VA Sunshine Healthcare Network (VISN 8)

Issue: Employee A, a soon to be retiree received a retirement package in the mail from Employee B. The information belonged to Employee C.…

Outcome: 11/03/14: The Incident Resolution Service Team has determined that there was a policy violation. While there was an unauthorized access/disclosure of data, it has been determined that the incident has a low probability of a risk of compromise.…

Issue: Veteran A was handed Veteran B's prescription bottle. The bottle had the medication name and Veteran A's name. Update: 05/16/13:One Veteran will be sent a letter of notification.…

Outcome: NA

Issue: Police service discovered several documents containing personally identifiable information (PII)/protected health information (PHI) in a trash can in front of the main entrance of our facility. The PII/PHI were from the University of Miami, Jackson Health System, and the Miami…

Outcome: Service to take administrative action.

Issue: Enrollment/eligibility clerk reported that a veteran was given another veteran's 10-10EZ form. Update: 04/25/13:One Veteran will be sent a letter offering credit protection services.…

Outcome: Administrative staff have been re-educated regarding the process and proper handling of sensitive information. Patient information is not to be left/accessible in an open area.

Issue: Inpatient Veteran indicated that, while he was undergoing a test which was videotaped, the monitor was placed where other patients or visitors could see him. Update: 04/25/13:One Veteran will be sent a letter of notification.05/08/13:This was determined to be non-HITECH…

Outcome: Process for procedure being changed and additional education and screens being implemented.

Issue: A ward roster listing the full SSNs of 18 patients was discovered by a veteran in a government vehicle. The roster was printed/dated on April 11, 2013, but it was discovered sometime between April 17-19, 2013. A veteran who discovered…

Outcome: Service to take administrative action. Newly discovered issue referred to OIG due to existing OIG investigation.

Issue: Veteran A was handed a mis-labeled pharmacy bag containing Veteran B's medications. When Veteran A discovered the error after arriving home, he notified the Pharmacy who in turn cross-checked the second bag and discovered Veteran B's bag, with Veteran A's…

Outcome: Employees cautioned to exercise more diligence when labeling Pharmacy bags.

Issue: Veteran A received a VISTA Blood Bank Report intended for Veteran B. Update: 04/16/13:Veteran B will be sent a HIPAA notification letter due to Protected Health Information (PHI) being disclosed.…

Outcome: Veteran A returned the information to the Privacy Officer. A copy of the Blood Bank Report has been sent to Veteran B.Notification letter mailed to the Veteran on 4/19/13. Appropriate staff have been reminded to safeguard information and to verify…

Issue: VA Employee A accessed VA Employee B's medical record without authorization. After meeting with VA employee A, the justification for the access was unwarranted and improper. Update: 04/12/13:Employee B will be sent a HIPAA notification letter.…

Outcome: Additional safeguards have been put in place to protection sensitive information; the employee responsible for the unauthorized access has been addressed by supervisor for any appropriate disciplinary action. Education provided by Privacy Office.…

Issue: A Veteran problem list, face sheets with demographics info, labs, and physician notes, patient care notes and Home Health evaluation forms was mis-faxed to a number other than the Long Term Care Facility. Update: 04/10/13:Veteran A will be sent a…

Outcome: LETTER OFFERING CREDIT MONITORING WAS MAILED TO THE VETERAN ON 4/19/13. THE CLINIC ADMINISTRATOR (CBOC) WAS NOTIFIED. EDUCATION WAS PROVIDED TO THE APPROPRIATE STAFF.