Legal Aspects of Health Information and Health Care Statistics Week 2 Robyn Korn, MBA, RHIA, CPHQ

General Information Discussion Board Enter first post by Saturday and a total of 3 posts by Tuesday Assignments Make sure your name is on the assignment attachments when they are submitted

General Information Late work will not be accepted unless there are clear and compelling extenuating circumstances. If you have extenuating circumstances that prevent you from completing course assignments/exams you must contact your instructor immediately—prior to the assignment/exam/quiz due-date unless prevented from doing so by emergency circumstances.

American Legal System Key Terms Law-defined system of principles and processes devised by organized society to deal with disputes and problems without resorting to the use of force. Private law- conflicts between private parties. Public law- conflicts between government and private parties.

American Legal System Key Terms Plaintiff- person who initiates the lawsuit. Defendant-person sued by the plaintiff. Malpractice- misconduct involving the failing of the physician to follow a standard of care, which results in harm to the patient. Res Ipsa Loquitur- the thing speaks for itself

Private Law Contract Law ◦ Oral or written ◦ Failure to fulfill terms/breach of contract Tort Law ◦ Rights and duties between parties without a contract ◦ Medical malpractice, invasion of privacy

Private Law New area of law Intellectual Property Law Legal Rights to software Electronic Health Record (HER)

Public Law Defines appropriate behavior between citizens, organizations and government Criminal Law – a large segment of public law

Sources of Law Constitution – fundamental law Statutes – laws written by legislature Regulations - administrative agencies Judicial Decisions – court rulings

Branches of Government Legislative – creates statutes or enacts laws Executive – enforces or adminisers the laws Judicial – interprets the laws

Quasi-legal Requirements State licensing requirements Accreditation standards Recommendations of Professional Associations Often establish standard of care in health care

Court Systems Jurisdiction ◦ Federal  Federal question - constitution or federal regulations  Diversity - different states and over $75,000 ◦ State  General jurisdiction  Specialized courts – probate, juvenile, small claims

Court Structure Federal System 1.Trial courts (district courts) 2.Courts of Appeal (circuit courts divided by geographic region) 3.Supreme Court (court of last resort)

Court Structure State System 1. Inferior Courts (municipal courts) 2. Trial Courts 3. Intermediate Appellate Courts 4. State High Courts (State Supreme Court)

Court Rules Implement statutory requirements Establish uniform procedures Guide attorneys Mirroring approach (each level bases rules on the next higher level)

Court Rules - Federal Rules of Civil Procedure * Rules of Criminal Procedure Rules of Evidence* *Impact HIM professionals

Steps in a Lawsuit 1. Complaint 2. Discovery 3. Pretrial Conference 4. Trial 5. Appeal 6. Satisfying the Judgement

Terminology of a Lawsuit Plaintiff – person initiating lawsuit Defendant – person being sued Complaint – written document describing the claim

Terminology of a Lawsuit Discovery – obtaining information and facts E-discovery – obtaining information stored on electronic medium Depositions – testimony under oath outside the courtroom to uncover details

E-Discovery Electronically stored information ESI Metadata – unseen documentation such as edits, notes, etc Spoliation – wrongful destruction or alteration of evidence Litigation hold – prevent destruction ◦ Notice of preservation ◦ Order of preservation

Terminology of a Lawsuit Written Interrogatories – questions asked to gain information Production of documents – copies of documents Physical or mental examinations – court ordered

Terminology of a Lawsuit Request for Admission – questions asked to obtain certain facts Pretrial Conference – meeting with the judge Trial – may be judge or jury trial

Terminology of a Lawsuit Appeal – is a review of the original trial Satisfying the Judgment – collection of monies if awarded Alternative Dispute Resolution ◦ Mediation – neutral 3 rd party assists in resolving differences ◦ Arbitration – neutral party renders a decision

Liability Relationships Physician – patient Hospital – patient Hospital - physician

Theories of Liability Breach of contract Intentional Torts – intent to do wrong Nonintentional Torts – lack of intent to do wrong

Nonintentional Torts Negligence ◦ Failure to do something Medical malpractice ◦ Professional misconduct ◦ Failure to follow standard of care

Negligence Claim 1. Duty of care – obligation 2. Breach of duty of care – failed to maintain a certain level of care 3. Causation - causal connection between duty of care and injury 4. Damages – nominal, actual, punitive

Res Ispa Loquitor “The thing speaks for itself” 1. Injury would not occur without someone’s negligence 2. Medical professional has exclusive control 3. Injury could not have occurred by action of the patient

Vicarious Liability Respondeat superior The facility is responsible for the actions of the employees within in the scope of their employment

Corporate Negligence Facility owes a duty to the patient regarding care and treatment

Failure to Warn Failure to protect – ethical and legal duty Patient is a danger to a third party

Breach of Confidentiality Provide a notice to the patient of the breach Notify Secretary of HHS Punishable by fines and jail terms

Intentional Torts Assault and Battery ◦ Technical battery – exceeds consent given by patient Defamation ◦ Libel - in print ◦ Slander - oral Invasion of Privacy Medical Abandonment – unilateral severing

Intentional Torts False Imprisonment – restraint against their will Intentional Infliction of Emotional Distress – outrageous and extreme Breach of Contract

Statute of Limitations Fixed time period Varies by state Varies by type of lawsuit Extensions to minors and some types of legal disabilities

Limitations on Liability Government Immunity ◦ Tort lawsuits are permitted with certain limitations and restrictions Charitable Immunity ◦ Hospitals were shielded from liability ◦ Most states have limited or abolished

Limitations on Liability Good Samaritan Statutes Contributory Negligence – plaintiffs conduct contributes to injury many prevent recovery of damages Comparative Negligence – reduces amount of damages that can be recovered

Limitations on Liability Assumption of Risk – plaintiff voluntarily exposes self to risk Apologies – apologizes but it is not an admission of guilt

Questions