Medical Lessons

A recent post by Dr. Wes Fisher, a cardiologist-​​​​electrophysiologist and med-​​​​blogger in Illinois, caught my attention. It’s on HIPPA, the Health Insurance Porta­bility and Account­ability Act of 1996, and how patient privacy reg­u­la­tions might impede dis­sem­i­nation of new infor­mation and physi­cians’ education.

What he con­siders is a case report pub­lished in the Annals of Emer­gency Med­icine. The authors describe a com­pli­cated cardiac pro­cedure per­formed in a 42 year old woman who was brought to the emer­gency department of a hos­pital in Coon Rapids, Min­nesota. The study is not HIPPA-​​​​compliant, Dr. Wes notes, and I agree.

The report exem­plifies the “small cell problem,” an issue of privacy men­tioned by some IRBs but (I found) hard to find pub­lished infor­mation on. Wes describes it succinctly:

Clin­i­cians should be sen­sitive to the “small cell problem”: the exis­tence of indi­viduals with such unique or unusual diag­noses or ill­nesses, that it might be pos­sible for others (or patients and fam­ilies them­selves) to

See more The Small Cell Problem, Case Reports and Valuing Patients’ Privacy