BMV and HIPAA

[paw]

On another thread, we discussed the dangers of vision impaired people who drive anyway.

Now that HIPAA is the law of the land, can an MD or OD notify the BMV to have the license of the impaired driver revoked, without violating HIPAA?

[optigoddess]

Great question! (I have no answer though)

[Joann Raytar]

Probably not unless they signed a notice saying that you may share information with the DMV.

[Robert Wagner]

Sorry its so long, But here it goes:

OR #735-074-0070 states:
Authority to obtain medical information and DMV use of medical information is authorized by law, ORS 807.710, to receive protected health information from covered health entities for the purpose of preventing injury which may be caused by drivers who are unable to safely operate a motor vehicle because of severe and uncontrollable cognitive or functional impairments.
DMV will-use the medical information provided by physicians and heath care providers only to determine whether or not a person can safely operate a motor vehicle and is qualified for driving privileges, and for taking any action deemed necessary by DMV.
The protected health information required to be reported by these rules s the minimum necessary to accomplish the purpose of bla bla bla.
It goes on to say about our field, we need to report to the state, visual acuity or field of vision not meeting DMV standards.

I could go on and on like any state document but you get the drift.

Wheeeeee SO. HIPPA and the STATE OF OREGON can exchange the PHI in this matter.

Robert

[harry a saake]

What i would like to know is who is qualified at DMV to make a medical decision.

[Ray Parent]

I'm gonna take a wild guess and say you probably saw what happened on Wednesday in Santa Monica.

This may be going a bit far, but as it applies to our field, I would like the DMV or BMV to require mandatory periodic vision testing. Pretty much anybody with a corrective lense restriction on their license should be required to get vision check say every 24 months.

My mom, prior to her cataract surgery about 6 years ago, shouldn't have been allowed to drive. After she had surgery she told me her procedure for changing lanes (before surgery) was to let the signal go for 30 seconds and then listen for horns when she started changing lanes. Prior to surgery, she was a -13 and a -16 with a bit of cyl as well. She was about 46ish when she had the surgery done.

About 18 months ago, my grandmother (81 at the time) did a hit and run accident and didn't even remember where she had the collision. Immediately after she got home I went out looking for whatever she had hit, but was unable to locate it. Ireported it to her insurance and to the police, but nothing ever came of it. Moving right along on same story though, 2 weeks later when I took her to pick up her car, I followed her home, which was about a 2 mile drive, I was amazed at how badly she drove. Fortunately she stopped driving a few months later.

Neither my mom nor my grandmother had been having regular exams, however my mom now gets them somewhat regularly now. Granted my grandmother's driving was based more off of age and diminished capacity.

[Robert Wagner]

harry a saake said:

What i would like to know is who is qualified at DMV to make a medical decision.

I got out this lovely state Administrative rules and looked up the answer at least for Oregon.

DMV will review a report received under OAR 735-074-1020 to determine if sufficient information has been provided. If the report does not contain the information required by the OAR 735-074-1020 it may be returned to the reporting physician or health care provider for completion. If DMV is unable to determine from the report whether the person is able to safely operate a motor vehicle, the report will be submitted to the State Health Office for review.



Robert

;)

[paw]

The thing is, to report this info to the BMV is releasing protected healthcare information (presumably without the patient's permission.) I can imagine that the driver would be quite upset at being turned over by the doctor to the BMV, and could pounce upon the unauthorized release of protected healthcare info to get the doctor in trouble or to reverse the revocation of the drivers license.

If the doctor reports the info to the BMV, regardless of HIPAA, there could be lawsuit. If the doctor doesn't report anything, the driver keeps on endangering the public.

I think this is something that should be worked out between the HIPAA powers-that-be and the BMV before lawsuits or accidents occur.