How multidisciplinary teams can comply with HIPAA

As defined in The Multidisciplinary Team (MDT) Approach and Quality of Care, "The core function of a multidisciplinary team (MDT) is to bring together a group of healthcare professionals from different fields in order to determine patients' treatment plan". These collaborative groups bring together professionals from various specialties—physicians, nurses, social workers, therapists, pharmacists, and other healthcare providers—to address patient needs holistically.

Rather than viewing HIPAA as an obstacle, the Institute for Patient- and Family-Centered Care provides that healthcare organizations should recognize that "HIPAA's focus on patients' rights to confidentiality and to access to information has created an environment that can facilitate and support collaboration among patients, families, and health care providers". 

Understanding HIPAA in the context of multidisciplinary teams

HIPAA establishes national standards for protecting patient health information, covering how Protected Health Information (PHI) can be used, disclosed, and safeguarded. When applied to multidisciplinary teams, these regulations must account for the legitimate need for multiple healthcare professionals to access and share patient information while maintaining privacy protections.

As noted by the National Crimes Against Children Investigators Association in their article HIPAA, Child Advocacy Centers and Multidisciplinary Teams, "One of the key aspects of the work done by CACs and MDTs is information sharing among team members to facilitate effective coordination and collaboration." However, this collaboration must occur within HIPAA's framework, requiring teams to develop "specific protocols and agreements that allow for the lawful exchange of information while still safeguarding individuals' privacy rights."

The Privacy Rule, Security Rule, and Breach Notification Rule all apply to multidisciplinary team operations. The Privacy Rule governs the use and disclosure of PHI, the Security Rule establishes safeguards for electronic PHI (ePHI), and the Breach Notification Rule requires organizations to notify patients and authorities of potential breaches. Each team member, regardless of their discipline or role, must understand these requirements and their individual responsibilities.

Multidisciplinary teams often face challenges because they may include professionals from different organizations, departments, or even separate healthcare systems. This requires clear protocols for information sharing, access controls, and accountability measures that span organizational boundaries while maintaining HIPAA compliance. However, according to the Institute for Patient- and Family-Centered Care, healthcare leaders must remember that "correct interpretation of this complex law requires, first of all, an understanding of its key terms".

Read also: What is the key to HIPAA compliance?

Establishing clear roles and responsibilities

HIPAA compliance in multidisciplinary teams begins with clearly defined roles and responsibilities for each team member. Organizations must designate who has access to what information, under what circumstances, and for what purposes. This role-based access control ensures that team members only access the PHI required to perform their specific functions.

Understanding the coordination role is important, as research in The Multidisciplinary Team (MDT) Approach and Quality of Care article shows that "The nurse will facilitate and coordinate the activities among all the specialists of the MDT, framing their activities in care plans and integrating healthcare processes in collaboration with other professionals involved in cancer care". Each discipline within the team should have documented responsibilities regarding PHI handling. For example, physicians may need access to complete medical records, while social workers might only require specific psychosocial information, and pharmacists may need medication-related data. 

The Institute for Patient- and Family-Centered Care states that "hospital administrators and staff who wish to comply with HIPAA in a way that is synergistic with patient- and family-centered approaches need to understand that the law does allow room for flexibility and professional judgment". This flexibility enables teams to adapt their protocols to meet the specific needs of their patient populations while maintaining compliance.

Team leaders or coordinators should be designated as primary points of contact for HIPAA-related questions and concerns. These individuals should receive training on privacy regulations and serve as resources for other team members. They also play a role in ensuring that all team communications and documentation practices align with HIPAA requirements.

Clear documentation of roles and responsibilities should be maintained and regularly updated as team composition changes. This documentation should include specific protocols for different types of patient information, emergency situations, and interactions with external providers or organizations.

Implementing secure communication protocols

Effective communication is the cornerstone of successful multidisciplinary care, but it must occur within HIPAA compliant frameworks. As noted in How can healthcare organizations ensure HIPAA compliance in electronic communications?, "Ensuring HIPAA compliance in electronic communications is not only a legal requirement but also an ethical requirement to maintain patient trust and the integrity of healthcare services." Teams must establish secure communication channels that protect PHI while enabling real-time collaboration and information sharing. 

Electronic communication platforms should be HIPAA compliant and encrypted to protect transmitted information. According to How can healthcare organizations ensure HIPAA compliance in electronic communications?, the "Encryption transforms sensitive data into unreadable code, making it harder for unauthorized parties to access or decipher the information." This includes email systems, messaging platforms, video conferencing tools, and any other digital communication methods used by the team. The same article emphasizes that "Healthcare organizations should also leverage secure messaging platforms designed explicitly for healthcare communications. These platforms often provide features such as secure messaging, file sharing, and real-time communication while adhering to strict security standards."

Organizations should provide approved communication tools and prohibit the use of unsecured platforms like personal email or consumer messaging applications. Solutions like Paubox offer HIPAA compliant email services that enable healthcare teams to communicate securely without the friction of traditional encrypted email portals, making it easier for multidisciplinary teams to collaborate effectively while maintaining compliance.

Access controls are equally important, as "Controlling access to ePHI is necessary for HIPAA compliance. Covered entities under HIPAA should implement access controls to ensure that only authorized personnel can access patient information". This involves implementing role-based access control mechanisms and multi-factor authentication to ensure that only team members with legitimate needs can access specific patient information.

When verbal communication is necessary, teams should establish protocols for discussing patient information in appropriate settings. This includes identifying secure locations for case discussions, implementing procedures for telephone consultations, and establishing guidelines for emergency communications. As highlighted in " How can healthcare organizations ensure HIPAA compliance in electronic communications?" "Healthcare professionals need to know how to identify potential security threats, such as phishing attacks or suspicious requests for patient information." Team members should be trained to be mindful of their surroundings and avoid discussing patient information in public areas or where unauthorized individuals might overhear.

Training and education programs

Training programs ensure that all multidisciplinary team members understand their HIPAA obligations and how to fulfill them in collaborative care settings. Training should be tailored to address the specific challenges and scenarios that multidisciplinary teams encounter.

Initial training should cover basic HIPAA principles, including the definition of PHI, permitted uses and disclosures, patient rights, and security requirements. However, multidisciplinary team training should go beyond basic compliance to address the complexities of information sharing across disciplines and organizations.

According to the Institute for Patient- and Family-Centered Care, the ultimate goal of both HIPAA and effective multidisciplinary care is to "restore and strengthen trust among patients, families, and health care professionals" while enhancing "patient rights" and improving "the efficiency and effectiveness of care". Training programs should emphasize these shared objectives to help team members understand that compliance supports rather than hinders quality care.

FAQs

How should multidisciplinary teams handle HIPAA compliance when working across state lines with differing privacy laws?

Teams must coordinate HIPAA compliance alongside applicable state laws, often defaulting to the stricter regulation.

Can non-healthcare professionals on MDTs, such as law enforcement or educators, access PHI under HIPAA?

Only if there is a legal basis and appropriate agreements, such as Business Associate Agreements or court orders, permitting limited access.

What happens if a multidisciplinary team includes volunteers or interns—how are they trained on HIPAA?

They must undergo the same HIPAA training and be bound by confidentiality agreements before participating in any patient-related activities.

How can MDTs document verbal disclosures of PHI in a HIPAA-compliant manner?

Verbal disclosures should be recorded in secure logs with justification, recipient identity, and context to ensure audit readiness.

What are some common HIPAA violations in multidisciplinary settings that teams should watch for?

Unsecured messaging, over-disclosure of information, and lack of proper access controls are frequent violations in MDT environments.