Mc connell pp_ch25

© 2010 Jones and Bartlett Publishers, LLC

Umiker's Management Skills for the New Health

Care Supervisor, Fifth Edition

Charles McConnell


Chapter 25

Privacy and Confidentiality, Privacy and Confidentiality,

Employees and ClientsEmployees and Clients


Privacy Today

There is a growing belief in American

society concerning the right of the

individual to privacy. There are also

increasing doubts about how the

government might use information

that it collects about individuals.


Privacy and the Law

Title VII of the Civil Rights Act of 1964

Privacy Act of 1974

Employee Polygraph Protection Act of

1988

Employee Polygraph Protection Act of

1988


Personnel Files

Considered the property of the

employer., but any organization

having a privacy policy in place will

strictly limit access to personnel

files to those having a legitimate

need for the information


Employee Searches

Every organization should have an official

policy governing such searches, publicized

so that employees know that searches can

occur and the basis for the searches,

specifically whether they can to occur at

random or for reasonable cause or both.


Employee Health Records

Once integrated into personnel files,

employee health records are now

considered legitimate medical

records and thus subject to stricter

rules of accessibility.


Patient Privacy and Confidentiality

Patient records should always be

held in the strictest confidence. It is

a violation of ethical principles to

reveal patient information to

anyone outside of the organization

without proper authorization.


Patient Privacy and Confidentiality

No information about a patient’s

condition—not even acknowledgment

that the individual is a patient—should

be given out without the express

permission of the patient (or individual

empowered to act for the patient).


Information Security

Health information management (HIM)

employees must fully orientated and trained.

All HIM employees should be required to

complete a confidentiality statement.

Students, researchers, and others having

access to health care data should receive be

oriented and sign a confidentiality statement.



Provisions for data security should be included

in any contract for external services.

All requests for the release of information

should be processed centrally in HIM.

Detailed rules should be developed and

enforced to limit the use of health care data.



There should be appropriate safeguards

for computerized processing and

storage of health information.

Only persons with a legitimate and

verifiable need to know should be

permitted access to confidential health

care information.


“HIPAA”

THE HEALTH INSURANCE

PORTABILITY AND ACCOUNTABILITY

ACT Of 1996


HIPAA Title II

HIPAA consists of Titles I, II, III, IV,

and V. It is Title II, devoid of any

significant reference to health

insurance, that addresses privacy

and confidentiality.


HIPAA Title II

The full name of Title II is: “Preventing Health Care Fraud and

Abuse, Administrative Simplification, and Medical Liability

Reform.”

Within Title II is the “Privacy Rule”


Intent

The law was intended to strike a balance

between ensuring that personal health

information is accessible only to those who

truly need it and permitting the health care

industry to pursue medical research and

improve the overall quality of care.


Reality

The applicable portions of Title II created

much work and expense for health care

providers and organizations that do

business with them, plus creating

inconvenience and often frustration for

patients and their families.


Public Reaction

Patients and patient advocates

claimed that these new

requirements were forcing people to

choose between access to medical

care and control of their personal

medical information.


Patients’ Rights Under HIPAA

Patients are entitled to know how their

personal medical information will be used or

disclosed.

Patients may request and receive copies of

their health records.

Patients may ask for corrections,

amendments, or restrictions to their

personal medical information.



Patients may request a full

accounting of disclosures of their

personal medical information.

Patients may file complaints if they

believe their privacy rights have

been violated.



Employers and marketers are prevented

from obtaining patient medical information

without the patient’s express written

authorization.

A hospital inpatient may forbid the facility

to release information on his or her medical

condition to anyone.


Non-Consent Uses

There are a number of instances in

which personal medical information

can be used without patient consent.

These are related mostly to

research and public health uses, and

patient identification is removed.


Widespread Requirements

All health care plans and providers

and all other organizations that

serve the direct providers of health

care, such as billing services and

medical equipment dealers. All

affected entities must: (next)



Safeguard patient information in all forms from unauthorized use or distribution.

Protect patient information from misuse. Implement specific data formats and code

sets for consistency of and preservation. Establish audit mechanisms to safeguard

against fraud and abuse.



Contracts with involved organizations must: Define the proper uses of all patient data; Specify audit mechanisms and safeguards; Require disclosure when patient information

is improperly used or disclosed; and Call for the destruction or return of protected

patient information when no longer needed.


Departmental Involvement

Privacy rule compliance involves:

Information technology;

Health information management;

Social services;

Finance;

Administration; and

Various ancillary or supporting services.


Effects on Systems

The HIPAA Privacy Rule created a

widespread need for health care

providers to reengineer their

systems to protect their patient

information infrastructures and

combat misuse and abuse.


HIPAA and the Supervisor

Depending on the kind of activity you

supervise, the requirements of HIPAA

can significantly affect your role. In

some departments you may never

have to concern yourself with HIPAA;

in others HIPAA will be with you daily.

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