A nurse has been fired by a Texas hospital after accessing information on patients for whom she had no clinical responsibility, according to the Mt. Pleasant, TX Daily Tribune. The hospital, Titus Regional Medical Center, reportedly discovered the unauthorized access in the course of an audit in November. The nurse admitted to looking at the records out of curiosity but insisted that no records had been further disclosed.

The hospital decided to notify 108 patients in a letter which warned them of a slight risk of identity theft. The hospital administrator indicated that the notices may not be required under HIPAA but were being sent out of an abundance of caution, and emphasized that there was no evidence any data was printed nor disclosed to any third parties. Although most records accessed did not contain social security numbers, affected patients were nevertheless advised to contact the three major credit bureaus, Equifax, Experian and TransUnion.

This incident is reminiscent of the 2011 UCLA breach which resulted in a prison term for the snooping employee and similar incidents involving other California hospitals. A common element in these breach incidents is that the health information was not sold, distributed or otherwise further disclosed by the snooping employees. However, after an investigation, federal health regulators determined that UCLA employees reviewed patients’ electronic medical records "repeatedly and without a permissible reason."   Ultimately, UCLA entered into a settlement agreement with federal health regulators, which among other things, socked UCLA with a fine of $865,000. 

These cases illustrate the seriousness of HIPAA’s still poorly-defined “minimum necessary” standard which, at the least, requires workers at covered entities and business associates to have a valid reason beyond mere curiosity before they access PHI. The ease with which employees can call up any record in a health system’s database can present an overpowering temptation, and it is incumbent on employers to educate their workforce about the need to resist the urge to snoop.