The Truth About Doulas and HIPAA

Doulas and HIPPAThere’s a myth out there. A myth many doulas believe. A myth perpetuated bu those who do not understand the law. The myth is that doulas need to be careful of client privacy to comply with HIPAA.

First, trust no one who spells it “HIPPA” – it’s the “Health Insurance Portability and Accountability Act” – the word “privacy” isn’t even in the title. It deals largely with electronic communications and medical records. Privacy laws are only one part of HIPAA.

And doulas are not subject to HIPPA. According to the official HIPAA web site, covered entities are:

  • Health Plans (insurance companies, Medicaid, HMOs)
  • Health Care Clearinghouses (Companies that amass large amounts of data for research or education)
  • Health Care Providers like doctors and midwives…but “only if they transmit any information in an electronic form in connection with a transaction for which HHS has adopted a standard.”

Doulas do not fit into any of those categories, which means they do not have to comply with HIPAA. Yet I still hear “As a doula, I consider myself under HIPAA whether I legally am or not!”

When I hear that I want to ask: “So that means you…..

  • Have a written privacy policy and have your clients sign that they receive it?
  • Have that written policy posted on the wall at the place where you are providing services?
  • Have approved locks and secure shredding facilities for your paperwork?
  • Have written procedures in place for handling complaints?

Because these are ALL requirements of HIPAA, and if you consider yourself “under HIPAA”, then you’d better start doing them!

So please, let’s stop citing HIPAA as the reason for client confidentiality. Let’s just do it because it is simply the right thing to do!

This article originally appeared on the author’s website. Reprinted with permission.


Client Privacy and Social Media

Doulas, Privacy and Social MediaI am a smart woman. I can put two and two together. And many times, I’ve been able to tell who a doula’s client is by what she posts on Facebook, even if she is careful not to use the clients name. And I always wonder if the doula has permission to share in social media.

Client privacy is about more than just not using the client’s name. It is about preserving the client’s right to tell her own story on her own terms and in her own timing.

With the rise in social media and the immediacy of information, many doulas want to use social media to market themselves. They want to share the high from a glorious birth and gain support from colleagues after a difficult birth. These are very human desires, but they are also things that are of benefit to the doulas rather than the client.

My personal guidelines on client information online are:

  • 1. In my contract, I have a place where parents can initial if they are OK with non-identifying information shared on social media. If a client has not initialed there, I say nothing, ever. If client does initial there, what I post is *very* non identifying. I might post something like “How sweet it is to sleep a full night after an all-night birth!” or “Great birth this morning, I love my job!” I personally stay away from identifying birth places or care providers, as that might be just enough for someone to figure out who the client is.
  • 2. I do not post anything to social media while at a birth. My clients deserve my focus. Any requests for support or help from other doulas is done privately.
  • 3. Since I also do birth photography, I have a strict rule that the parents see the images before I share them on my site or Facebook page. Some parents have requested a quick turnaround of one image so that they can announce the birth, I get that to them privately and they post it before I do.

If you have not yet carefully considered and thought about your personal guidelines on social media, I encourage you to do so. It can be easier to decide in the moment if something is “postable” if you’ve carefully considered the ramifications and possibilities ahead of time.

A dear friend of mine once went online to announce the birth of her very long awaited baby and instead found that two others had already gone online and announced to the world what was happening, and in a way that portrayed her experience as very different than the way she lived it. She says “It was so frustrating to have other people telling my experience, especially framing it in a way that I did not feel at the time…it really was not fair to me at all to not even be able to tell the story the way I wanted it known.”

Please remember in your interactions online that you may be telling more than you realize, and that the family’s right to tell the story in their timing and in their way.

This article originally appeared on the author’s website. Reprinted with Permission.