Chapter 3- Confidentiality
EXCEPTIONS TO CONFIDENTIALITY IN HEALTHCARE
- Child Abuse - Elder Abuse - Mental Health Patients - Matters of the Greater Good
Under HIPAA, personal records can be covered by other legislation, such as the ...?
- Family and Medical Leave Act (FMLA) - Gramm-Leach-Bliley Act (GLB)
Learning Objectives
- The importance of confidentiality in the healthcare industry. - The Health Insurance Portability and Accountability Act (HIPAA). - Violations of a patient's confidentiality and consequences. - Common breaches of medical information. - The Privacy Rule.
What items does HIPAA not cover?
- financial documents - educational records - employment records
What three forms does PHI or the privacy rule come in?
- written -electronic - oral
Under HIPAA, what five different forms are required to protect patient information?
1) the privacy notice 2) the signature of the patient indicating reception of the privacy notice 3) the patient's permission to provide medical information to other people or entities 4) a trading partner agreement specifying the parties involved (e.g., physician and patient) 5) a contractual statement between the physician or facility and the patient.
Under HIPAA, what are two main ways for the healthcare professional to achieve confidentiality for the patient?
1. professional silence 2. secure data management
What 3 things does HIPAA include?
1. to improve conditions when individuals change health insurance programs, including portability. 2. provided there is no lapse of coverage, preexisting conditions are covered. 3. the HIPAA legislation includes protection of private medical information, standardization and simplification of forms, and strategies to prevent fraud, waste, and abuse.
What is covered by HIPAA?
A company that is self-insured for medical coverage of employees, the handling of insurance claims and other health-related information is covered by HIPAA.
Matters of the Greater Good
Alerting the public to a potential danger can help to ensure safety.
Which is a forerunner to HIPAA?
COBRA
What does COBRA mandate/do?
COBRA, a forerunner to HIPAA, mandates that businesses with 20 employees or more must provide health insurance for up to 18 months, usually paid by the employee. It also gives workersand their families who lose their health benefits the right to choose to continue groups health benefits provided by their group health plan for limited periods of time under certain circumstances.
Why is confidentiality important?
Confidentiality is important because a person's healthcare information is private and personal and because a person might be more likely to seek healthcare if assured of privacy.
What does COBRA stand for?
Consolidated Omnibus Budget Reconciliation Act
What is an exception to HIPAA?
Exceptions to HIPAA include suspected abuse
What is an example of a healthcare professional achieve confidentiality for a patient?
For example, having access to a patient's medical record (e.g., as a receptionist) does not involve automatic permission to view the record. (secure data management)
Healthcare industry confidentiality
For the healthcare industry, confidentiality means keeping personal medical information private. Confidentiality is not only ethical but is mandated by law
What would you find on the U.S. Department of Labor website at http://www.dol.gov ?
Further data on medical information, safety records, and family and medical leave records.
Generally speaking, ____________ __ __________. ____________ ___________ should never be shared with others.
Generally speaking, knowledgeof patients' medical records should never be shared with others.
When was HIPAA signed into law and by who?
HIPAA was signed into law in 1996 under president Clinton
Child Abuse
In 18 states any person who suspects child abuse is required to report it.
Case Study: Releasing Medical Information.
Initially a data bank made people aware of fraud and abuse by a provider- now a national practitioner base can look at provider base
Mental Health Patients
Patients Who Might Pose a Threat are a vulnerable population.
What is covered by federal law such as the Privacy Act and HIPAA.
Patients have a say in how their medical information is shared, with few exceptions, covered by federal law such as the Privacy Act and HIPAA.
Hippocratic oath confidentiality
Patients have the right to have their medical information kept confidential due to the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
What does portability mean?
Portability means that no lapse of healthcare coverage occurs when a person changes from one job to another even if insurance carriers change.
What are pre-existing conditions?
Preexisting conditions are ailments or diseases that the patient has before health insurance coverage begins.
What is PHI?
Protected health information (PHI) is any health-related personal data under the privacy rule.
What is HIPDB replaced by?
Replaced by National Practitioner Date Base
What does HIPAA stand for?
THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
What are potential examples of breeching HIPAA?
Telling patient's family members or spouses or partners about their treatment without permission of patient.
Which act was the forefather to HIPAA?
The Privacy Act
Case Study: Dr. George Sheffield. Beginnings.
The Privacy Act of 1974, applying only to US citizens and permanent residents, was signed into law by President Gerald Ford.
Which is a portion of HIPAA?
The Privacy Rule
What is the Privacy Rule?
The Privacy Rule, implemented in 2003, is a portion of HIPAA that refers to personal data, known as protected health information (PHI).
Why was HIPAA enacted?
The federal law was enacted to address privacy issues and continuation of health insurance coverage.
What does pre-existing allowance permit?
The preexisting allowance in the law permits continuous coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA), 1985.
Confidential reporting system for violations of patient safety
ThePatient Safety and Quality Improvement Act (PSQIA)
The law (HIPAA) was introduced in three phases between writing the law in 1996 and implementation in 2003. What are the three implementations?
There was the implementation of: federal privacy regulations, of insurance claims, and of a clearinghouse of electronic and medical claims.
What does HIPAA provide?
This legislation gives the patient more control over personal medical information and how it is used or released.
Common Breaches of Medical Information
To breach confidentiality means to violate, and there are many ways in which a professional can fail to guard personal medical information.
What does it mean to breach confidentiality?
To breach confidentiality means to violate, and there are many ways in which a professional can fail to guard personal medical information.
Release of Information
To protect a patient's medical information under HIPAA, there are rules about accessing that information.
A Release of Information form is ...?
a document that allows the healthcare provider to share certain information (e.g.. when a patient is referred by the physician to a specialist), but not necessarily the whole record.
what can the confidentiality laws can protect?
can protect the healthcare provider to ensure better patient care.
In addition to patients' medical information, ________________ laws can protect the healthcare provider to ensure better patient care.
confidentiality
The Patient Safety and Quality Improvement Act (PSQIA), published in 2005 and implemented in 2009
provides a confidential reporting system for violations of patient safety by creating an environment where providers can report and examine patient safety events without fear of increased liability risks.
Elder Abuse
refers to harmful treatment of an elderly person, with reporting being mandated in 16 states.
Healthcare professionals have a __________________ to protect patient information.
responsibility
Confidentiality is a ______ of every patient in the United States.
right
Healthcare Integrity and Protection Data Bank (HIPDB)
under HIPAA, is a national data bank to prevent fraud/abuse by practitioners and suppliers.