Law and Ethics : Dynamics of Healthcare

Why was HIPAA created?

To bring a balance between improving flow of information and protection of patient privacy.

What does the privacy rule do?

Protects the personal health information and the medical records of individuals

What does the security rule do?

Defines and regulates the standards, methods, and procedures related to the protection of electronic PHI on storage, accessibility, and transmission.

What does the transaction rule do?

Regulates data transmission specifications that govern how data is electronically transferred from one computer to another. The rule defines the types of electronic transactions subject to HIPAA, and specifies the exact format for each transaction record.

What does the identifiers rule do?

Requires all healthcare entities, including individuals, employers, health plans and healthcare providers, to have a unique 10-digit national provider identifier number.

What is PHI?

Personally identifiable information found in medical records and conversations between doctors and nurses regarding patient treatment.

What does PHI include?

Billing info and any information that can be used to identify an individual in a health insurance company's records.

What is the "need to know" principle?

The "minimum necessary standard" states that protected health information should not be used of disclosed when it is not necessary to satisfy a particular purpose or carry out a function.

What is reportable patient information?

Births, deaths, adverse reactions to meds or vaccines, child abuse, elder abuse, crimes/violence, communicable diseases, and error by other physicians.

Where can PHI be found?

Medical documentation/forms, records of communication, blood tests, prescriptions, billing info, MRI/X-RAY results, and doctor/clinical appointments.

What did the HIPAA act allow the Department of Health and Human Services to set standards for?

The safeguarding of identifiable health information and increasing the efficiency and effectiveness of the healthcare industry as a whole.

What does the enforcement rule do?

Establishes guidelines for investigations into HIPAA compliance violations.

What is the percentage of complaints that have ended in a financial settlement since the compliance date of the privacy rule?

0.04%

What are the three goals of the patient bill of rights?

Strengthening consumer confidence that the healthcare system is fair and cares about their needs, reaffirming the strong relationship between patients and their health care providers, and reaffirming the critical role consumers play in safeguarding their own health.

What should a healthcare professional always be?

An advocate

What is quality of care?

Healthcare professionals evaluate the quality and effectiveness of their practices.

What is education?

Healthcare professionals acquire and maintain current knowledge in their practices.

What is collegiality?

Healthcare professionals contribute to the professional development of peers, colleagues, and others.

What is collaboration?

Healthcare professionals collaborate with patients, significant others, family, and other healthcare providers in providing appropriate patient care. Health care professionals do not make all the decisions for the patient.

What is primary commitment to patient?

Healthcare professionals respect human dignity, worth and the rights of human beings regardless of the nature of their problems.

What is ethics?

Healthcare professionals make decisions and act on behalf of patients in an ethical manner?

What is research?

Healthcare professionals advance the profession through scholarly inquiry to identify, evaluate, refine, and expand their profession’s body of knowledge.

What is resource utilization?

Healthcare professionals consider factors related to safety, effectiveness, and cost in planning and delivering patient care.

What are the goals of ethics committees?

Promoting patient rights, promoting shared decision making between healthcare providers and patients, assisting institutions in the development and review of policies related to ethical responsibilities, ensuring that policies are implemented and understood by changing groups of health care providers, and serving as resource persons or consultants for specific situations with ethical dimensions

What is the Joint Commission’s mission?

To improve the safety and quality of care provided to the public by accrediting healthcare facilities and supporting performance improvement in healthcare organizations

What are the benefits of joining a professional organization?

Continuing education classes, subscriptions to professional publications, access to online resources, professional conferences/conventions/workshops, networking opportunities, information on new technologies, management tools, ethics guidelines, patient educational materials, and news on emerging technologies.

What body part is universal and can be donated to anyone without a match?

Cornea

How many children under 18 are awaiting a transplant?

About 2,000

What is the National Organ Transplant Act?

An act passed in 1984 established to guarantee fair distribution of donated organs.

What percent of transplant waiters are ethnic minorities?

59% are ethnic minorities

The majority of people awaiting transplants are over what age?

50 years old

How often is someone added to the national transplant list?

Every 10 minutes

What are the three criteria of brain death?

Irreversible coma, absence of brain stem reflexes, and apnea.

How much minutes are there after extubating where if they do not go into cardiac arrest, organ harvesting cannot occur?

90

What are the 3 major components of questioning that will take place with the next of kin to determine if a donor can donate organs?

Risk behaviors that may have exposed the donor to certain diseases, the donor’s past medical history, and Relevant travel history(to see if the person was exposed to certain pathogens).

What did the HIV Organ Policy Equity Act enable?

The act allows organs of HIV-positive donors to donate organs to HIV-positive recipients when following specific protocols.

4 reasons that are a contradiction to donation?

Malaria, tuberculosis, diabetes mellitus, and prolonged hypotension or hypothermia

What are the 7 infectious diseases that must be screened for before taking an organ?

HIV, Hepatitis B, Hepatitis C, Syphilis, Cytomegalovirus, Epstein Barr virus, and Toxoplasmosis.

What are the 7 items that are involved in the matching process when matching a donor to a recipient?

Blood type, body size, severity of patient condition, distance between donor and patient, patient waiting time, patient availability, and tissue type.

What are 5 barriers to organ recruitment?

Religion, culture, family influences, body integrity, and mistrust of the healthcare system.

What are 6 process breakdowns that can jeopardize organ recovery?

Missed referrals, untimely referrals, suboptimal request, hemodynamic stability not maintained, patient withdrawn from a ventilator, and the requestor is untrained.

What are the seven patient rights?

Receive a copy of an agency’s privacy practices, know that an agency will use its PHI only for treatment, payment, operations, and certain other permitted uses as required by law, control the use and disclosure of their PHI, have access to a copy of their PHI, request amendment or addendum to their PHI, receive records of disclosures (times when PHI was given out), file a privacy complaints to an agency officer