GLASGOW — Privacy is at the forefront of new federal regulations that went into effect a week ago, but the new law has created big problems for many in the health care industry. The regulations require health care providers to enact a series of measures aimed at protecting patient health information.

"It has changed the way health care does business," said Mike Swift, president of the Kentucky Ambulance Providers Association and director of the Barren-Metcalfe Ambulance Service.

Voted into law in 1996, the Health Insurance Portability and Accountability Act or HIPPA will oversee the regulation and dissemination of all patient medical information.

According to established guidelines, everything from medical records to conversations with health care personnel including physicians, nurses, and emergency medical technicians (EMTs), or electronically stored information is protected under the new law.

Violation of the law could bring criminal penalties of up to $250,000 in fines or 10 years in jail or both.

The privacy rule applies to health care providers such as hospitals, physician offices, medical transports and health departments, as well as health plans and health care clearinghouses.

"In theory, the intent to protect patients' privacy is excellent, but the implementation is the problem," said Swift. Basically, he said, "the golden carriage turned into a pumpkin on Apr. 14."

Under the set provisions, the ambulance service is responsible for distributing a seven-page brochure regarding patient privacy rights and for obtaining a signature of consent for each patient it transports.

The paper trail, said Swift, will inevitably cause confusion among both the patients and health care providers.

The tabulated version of the law which outlines HIPPA regulations is a lengthy 267 pages.

"The bottom line is they have taken a very simple premise and made it confusing," said Swift. "The ambulance industry is so different than any other facet of health care," he continued, saying the regulations have created a hardship for ambulance providers which don't have large staffs or the financial clout of larger health institutions.

In addition to the paperwork, compliance with HIPPA regulations has come at considerable cost to ambulance services nationwide--to the tune of millions, said Swift. In order to meet federal mandates, local ambulance service employees were required to undergo additional training and to purchase containers and cabinets for each substation where patient information can be deposited and secured under lock and key.

"Ultimately as with any change, we'll adjust," said Swift, but its going to take time and patience on part of everyone involved, he said.

While, according to Swift, ambulance services throughout Kentucky have struggled, other health care agencies have made the transition with little problem.

"A lot of things HIPPA demanded you do, we already have in place," said Sharon Bybee, chief privacy officer for T.J. Samson Community Hospital.

"We've been preparing and have planned well," she said.

The hospital has initiated privacy notices to patients at registration covering patient rights and right to disclosure.

However, the facility has been working toward implementing the new privacy guidelines while slowly integrating changes over the course of several years, said Bybee, who was appointed to oversee privacy policies and procedure as required by HIPPA.

T.J. Samson conducted a gap analysis about a year-and-a-half ago to review current policies. The exercise helped to "see where we may have needed changes" said Bybee, and then those needs were addressed, she said.

When the new wing of the hospital was constructed, computers set up at registration area were built into the wall units and the separating walls provide a sound barrier for another measure of protection, Bybee explained, adding, "We want patients to feel secure."