Murphy introduces legislation examining overdoses, patient privacy

By:  Jessica Lerner
New Haven Register

U.S. Sens. Chris Murphy, D-Conn., and Bill Cassidy, R-La., have introduced bipartisan legislation to ensure health care providers have clear guidelines about when they are allowed to tell a patient’s family about a nonfatal overdose while abiding by federal privacy laws and regulations.

During a medical emergency such as a nonfatal overdose, health care providers must take into consideration a variety of federal laws and regulations governing the protection of patient information, including the Health Insurance Portability and Accountability Act, which protects patient privacy.

The Saving Lives Through Proper Notification of Overdoses Act would require the U.S. Department of Health and Human Services to annually inform health care providers about permitted disclosures of patient information during medical emergencies, including nonfatal overdoses, with the goal of saving lives by alerting family members of a loved one’s struggle with addiction, the release stated.

“A tidal wave of addiction is devastating families and straining communities across Connecticut. Congress needs to do more,” said Murphy in a statement. “In emergency situations, lack of notification and information sharing can freeze out family members who need to be there for a loved one. I’m happy to work with Senator Cassidy again to help make sure first responders and doctors know they can share critical facts with family members and health providers of patients suffering an overdose.”

While Dr. Gail D’Onofrio, chair of the department of emergency medicine at Yale New Haven Hospital, said clear guidelines would be beneficial to providers and patients, she said the best approach is to speak with the patient and ask about involvement of friends and/or family.

“I think it is unlikely providers will disclose this information if [a] patient is adamant about not telling. The important part is offering treatment, (following) up and having someone continue the conversations once they leave the (emergency department). Whether this is primary care, their current counselor or a treatment program,” D’Onofrio said. “Having caring others always helps but opioid use is not something one can will themselves out of. It is a disease and needs treatment.”

John Thomas, a Quinnipiac University professor with a law degree and a master’s in public health, said families may be able to help intervene and convince those affected to seek treatment, but said he’s worried the proposed legislation could set a dangerous precedent in regard to possible intrusion into doctor-patient confidentiality.

“I worry that it will breach the historic confidentiality of the physician-patient relationship, and if those opioid users know this trust between patients and physicians (has) been breached in some way, it may discourage them from seeking treatment,” he said.

Thomas said he believes this issue needs to be attacked from every direction. “Opioids have been around for a long time, but the crisis is relatively new,” he said.

He wants to see studies and conversations from health care providers on the front lines, such as ER doctors, emergency medical responders, social workers and psychologists, before reaching a conclusion on the proposed legislation, despite applauding Murphy’s pursuit of a solution.

Many people die after overdosing on multiple occasions over a period of time without their family ever knowing of their condition. With proper notification in accordance with patient privacy laws, family members might have the opportunity to save a loved one’s life by helping them overcome addiction and avoid a repeat overdose, Murphy said in the release.

However, Thomas said if the family of a patient who’s had many overdoses is unaware of his or her addiction, “then there’s not much of a relationship there anyway, so I don’t know how beneficial the legislation would be.”

Recent testimony to the Senate Health Committee included the story of Emmett Scannell. After he died, the release said Emmett’s family discovered he had had seven overdoses reversed at local hospitals and no one had been notified.

“How we respond to nonfatal overdoses in this country is the most important and one of the first things we should be doing,” Jessica Hulsey Nickel, president and CEO of the Addiction Policy Forum, told the committee, according to the release. “Of the nearly 64,000 people that we’re losing annually to overdoses, 70 percent of them had a previous nonfatal overdose.”

This legislation builds upon Murphy and Cassidy’s Mental Health Reform Act, which was signed into law in 2016 and requires HHS to identify and model programs and materials for training health care providers and patients in understanding HIPAA, the release said.