2/5 cornell v 'gate postgame

[jeh25]

[Q]ugarte Wrote:
1) It isn't about a right to know, it is about a desire to know. If there is a discussion going on in Ithaca about whether a player is or isn't injured, I'd like to hear it. I don't want the doctors revealing the information, but if a player/equipment manager/groupie has information, HIPPA is besides the point.
[/q]

Spoken just like a lawyer...

HIPAA may not have been designed with athletics in mind, but it doesn't change the fact that a patient is entitled to privacy and confidentiality with regard to their medical condition. Moreover, I'd argue that the equipment manager is analogous to a receptionist in a medical office; they may not be involved in directly treating the patient, but they will become privy to PHI in the course of their duties.

With regard to other players and various hangers on, no, they are in no way covered by HIPAA. Doesn't change the fact they should keep their damn mouths shut. Ethically, our 'right' to know does not trump Sasha's right to privacy just because it came from a different source.

And for what its worth, the public figure argument doesn't hold water either. I can't find a source online but multiple investigations are underway for violation of Pres. Clinton's privacy rights following his heart surgery. If a former president isn't a public figure, I don't know who would be.

[q]
They don't have any expectation that when they skate off the ice clutching their arm - and don't return - that we will refrain from talking about it.[/q]


A player doesn't have the expectation that we won't discuss the fact that he left the ice holding his arm, but he does have the expectation that the explicit nature of the injury will remain private unless *he* chooses to disclose it.

Frankly, I like the policy that Syracuse put into place. It seems to be a reasonable compromise.

Anywho, I have to go check the hot tub and clean the kitchen before the superbowl, but here's more fuel for the fire:

http://espn.go.com/ncaa/news/2002/1024/1450628.html

http://www.splc.org/report_detail.asp?id=937&edition=23

[Chris 02]

Just for curiosity's sake and not that the polls matter...not many near the top went unblemished last weekend.  

 Team                               Last Week
 1 Boston College                    T   (Providence)
 2 Colorado College                  W,T (Minnesota-State)
 3 Wisconsin                         W,L (8 Minnesota)
 4 Denver                            W,W (13 North Dakota)
 5 Michigan                          T,T (Michigan State)
 6 Cornell                           W,T (11 Colgate)
 7 New Hampshire                     L,W (15 Maine)
 8 Minnesota                         L,W (3 Wisconsin)
 9 Ohio State                        W,W (Lake Superior)
10 Harvard                           W,W (Union, Dartmouth)
11 Colgate                           L,T (6 Cornell)
12 Mass.-Lowell                      T,W (14 BU, Providence)
13 North Dakota                      L,L (4 Denver)
14 Boston University                 T   (12 Mass.-Lowell)
15 Maine                             W,L (7 UHN)

Others Receiving Votes: Northern Michigan 31 (W,L),
Vermont 22 (L), Dartmouth 3 (W,L), Nebraska-Omaha 2 (T,W)

[Avash]

[Q]andyw2100 Wrote:



[Q2]atb9 Wrote:


[Q2]andyw2100 Wrote:
I'm sure "The Ithaca Journal" will have a story about it in Monday's paper. [/Q]
Avash took care of this one and if you look at the recap Avash wrote for USCHO, which is written after he speaks with the players and coaches, there is not one mention of Pokulok.  That says a lot to me. [/Q]

I don't understand this. It sounds like Avash is a journalist of sorts. If he wrote a recap of a game, in which one of the starting players leaves the ice with an injury in the first few minutes of the game and does not return, without any reference to this whatsoever in his piece, then I think he may need to take Journalism 101 again.
                            Andy W.[/q]


Thanks for the suggestion, but I know what I'm doing. Fortunately, in my response to you, I'm not going to resort to cheap shots.

Sure, in retrospect, I could have mentioned that Cornell was forced to play with 5 defensemen for most of the game, but to be honest, as I was writing the recap so it could be up on USCHO around midnight, I thought there were more relevant quotes and points to include - describing the goals, the timely saves, and the intense game in context of this grueling and important weekend, for instance. I even included a pun in the headline, for God's sake. Surely that has to count for something...

After the game, if you really must know, Schafer commented VERY briefly on Pokulok but was reluctant to provide any injury details and instead focused on how other guys in the lineup need to step up now in Sasha's absence. Since this is a direct quote from Schafer, I'll include it here: the preliminary report on Pokulok was that he will be out "for 6 weeks at least."

