Confidentiality between a patient and the health provider is one of the basic principles of modern health care. Without confidentiality, the effectiveness of the health care system decreases, due to patient fear of having their medical records revealed and possibly used against them.
In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA) with the final wording of the Act being approved last year. The Act is designed to increase the patient’s privacy and ease of obtaining their medical records. The US Department of Health and Human Services is responsible for regulating the Act. Violations of the Act can be punished by fines and/or criminal sanctions as well as be subject to civil lawsuits.
Meeting the HIPAA Standards requires specialized computer systems and staff training, among other changes to the hospital operations to protect the patient’s medical records. It also places additional consideration on the architectural design of the medical facility. There is now a legal obligation to provide speech privacy between the patient and the health care provider, especially in key areas, such as in Treatment/Exam rooms, and in Admission areas.
Speech privacy between two spaces can be measured using methodologies such as the Articulation Index (AI). The AI is a measure of speech intelligibility, with a value from 0 to 1. A “1” indicates perfect speech intelligibility, while a “0” indicates perfect speech privacy. Typically, AI ratings of 0.2 or less are appropriate for medical system speech privacy.
Providing “confidential” speech privacy in medical environments demands that careful attention be paid to many aspects of the design. The common walls between patient consultation areas and the rest of the hospital must be constructed to sufficiently reduce sound transfer between the spaces. Plumbing and electrical penetrations in the common walls can reduce the sound isolation and must be addressed. Suitable doors must be selected and properly gasketed. The HVAC system must also be designed to prevent cross-talk and other ductwork related noise transfer problems.
In addition to good sound isolation between areas, the background noise must also be of an appropriate level – too quiet, and sounds from one space will be more easily heard; too loud, and people will raise their voices during conversation. When the background noise level is too low, a sound masking system can be installed to create a higher level of inoffensive background noise. This, in fact, was a solution Thorburn Associates employed on a recent counseling center project in which the counseling room common walls were not full height.
Thorburn Associates is currently working on several medical facilities and has a wealth of experience dealing with speech privacy issues. Please feel free to contact us(link to contact page) with any questions you may have.
The HIPAA Standards may be viewed at: http://aspe.hhs.gov/admnsimp/index.shtml.