Unhealthy job records

September 11, 1997|By Ann Cox

TODAY IS YOUR first day at your new job. You're given the typical forms to fill out.

You complete a questionnaire about your current state of health, including questions about family medical history and allergies. What happens to that information after you provide it? What happens if you confide in a company health professional at your workplace about a worsening ulcer, a difficult pregnancy or a chronic ailment?

Most individuals assume that their personal health information will be kept confidential, but few laws exist to protect this kind of information.

After working for the Lord Corporation for a number of years, Bettye Jean Gass, an occupational health nurse in the company's Bowling Green, Kentucky, plant, was fired with no notice after refusing to surrender confidential employee health records to a company official.

Her responsibilities included coordinating activities of the company's preventive health screening program. Ms. Gass refused to turn over to a company supervisor the data resulting from the screening effort.

Her professional stand for confidentiality cost her a job. The matter is now in federal court.

It's not difficult to imagine other situations involving health record confidentiality.

A health professional was asked by company officials to try to help Jim, one of the company's three top marketing pros. Normally a workaholic, he's taken an unusual number of sick days recently. The occupational health nurse discovers that Jim has been diagnosed with clinical depression, and is now taking Prozac. Jim confides in the occupational health nurse on staff. Management wants to know why Jim has slipped.

Bill, a 32-year-old receptionist, approaches the company's occupational health nurse about the use of family medical leave. He asks whether he can take the time for himself and not for a family member. He discloses that he has been diagnosed as HIV-positive.

The company's right to know, or the employee's right to privacy?

Legally, employees have legitimate needs for information about an individual's ability to perform the functions of his or her job. However, most of the information is unrelated to the employee's ability to perform.

The American Association of Occupational Health Nurses opposes the unauthorized release of this health information. We believe that if more Americans were aware of how little health record confidentiality exists, they would be outraged.

Law unclear

Unfortunately, the law is unclear as to who has ultimate jurisdiction over an employee's health records: the employer, the employee, or the health care provider. There is a patchwork of state laws, leading to many disparities and complexities for multi-state employers.

Certain personal information falling under the Americans with Disabilities Act (ADA) has specific protections. But in most states, health information obtained at the workplace is not protected from inappropriate disclosures.

Information obtained through employer-sponsored employee-assistance programs lacks adequate protection. With the advent of the information age, the use of telemedicine and telehealth, and efforts designed to reduce health care costs by streamlining insurance claims processing, the need for protections will increase.

There is increasing evidence that some personal health information is being misused.

A University of Illinois study last year found 35 percent of all companies surveyed admitting that they "use medical records about personnel in making employment-related decisions."

When an individual files a claim for work-related ailments, he or she must typically sign a release of all medical records, including any information collected at the work site. In a number of cases, this information, obtained through the company's wellness or other programs, has been used to defeat a worker compensation claim. Additionally, employers may review records obtained through work-site health programs or employee assistance programs when making hiring, promotion and disciplinary decisions.

Unless the general public begins to express concern, violations of privacy will likely escalate. We should all urge companies to establish policies on the rights of employees and their health records. We should encourage businesses to secure signed releases from employees before employees access employee health records.

Congress needs to create federal health care record confidentiality guidelines that every state can live with. Congress should move quickly to enact legislation in the House of Representatives sponsored by Rep. Gary Condit of California that would help prevent the abuse of employee health records.

With such national standards enacted, America's workers in every occupation could enjoy something many of them mistakenly think they already have -- health care record confidentiality.

Ann Cox is executive director of the American Association of Occupational Health Nurses Inc.

Pub Date: 9/11/97

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