[The Rancor]

fantastic game. gotta give a lot of credit to silverthorn, he kept colgate in that game. best overtime without a win i've seen in a very long time.
my new theory about the team is this: we will win against teams with strong offense, because our d is so freeking good. teams that focus more on defense, will be harder for us. meh.

[atb9]

"Fans, reporters and announcers who see a player carried off the field will be left only to speculate on the extent of the injuries"

So the question then becomes how much speculation can you take and still enjoy, right? :-P  And what is speculation and what is personal information that is being unfairly released through rumor (overhearing conversations that are meant to be in private)?  Eh, screw it, I'm ready to move on and watch some football!  :-)

[ugarte]

[Q]jeh25 Wrote:
Spoken just like a lawyer... [/q]
1) I'll have you know that I argued like this well before law school.
2) I also used numbered lists.

[q]HIPAA may not have been designed with athletics in mind, but it doesn't change the fact that a patient is entitled to privacy and confidentiality with regard to their medical condition.[/q]What they are entitled to legally is clear. Ethically is something of an open question isn't it? You see it as more of an ethical question than I do. The players are engaged in a public activity - for which they (or the school or whatever) actively seek attention - in which the day-to-day (or game-to-game) health of the players is a real factor. People are going to talk about it. The team has the right to keep information private; the medical staff has an obligation to do so (I disagree about the equipment manager, by the way; (s)he is an adjunct to the Athletics staff, not the medical staff). That doesn't make it an actual ethical issue, even if you want to get sanctimonious about it. I don't care if Bill Gates has the sniffles, but I sure do care if TO is still limping from the practice field to his car.

[q]With regard to other players and various hangers on, no, they are in no way covered by HIPAA. Doesn't change the fact they should keep their damn mouths shut.[/q] That isn't much of a point. I agree with that. So what? That they probably should keep their mouths shut as a matter of professionalism and courtesy doesn't impose an obligation on the rest of the world to actively ignore information from such quarters. It also doesn't mean we should pretend the information (or some version) isn't out there when it is. As andyw said, a rink full of people saw Pokulok leave and not come back. I, for one, don't feel that I have to just wait until the official word comes down for any hint at all. It isn't a question of our "rights" or "obligations" as fans. We don't have a "right" to know, but we also don't have an "obligation" to refrain from speculation.

[atb9]

Avash, you're now a public figure!  Bask in all of its glory!!!  ;-)

[Avash]

[Q]atb9 Wrote:

 Avash, you're now a public figure!  Bask in all of its glory!!![/q]


Thanks Adam....but does that mean I have to disclose to everyone that I have an injured right shoulder? I think I slept on it wrong. Don't worry though; I should return (to writing game recaps) in about 2 weeks.

[andyw2100]

I did not really mean to question your ability as a journalist, Avash. I was merely trying to make the point that a starting player leaving the game due to injury, and then not returning, was certainly newsworthy. I think you would agree that if coach Schafer had said nothing at all about Pokulok, and if you and other journalists present did not ask anything about Pokulok, that you guys would have been dropping the ball, so to speak. The fact of the matter is that Schafer --did-- talk, albeit briefly, about the Pokulok situation, and for whatever reason (deadline, length of article, etc.), you chose not to include the information.

Another relevant point is that you were brought into this discussion when Adam said that your not mentioning Pokulok in your USCHO article "said a lot" to him. I inferred, rightly or wrongly from that, that Adam felt that the injury could not have been too serious, or you would have written about it. In retrospect, I think we can also all agree that an injury that keeps someone out of action for "at least six weeks" is, in fact, a serious injury.
                                 Andy W.

[Jim Hyla]

[Q]ugarte Wrote:
(I disagree about the equipment manager, by the way; (s)he is an adjunct to the Athletics staff, not the medical staff). [/Q]It doesn't matter. Everyone with access to medical information has to agree to a privacy policy. In a med/dental surrounding that even means the cleaning people. It certainly means billing people, and people you hire from the outside to do non-medical tasks. I'd bet that everyone involved with athletics gets some HIPPA training.

[billhoward]

A couple thoughts on Sasha Pokoluk's injury Saturday against Colgate, the fans' curiousity, his privacy, etcetera.

- He was injured in a very public place in a very public event. There is curiousity about what happened to him. Some curiousity, some concern, some morbid interest, some competitive interest.

- The HIPAA privacy stuff that's being waved around, that's a serious matter for the health care providers that they not inadvertantly disclose information they're not supposed to. But there's a difference between a hospital letting slip out the information that so-and-so is ailing and, once that information if out, others making note of it.

