Transit dispatchers – both those communicating with demand-response drivers and fixed-route operators – often need to relay important information about passengers’ origin or destination locations. How to dispatchers effetely convey these crucial service details to their drivers without violating the passengers’ right to medical privacy protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)?

When I cover it in dispatch training (including CTAA’s Passenger Assistance Safety & Sensitivity program), I always stress using the address for the destination – perhaps an AIDS clinic or a methadone clinic, instead of naming the type or name of the facility. It avoids the sharing of potential medical information and could lead to a scenario like this:

Dispatcher: “bus 13: can you pick up Gertrude McClyment at the Cancer Treatment Center?”

Bus 13: “10-4”

Meanwhile on Bus 5, Gladys Spellman hears the conversation, and thinks, “Trudy never told me she had cancer. I better call Betty and see if she knows about this.”

You can insert AIDS Clinic, Dialysis Clinic, Methadone Clinic or any other destination that gives information about the type of medical attention the passenger may be receiving.

This doesn’t stop at just the radio chatter, but also applies to manifest creation. If the paper manifest, hand-held tablet or Mobile Data Terminal (MDT) shows a destination such as as Cancer Treatment Center, it can also be an indication of the type of medical attention that passenger is receiving. When a driver gets off the bus to help a passenger to the door of their house they usually leave the manifest unguarded. Some nosy passenger may decide to look at it and see if they know anyone. Or if they see medical treatment centers, they might share that private information with others. This may seem overly cautious, but I’ve experienced both scenarios as a supervisor at paratransit systems.

Although transit is not specifically covered by HIPAA but it is best practice to reduce the flow of personal information other than what is necessary to provide the trip, similar to the Americans with Disabilities Act (ADA). Paratransit service does not or should not know the disability of their rider. Granted, most of the drivers have a good idea and – in some case – it’s fairly obvious, but we cannot ask what a person’s disability is at the time of the reservation or at any time during the trip. We can ask if they will need assistance of a lift or ramp or any other information we might need to know to safely transport the person. Consider that this approach extends to any details of medical appointments or treatment for any passenger.

A couple helpful resources on HIPAA and patient communications are available:

• HIPAA Didn’t Kill the Radio Star – PSC Online
• The Intersection of Patient Privacy with Emergency Dispatch (PDF) – Douglas M. Wolfberg, Stephen R. Wirth, & Cindy R. Staffelbach, Esquires