitals from giving media access to facilities where protected patient health information can be accessed without patient prior authorization, and most inpatient COVID-19 patients are not able to lift those protections, ”said Hannah Peterson, spokesperson for Infirmary Health, which operates hospitals in Mobile and Baldwin counties.
The federal government is making patient privacy a priority during the pandemic. The Civil Rights Office of the US Department of Health and Human Services, in a guidance document released in May 2020, said healthcare providers cannot grant media access to patients without having to prior written HIPAA authorization from each patient who may be filmed or interviewed.
In addition, the agency said that a health care provider was not allowed to allow television crews to mask the identity of a patient while playing a recorded video after the fact. . In other words, “a prior express authorization of the patient is always required”, according to the agency.
“Hospitals are in a difficult position,” said Sharona Hoffman, professor of law and bioethics at Case Western Reserve University in Ohio. “The HIPAA privacy rule absolutely prohibits them from allowing the media to have information that could identify patients without their consent, or that of their proxy, including images of faces.”
William Brewbaker III, a professor at the University of Alabama School of Law, said violations of HIPAA rules can result in stiff penalties. Hospitals in New York and Boston have been fined for violating the privacy rights of HIPAA patients by allowing film crews to capture footage inside their facilities and disclose those footage without obtaining patient authorization. New York Presbyterian Hospital Paid $ 2.2 Million in Damages for Allowing ABC TV Series “NY Med” to Film Inside Hospital, Resulting in Unauthorized Disclosure protected health information of two patients.
“Most of us think it’s not an unreasonable thing to think the decision of (health disclosure) is in the hands of the patient,” Brewbaker said. “This is a situation where the HIPAA rules have a good consequence by allowing people to choose whether the general public should know if they have been infected with COVID or hospitalized or on a ventilator or undergo other forms of treatment. and support. “
“The cost of protecting people’s privacy is that it is more difficult to give the public a sense of what other people are going through when they are receiving health care in a situation like this,” said Brewbaker.
Don Williamson, president of the Alabama Hospital Association, said many hospitals have closed their doors to all visitors, not just the media. Hospitals need masks, but staff remain concerned about the viral spread between visitors and patients.
“How are they going to let journalists in when they don’t even let families in?” Williamson said.
Some hospitals have their own public relations teams who go inside hospitals and get permission from patients to provide images and videos. These in-house productions are then submitted to the media for publication.
Andy North, spokesperson for DCH Health System – which operates hospitals in the Tuscaloosa region – said his team had filmed footage of the hospital and provided it to media outlets in the region.
“We are doing everything we can,” said North. “Most of the TV channels that we’ve provided this content to have used it. “
North said that at the start of the pandemic, it was difficult to grant media access inside hospitals due to the lack of personal protective equipment, such as face masks. He also said there was still a lack of knowledge about the pandemic.
“It makes it more complex, and we try to work hard within that complexity to give the media what they ask for,” North said. “DCH was used to a few stories a month. During the pandemic, I met with the media three, five times a week to provide in-person updates. Over the past 18 months, this has happened on a weekly basis. “
UAB also provided images to the media. And they held press conferences several times a week to make experts and clinicians available to the media. Spokesman Tyler Greer said patients and their families are often too overwhelmed to deal with media inquiries. Privacy breaches not only violate federal law, they can also traumatize patients and their families.
“At the start of the pandemic, for example, we had a worried family member of a patient who contacted because he believed his loved one’s feet were being shown in a picture in local media,” he said. said Greer. “The image was not from UAB hospital, and it was not their loved one, but they were very upset. It was traumatic for them. So it’s experiences like that, as well as the law. federal government, why we don’t allow media in our COVID ICUs. ”
Dennis Bailey, an attorney who works with the Alabama Press Association, clarified that hospitals must comply with HIPAA – which can limit access to media – but the law does not apply to journalists.
“HIPAA would not apply to reporters’ reporting on health issues,” Bailey said. “HIPAA protects patients from the disclosure of their medical information. HIPAA makes hospitals (and others) responsible for disclosing specific medical records and patient information to those who are not authorized to see them. “
Still, a handful of hospitals have granted access to journalists and film crews. At the start of the pandemic, a photographer from Getty captured an image of a healthcare worker in protective gear comforting a COVID patient. A Minnesota hospital granted access to a journalist and photographer last fall. More recently another overwhelmed hospital in Louisiana opened its doors to STAT journalists. Williamson said all hospitals should develop their own guidelines for media access.
In Mobile Thursday, a film crew with WKRG-TV offered an “exclusive” look inside Springhill Medical Center. It was the first time a television crew filmed the interior of a hospital during the latest wave of COVID-19 in an area of the state that has been hardest hit.
The segment included an emotional interview with a mother of a 24-year-old woman who is in intensive care. A skeptical vaccine, who was hospitalized but recovering, was also questioned. The video shows the interior of the trauma unit, but it does not identify any other patients. A pulmonologist said the situation was approaching what a hospital could experience in a “war zone”.
“We have taken great care in leading a press team in some of the areas of the hospital where we treat COVID patients so that they can better understand the impact of this increase on our care teams and on the sick.” said Marian Faulk, spokesperson for Springhill Medical Center.
She added: “During the COVID-19 pandemic, all visitors, including vendors and the media, have been further restricted from entering the hospital as we do our part to prevent the spread of the disease. . So far, the community has been extremely understanding.