- HIPAA is making a lot of hospitals think about getting rid of paper charts hanging at the nurses' stations and implementing all-electronic records and walk-around tablets containing patient charts. That's going to be real secure, until it gets hacked. And anyway the records once electronic probably wind up in the hands of your insurance company and your life insurance carrier and the company running experimental trials on the drugs used on you and maybe by the state insurance department doing an anti-fraud audit. You really think that's secure? You want about six agencies to know you took a drug for an inflammation that's also a drug used by AIDS patients? Now go see what the age 30 quote on $500K of life insurance is once your carrier has that information in hand.

- Pokoluk is a public figure in my mind and in most peoples' minds but not everyone's minds. There is some case law bouncing back and forth that says people who wind up in a public arena inadvertantly may or may not be public not private figures. This is important in a bunch of areas but I think not here. (Others may say otherwise.) It reflects on things like, "So-and-so who was an innocent bystander got hit by a riccocheting bullet in a drug shootout [innocent bystander, right, in that bar and 1 in the morning] and it turns out he's just filed for personal bankruptcy and his wife tossed him out of the house but really he left the house after a spat with his wife and you mention that in a newspaper and some of it's wrong, there's a different standard for libel if the guy's a public vs. private figure. Some people who've tried to defraud the government (allegedly defraud) claim that the fact they have a contract with the govt doesn't make them public figures and so they sue the Globe or Inquirer (which reported it) and seek to be declared non-public figures so it's easier to prevail. As a practical matter, if Avash here or someone at USCHO finds exactly what happened and reports it, Sasha is not going to retain counsel.

- Pro sports especially, injury information has to - is supposed to be, at least - be disclosed fully so that gamblers who have inside information don't have inside information.

- As a practical matter also, college hockey is an insular and gossipy world and the extent of his injury is likely to get out. A Cornell player mentions it to his mom back in Ontario and she mentions it at the rink where the younger son players Junior hockey and oh by the way Sasha had played at this rink two years before and he seemed like a sweet boy and it's too bad he has a [I'm making this up] broken left clavicle and he'll be out six weeks everyone is saying. Some other kid's dad at the rink is part of this discussion and he has a nephew who plays at RPI and pretty soon it's not a secet anymore.

- The coach and the team have a vested interest in masking the injury and its severeity  because for a short time (like till the next weekend) it might have the opponent practicing a plan that includes neutralizaing a tall, great stickhandling defenseman. Longer term, when the injured player comes back, if the opponents know that the player is nursing a sore left arm, well, they're going to be sure to check him on the left side a few extra times just to see.

- Some injuries you can hide better than others. A pulled stomach muscle is easier to mask than a broken bone on a specific part and side of your body.

- Because this is a pro-Cornell site we may prefer not to talk up the extent of a Cornell player's injuries. Or that so-and-so has left the team. Eventually it's going to get out, I believe. The minute more than one person knows a secret, the secret is compromised. A couple people here say they have inside information through relationships with the players or the team and they don't want to abuse that relationship. Good point. But it's almost always - maybe always always - going to get out.

I guess I don't think it's a big deal to ask the coach, and expect him to say, It's a broken left wrist [I'm making this up, not talking abot Pokoluk] and our guess is he'll be out six weeks so even if the season extends into April, it's iffy if he's going to be back.

Look how quickly the news of Stempniak's injury got out of Hanover.

[jeh25]

[Q]billhoward Wrote:

 - HIPAA is making a lot of hospitals think about getting rid of paper charts hanging at the nurses' stations and implementing all-electronic records and walk-around tablets containing patient charts. That's going to be real secure, until it gets hacked. And anyway the records once electronic probably wind up in the hands of your insurance company and your life insurance carrier and the company running experimental trials on the drugs used on you and maybe by the state insurance department doing an anti-fraud audit. You really think that's secure?
[/q]

Actually Bill, I do. How many hours of HIPAA training have you been through?

The data security requirements of HIPAA go into effect in April of this year. They aren't f'ing around. For example, here at UConn our medical informatics director was telling us that even within a database,  PHI needs to be segregated from non-PHI in logically distinct tables and that PHI needs to be encrypted within the table itself. (Database guys are gonna love that)

Will there be accidental release of PHI? Sure. But HIPAA also contains *serious* criminal penalties for disclosure and misuse of PHI. These include:

[q]
   1. Be fined not more than $50,000, imprisoned not more than 1 year, or both.
   2. If the offense is committed under false pretenses, be fined not more than $100,000, imprisoned not more than 5 years, or both.
   3. If the offense is committed with intent to sell, transfer or use individually identifiable health information for commercial advantage, personal gain or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both.
[/q]

It may take a test case or two, but after a couple of insurance company execs spend 10 years in federal PYITA prison, I doubt anyone is going to  risk that just to jack up your insurance rates.

