One of the major differences between human and veterinary medicine is a little, well-known piece of legislation called HIPAA (Health Insurance Portability and Accountability Act). HIPAA calls upon the U.S. Department of Health and Human Services to issue patient privacy protections.
So why dos HIPAA not apply to the veterinary profession? Simple. Legal relations in our laws exist only between persons. Currently, most states consider pets to be property. And by law animals are things not persons. Some say that safe veterinary practice would be to follow the HIPAA guidelines even though they do not apply to veterinary medicine. The AVMA code of ethics states that a practice should act as though pet records are priveleged and confidential.
While veterinary hospitals do not now have to follow these human rules, how might facility design be affected if HIPAA were to be enforced in veterinary medicine? Besides the obvious patient privacy issues related to medical records, would clients become more concerned about their pets' privacy if they were granted "person" status? Would the design of the veterinary hospital become more like a human medical office?
Let's take a quick look at human and veterinary facility layout.
Due to current privacy concerns, human medical officers are much more compartmentalized than veterinary hospitals.
- Examination rooms are accessed through hallways and are not directly open to the waiting area.
- Procedural areas are much more private, usually with only one to two beds in each area.
- Doctors have their own offices instead of being out in the mix with everyone else.
Now think about your last visit to the veterinarian or think about your own practice. Because we are not as concerned about client and patient confidentiality, the line of privacy almost vanishes. This is good for us as designers, because we can create much more open, inviting environments for clients to enjoy and to decrease stress for patients.
- Reception areas act as a greeter's station with open cabinets and countertops instead of a reception counter with an area behind that is closed off to clients.
- Unlike human medicine, individual patient rooms are unnecessary in veterinary hospitals for ill patients, unless it is an isolation case. Fido doesn't care if Rocky has an ear infection. Holding cages and runs can be part of a treatment area or grouped together with other functions of the hospital allowing the design to be flexible and open.
- Lab/Pharmacy spaces are in communal hallways. Intensive Care Units are part of the main treatment area. Even doctors' offices are part of a "fish bowl" that is open to the other medical treatment areas.
A lot of these open spaces would not be possible if client and patient privacy became a customary concern. Fortunately, without HIPAA in place within in the veterinary profession, practices are taking advantage of a much more open plan. This open plan in turn fosters open communication and allows for easier, more efficient use of staff and better care of patients.