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EMT club in conflict with administration over privacy laws

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St. Olaf Emergency Medical Technicians (EMTs) are known across campus for their distinctive blue uniforms, medical expertise and vital first-responder services. However, according to anonymous reports by a number of EMTs, the club’s mission has been plagued by a lack of patient privacy, obstructive Public Safety officers and administrative ambivalence.

According to those EMTS, EMT medical records are not given traditional patient privacy protections, but are instead accessible to certain administrators. These disclosures have raised ethical concerns, particularly after allegations arose that administrative officials have viewed these reports to take punitive action against students treated for alcohol and drug-related medical issues. While such claims have not been confirmed, retroactive disciplinary actions are possible based on the weak privacy protections of EMT medical records.

In addition to privacy issues, sources say there have been numerous instances of Public Safety officers interfering with or obstructing medical care during a call. Some EMTs have also reported derogatory comments made by Public Safety officers towards patients.

The St. Olaf EMTs are a nationally recognized Emergency Medical Service (EMS) organization, registered with both the National Registry of EMTs and the Minnesota EMS Regulatory Board. However, unlike most EMS organizations, St. Olaf EMTs’ medical records are not given traditional privacy protections. The vast majority of EMS organizations’ privacy rules are determined by the federal Health Insurance Portability and Accountability Act (HIPAA). HIPAA establishes strict privacy requirements for health care providers, protecting most patient health information unless explicit permission for disclosure is given by the patient. Because St. Olaf EMTs do not bill for their services or require insurance reimbursement, they are not governed by HIPAA regulations. Instead, EMTs are subject to the Federal Family Educational Rights and Privacy Act (FERPA), which has weaker privacy protections than HIPAA.

In fact, according to some EMTs, the administration is able to view all EMT medical records with very few restrictions. Whenever a student calls Public Safety asking for medical assistance, the two EMTs on duty and a Public Safety officer are dispatched to provide medical aid. While the EMTs administer medical care, they write up a report that describes what happened, called a ‘run-report.”

According to an anonymous EMT, these run-reports are “submitted to an internal server in Public Safety.” In addition, run-reports are available to administration officials, meaning non-medical personnel can see all the medical care that was given during each call. The main concern among some EMTs is that this lack of confidentiality leads to distrust between students and EMTs, which may in turn hinder effective medical care. Students may be concerned about disciplinary action if they report having consumed alcohol or other banned substances, even though this information is essential for first-responders in making medical judgements.

On April 29, during the protests that took place in Buntrock Commons, several EMTs were on duty to provide medical care. An email sent to St. Olaf EMTs, reminded those on-duty to “follow your protocols, and fill out run-reports.” However, these run-reports could potentially be used by the administration to punish students.

Another issue surrounding these reports is their ease of access. At other EMS organizations, certain administrators have access to their organization’s run-reports. When these officials want to view them, they must state a reason. In addition, a time-stamp is marked denoting when and for how long the official viewed the reports. None of these restrictions are in place for EMT run-reports at St. Olaf. Non-medical administration personnel can read run-reports at any time, for any reason.

The weak privacy protections of run-reports could also pose a problem when reporting sexual assault. Under Minnesota law, EMTs are mandated to report sexual assault committed against a “vulnerable population,” usually considered to be minors or anyone that is incapacitated. For victims 18 or older, however, EMTs must obtain permission from the survivor in order to report sexual assault. Even if it’s not reported to law enforcement, run-reports describe any sexual assault that has occurred. These reports are accessible by Public Safety officers and administration officials, leading to legal and ethical concerns. According to an anonymous EMT, if an incident of sexual assault “is written up in any of the run-reports and is seen by Public Safety, they are now mandatory reporters and will report it.” This would mean that Public Safety officers could report cases of sexual assault against the survivor’s wishes.

“The National Collegiate EMS Foundation has said that run-report information should only be visible to those who are directly responsible for the call,” the EMT said, “as well as a medically trained supervisor, and therefore should go under the standard of protected medical information, along with things like school nurse documents, which they currently do not.”

While Public Safety officers are present for almost every EMT call in order to ensure safety and serve as a legal representative of the college, they are not medically trained. Public Safety officers are only allowed to help administer medical care if the EMT gives them permission.

“There have been numerous cases of Public Safety officers overstepping their non-medical boundaries in interfering directly with patient care,” the anonymous EMT said.

In one instance, a student was asked to take a blood sugar test, which the student questioned. Before the EMT could reply, the Public Safety officer informed the student that they didn’t have to comply.

“While we don’t force anyone to do anything, we believe it’s important to inform the patient as to the importance of certain medical procedures and how they help to serve the patient’s needs as best we can,” the EMT said.

Public Safety made a brief statement to the EMT club saying it is going to work on this.

There have been other sources of tension as well. EMTs have said that Public Safety officers can call an ambulance even if the EMT doesn’t think it necessary.

There have also been reports of some Public Safety officers making disrespectful remarks towards patients during medical calls.

“There have been instances of officers making comments that detract from the sense of trust that you would need for your patient to be able to tell you what is actually going on so you can help them,” one EMT said.

All these incidents exemplify the discrepancy between the perceived autonomy of the St. Olaf EMTs and their official status as subordinate to Public Safety and the administration.

“The EMT club is sort of autonomous, there is a lot of autonomy within the club,” EMT Stein Acker ’20 said. “And Public Safety, for the most part, stays out of our business.”

This perceived independence is hampered by the lack of traditional patient privacy protections and Public Safety interference. EMTs on the club’s executive team have tried to make this autonomy a reality by moving the club underneath the control of Northfield Hospital. If this happened, the EMT club would be bound by HIPAA.

“Until then, documents are not confidential,” one anonymous EMT said. “[The administration] said ‘If that’s something that you’re not okay with, feel free to step away from the organization, or we can just disband it, and let the fine men and women of Northfield Hospital handle EMS here on campus, because I can see them from the window from my office.’”

“Even with the whole HIPAA/FERPA thing, if you need us, you should call us, because it’s more important for you to be safe in the long run,” the EMT said.

Nonetheless, many EMTs remain frustrated by the problems confronting the club and are disheartened by the administration’s ambivalence towards solving them.

According to an anonymous report, “[The club has] been running just fine for 22 years, and will continue to do so,” one administrator said. Many of the EMTs would beg to differ.

carlen1@stolaf.edu