Interestingly, in the first criminal prosecution under HIPAA, the individual charged was *NOT* a "covered entity." Instead, he was an employee of a covered entity.  The DOJ  determined that it could prosecute him anyway. I'm not saying that DOJ is actually gonna prosecute a team manager, but this strongly suggests that the "manager isn't a health care provider" argument just doesn't fly.

[q]
 Pro sports especially, injury information has to - is supposed to be, at least - be disclosed fully so that gamblers who have inside information don't have inside information.
[/q]

Pro being the operative word. We're talking about NCAA student-athletes here.

[q]
- As a practical matter also, college hockey is an insular and gossipy world and the extent of his injury is likely to get out. [Ferris needs a liver-style game of telephone]. pretty soon it's not a secet anymore. [/q]

Besides the point. If parents gossip, that's their business. But posting declaritive statements on an internationally accessible online forum is a different matter altogether.

[billhoward]

I say tomato, you say tomahto. There is no question HIPAA (health insurance and portability act of 1996, "HIPAA" (pronounced but not spelled HIPPA)) has severe penalties and has health care providers and their adjuncts rightfully concerned.

a) because they should be. There are as you note really severe penalties possible for disclosure, theft, embezzlement of the data
b) (IMO) health care providers are like academics and social service agencies and they run scared and have lots of committee meetings and training and pledges to sign.

Here's the tomato / tomahto difference (as I see it): eLynah, the Boston Globe, Cornell Daily Sun, and Bob Woodward are not signatories to HIPAA. It's wrong and it's illegal for Gannett Clinic to post Sasha's Xray on-line. Someone from the media (and this site broadly defined is part of the media, just without printing presses) who has this information and passes it on to the public, they're in a different boat. Are you going to fine or toss in jail the Washington Post Supreme Court reporter for saying that the Chief Justice's cancer is worse than anyone thought (or not as serious, or whatever)? OK, he's a public figure. Sasha less so but not a truly private figure.

The HIPAA wording can appear to make it illegal for someone to steal or possibly to possess patient records, but the courts not congress decide which wins out, the First Amendment or HIPAA, and in what circumstances.

The gray area (and this is not the media's finest moment) is what is the legal liability of someone in the media who steals Burger's medical chart or Sasha's X-ray ... vs. hearing about it from two or three sources ... vs. having someone slip it to him/her without the writer seeking it out directly?

If I was a lawyer worried about running short on clients as the tobacco / asbestos litigation winds down, I'd become an expert in HIPAA privacy suits. As you noted, adjuncts can be (should be) accountable, and you can expect a rash of suits saying essentially, "The health care provider should have known when it outsourced its medical dictation transcription business to Bangalore that it was an unsecure privacy environmet ... etcetera ... so pay up."

I love computers, I think computers are great, but I think the potential for widespread theft / disclosure is just immense.

Anybody see the IBM TV commercial where a medical team comes running up to the IBM Answer Man and says we've got a patient in bad shape but we can't contact his doctor at home or his hospital for his records and how do we get his vitals? And the IBM Answer Man says, "Done." Maybe IBM's agency intended for that to show the power of technology to cure the sick. To some other people I think it brought home the specter of Big Brother. (And did anyone catch William Safire's farewell columns in the NYT in which he broke ranks from his fellow conservatives and said our privacy erodes more each year especially when the government says "pressing needs of national security"?)

[ugarte]

[Q]jeh25 Wrote:
Interestingly, in the first criminal prosecution under HIPAA, the individual charged was *NOT* a "covered entity." Instead, he was an employee of a covered entity.  The DOJ  determined that it could prosecute him anyway. I'm not saying that DOJ is actually gonna prosecute a team manager, but this strongly suggests that the "manager isn't a health care provider" argument just doesn't fly.[/q]Interesting. I'll defer to your (and Jim Hyla's) superior knowledge here. It would depend on how the equipment manager came into the information, right?

[Harrier]

I sat behind those kids in the Jerseys, before you get too excited...they were maybe 15 years old, probably 14.