Presented by Yvette Jones, MHA, RHIA, LHCRM

 WELCOME!!!!!!  My story  Questions-Please hold questions until designated question time.

Ethical Models: 1. What are ethics? 2. What are morals? 3. Laws 4. Values 5. How should HIM professionals apply there values & ethics to the workplace?

 Are abstract ideas or thoughts that deal with ethics- P. 96 Tabe 5.2  Autonomy  Beneficence  Nonmaleficence  Best interest Standard  Fidelity  Jutice  Rights  Veracity

Privacy & Confidentiality: What is the difference between privacy & confidentiality?

Ethical Theories: P. 102, Table Utilitarianism 2. Deontology Question- Which ethical theory would serve you best in your role as a HIM director?

Code of Ethics: Are written lists of a profession’s values and standards of conduct.  AHIMA code of ethics p.111&112  Ethics Committees

◦ Are the recognition that the patient is entitled to determine on their own the extent to which he or she will forgo care and treatment.  Paternalism the health care professional acted in the role of a father to his children, deciding what was best for the patient’s welfare without first being required to consult with the patient.  PSDA  HIPAA  ARRA

 Helped move he concept of patient rights from an ethical basis to a legal basis.  The goal was “to ensure that a patient’s rights to self-determination in health care decisions be communicated and protected”.  Obligates health care providers who are Medicare or Medicaid certified to inform their patients of the statutes of state law governing a patient’s rights to make advance directives for accepting or refusing healthcare services and the health care provider’s written policies concerning implementation of the patient’s rights.

QUESTIONS ?

-HIPAA contains 5 titles -Patient Rights Under HIPAA-P.115 Table HIPAA has 2 Rules: ◦ Privacy ◦ Security

HIPAA acronyms  HIPAA (health insurance portability and accountability act of 1996)  CEs (covered entities)  PHI (protected health information)  TPO (treatment, payment, operations)  BAs (business associates)

 Reinforces patient’s rights of access to their own information when the health record is in electronic format  It also focuses on breach notification, access to patient information, and requests for restrictions

1. What is the ethical issue? 2. What are the facts? 3. What are the values at stake? 4. What are the options? 5. What should I do? 6. What justifies your choice? 7. Implement the decision. 8. Evaluate the outcome. 9. Examine how to prevent the issue from recurring.

 What are ethical challenges?  Do you address ethical challenges or just ignore?  Can you teach a person ethics?

 Conflict of Interest  Impaired Colleagues  Disparagement

 Serve as a Role Model  Encourage Ethical Behavior  Monitor Employee Conflict

Scenario A physician that has a pattern of being delinquent is always very pleasant with the HIM staff and often offers to buy them lunch. He also offers to give the HIM director a gift, such as a trip to the Bahamas in exchange for not suspending him and allowing him more time to complete his records. You are the HIM director. Should you accept the trip? What should you tell your staff about the lunch offers? Explain your answer.

Wrestling with Ethical Challenges: How can HIM professionals seek guidance in solving ethical challenges?

 These challenges arise from ◦ Changes in the h.c. environment ◦ Requirements for documentation and access to and release of information ◦ Developments in technology, including sharing info electronically ◦ Changes in reimbursement systems and their attendant coding systems.

 Historical view of HIM-from Record Librarians to HIM Directors  Technology-Paper to EHR  Financial/Reimbursement-Coding  Patient Privacy-HIPAA  Patient’s getting more involved in their health and wanting to access their medical records

 Is the study of ethical issues that result from technologic and scientific advances, especially in biology and medicine.  As science and technology advance, the number and complexity of bioethical issues seem to increase.  Current Bioethical Issues- P. 132, Table 7.1

 P. 132, Table 7.2  Family Planning  Abortion  Perinatal Ethics  Eugenics

 P. 136, Table 7.3  HIV/AIDS  Organ Transplantation  Genetic Science

 P. 141, Table 7.4  Planning for the End of Life ◦ Advance Directives, Living Will, Durable Power of Attorney for Healthcare  Euthanasia ◦ Passive Euthanasia ◦ Active Euthanasia  Withdrawing/Withholding treatment ◦ Withholding treatment ◦ Withdrawing treatment

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