Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ HS101 Seminar Rubric GradeEvaluation CriteriaPoints A  Frequent interactions on concepts being discussed by students and instructor  Posts are on topic and contribute to the quality of the seminar  Student arrives on time and stays the entire seminar  Student supplies reference to back up comment % points B  Some interactions on concepts being discussed by students and instructor  Posts are generally on topic and contribute to the quality of the seminar  Student is tardy or leaves early 80-89% points C  Few interactions on concepts being discussed by students and instructor  Student is tardy and leaves early 70-79% points D  No interactions on concepts being discussed by students and instructor  Off topic conversations  Student attends less than half of the seminar  Student appears unfamiliar with seminar topic 60-69% points F  Off topic conversations and/or abusive or inappropriate behavior  No interactions with students and instructor  Student attends a fraction of the seminar <60% 0-11 points

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Confidentiality in Medical Practice Chapter 10

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Confidentiality Physicians are expected to maintain all confidences concerning their patients Modern medicine and technology make patient privacy issues a paramount concern Confidentiality preserves the patient's dignity

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Health Insurance Portability and Accountability Act (HIPAA) Signed into law in 1996 Regulates the privacy of patient health information Five major categories covered under HIPAA – Insurance portability – Administrative simplification – Medical savings and tax deductions – Group health plan provisions – Revenue offset provisions

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Privacy Rule Applies to protected health information (PHI) Limits disclosures to only the minimum information necessary to carry out the medical treatment Patient must grant written consent or permission to disclose their PHI for treatment, payment, and other health care operations

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Denial of the Request for Privacy Some health care institutions, such as nursing homes, may have to deny access to a patient's medical information in order to protect the patient

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Who Is Affected? Public health authorities Health care clearinghouses Self-insured employers Life insurers Information systems vendors Various service organizations Universities

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Unique Identifiers for Health Care Providers Standard identifiers are used to reduce confusion and errors Employer Identifier Standard – Published 2002 – Uses employer’s tax ID number or Employer Identification Number (EIN)

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Can Public Health Information (PHI) Be De-identified? To “de-identify” patient information, remove – Patient’s name – Address, including – Telephone and fax numbers – All dates, including birth (except year), admission, discharge, and death – Social security number – Medical records numbers – Health care insurance numbers – License numbers – Facial photos – Other identifying numbers or characteristics

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Obligations to Patient Under HIPAA Obtain consent and authorization for any disclosure of medical information Permit patient access to medical information Provide only the minimum necessary standard

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Penalties for Noncompliance with HIPAA Civil penalties Federal criminal liability with sanctions (fines) and time in prison Risk of class action suit and public relations damage Health Integrity and Protection Data Bank (HIPDB): national data bank collects reports and disclosure of actions taken

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Patients’ Rights Under the Privacy Standards Copy of privacy notice Access to medical records Limit how health care information is shared Accounting of who information is given to Ask to be contacted in special way Examine health information provider’s copy Complain to “covered entity” if violation of privacy is suspected

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Special Rules Relating to Research Researcher must obtain – Patient authorization that complies with HIPAA – Waiver of authorization from a privacy board or Institutional Review Board Waiver must include extensive documentation as required by HIPAA

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Problems Relating to HIPAA’S Privacy Rules Some health care providers now refuse to provide medical records to anyone except the patient Compliance with HIPAA slows police investigations and impedes prosecution of crimes

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Misconceptions About HIPAA Does not prevent physicians or hospitals from sharing patient information to treat Does not prevent disclosure to clergy Allows hospitals and physicians to share information with spouse or anyone patient has identified as involved in their care Does not apply to most police or fire departments (may release information about accident victims) Does limit information EMTs may disclose

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Recommendations Appoint and train privacy officer Conduct internal assessment of existing policies Enter agreements with all nonemployee service providers Adapt procedures for handling patient requests Implement notice of privacy practices Revise employee manuals regarding HIPAA standards Train all employees on policies and procedures Retain signed authorizations, copies, etc. (six years) Implement and enforce sanctions for violations Establish complaint process for noncompliance

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Ethical Concerns with Information Technology (Informatics) Wireless local area networks (WLANs): communication system used to access patient records from central databases Medical informatics: application of communication and information to medical practice, research, and education Telemedicine: use of communication and information technologies to provide health care services to people at a distance

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Student Responsibilities Unit 7 – Post to the Discussion Board – Participate in Seminar or complete Option 2 Due EOD Unit 8 – Post to the Discussion Board (by Participate in Seminar or complete Option 2 Due EOD

Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ Unit 8 Project Unit 8 – Project Details under the Unit 8 tab. There is a case study to listen to. A written script is also available there. Template in Doc Sharing, questions to complete based on the case study and previous units material. Student will save this document as a word document and submit to the dropbox by EOD.