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Ethics > Chapter Four > Flashcards

Chapter Four Flashcards

1
Q

What is privacy?

A
  • the absence of intrusion into a person’s life and information from external sources
  • In health care terms, privacy means that the patients’ health and other information are securely held so that only authorized persons have access to that information.
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2
Q

What is confidentiality?

A

personal information shared with a professional such as a physician, attorney, or therapist.

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3
Q

Why is confidentiality and privacy different?

A
  • privacy is a condition while confidentiality is an ethical duty
  • Both privacy and confidentiality are protected by law and each has legal consequences for violation.
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4
Q

What does the doctor patient relationship have?

A

an implied confidentiality agreement

  • Even though implied, the new patient must sign certain documents to declare comprehension of health privacy policies and procedures.
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5
Q

Hippocrates realized the value of confidentiality in medicine. How?

A

Hippocratic Oath:

  • Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.
  • What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.
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6
Q

What organization made sure it was medical information will be kept confidential?

A

Health Insurance Portability and Accountability Act of 1996 (HIPAA), it is illegal

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7
Q

What does condientiality in healthcare industry mean?

A
  • can be defined as keeping personal medical information private.
  • This includes not only specific conditions and treatments, but the very fact that the person sought treatment in the first place
  • When a healthcare professional protects a patient’s medical information, that professional is showing respect for the patient
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8
Q

What happens when a patient feels respected?

A
  • he or she could be more likely to trust and more fully cooperate with healthcare providers
  • this includes giving the physician all information that would help the healthcare team best serve the patient
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9
Q

What led to the idea of confidentiality?

A

In the 1960s, the federal government increasingly found it necessary to establish and maintain records of many types. Concerned citizens and legislators wondered about the ways private information could be used by the government.

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10
Q

What happens in 1973 with the the Department of Health, Education, and Welfare (HEW)

A

issued a report titled Records, Computers, and the Rights of Citizens. This report caught the attention of legislators, who soon went to work

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11
Q

what is the Privacy Act of 1974 (Public Law 93-579)

A
  • was the result and was signed into law by President Gerald Ford
  • The Privacy Act is not exclusive to medical information.
  • It addresses a variety of private information, including how social security numbers can be shared.
  • The Privacy Act only applies to U.S. citizens and permanent residents; only these individuals may sue under the statutes of the act.
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12
Q

What did the privacy act of 1974 led into?

A

HIPAA

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13
Q

Why in the world is confidentiality so important anyway

A
  • speaking legally and ethically, a person’s healthcare information is private and personal in nature, and every patient has a stake in who views his or her medical record.
  • a person might be more likely to seek healthcare if he or she is assured that medical information will be kept private. By feeling free to be open and honest, the patient reveals accurate information that can help the healthcare team provide the best care.
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14
Q

What is breach?

A

to violate

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15
Q

List (5) the fews that healthcare professional fails to guard personal medical info?

A

Read pages 56-57 for the reasons why

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16
Q

What is HITECH?

A
  • The Health Information Technology for Economic and Clinical Health Act (2009) and was signed into law February 17, 2009.
  • This legislation was an economic stimulus package in which $250 million was appropriated toward technology.
  • The Act, which addresses confidentiality, sought to accomplish the following in regards to healthcare technology and the American healthcare system:
    1. Improve quality, safety, and efficiency
    2. Increase coordination efforts for the benefit of the patient
    3. Improve health status
    4. Promote patient autonomy
    5. Assurance of privacy and security
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17
Q

What is ransomware?

A
  • is malicious software used by computer hackers to block users from data in their own computer systems.
  • The hacker requires money to restore access.
  • It is digital extortion
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18
Q

How many ransomware attacks daily?

A

4000

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19
Q
  1. Who continually works to assist providers in security measures to prevent risks such as ransomware?
  2. The compliance and policy development is monitored by who?
A
  1. HIPAA
  2. Department of Health and Human Services
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20
Q

Since ransomware compromises the user/owner access to its own electronic information, some recommendations for risk management include:

A
  1. Conduct frequent computer system backups.
  2. Test restorations should be performed periodically to validate backed up data.
  3. Some ransomware may even remove or disrupt backups. Users/owners of the systems should consider backing up offline and separate from the primary network.
  4. Contingency plans for: disaster recovery planning, emergency analysis to ensure that all applications and data are present and accounted for, and peri- odic testing or contingency plans to assure effectiveness.
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21
Q

What is Medical Identity Theft

A
  • is the stealing of a patient’s personal information (name, address, social security number, etc.) in order to use it to wrongly acquire insurance coverage and/or prescriptions.
  • If the thief’s information gets integrated with a patient’s information, it can compromise the effectiveness of care given to the patient.
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22
Q

The wise medical consumer (patient) should be protective by: (6)

A
  1. Always carefully reviewing any medical bills or insurance statements (such as an EOB: Explanation of Benefits).
  2. Reading any medical collection notices, meaning being charged for a service, not knowing of change, and not paying, making the bills past due.
  3. Keeping up with benefit (insurance) financial limits.
  4. Contacting healthcare providers and/or insurance companies if any information is incorrect. Waiting to contact can cost the patient.
  5. Getting copies, occasionally, of the medical record and review for accuracy. Anything suspicious should be reported to whomever has the original record. Note that you may have to pay for copies, but it is worth the price to maintain patient record accuracy.
  6. Keep copies of records in a secure location.
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23
Q
  • When was HIPAA signed into law and under who?
  • What did it do?
A
  • in 1996 under the William Jefferson Clin- ton administration.
  • This federal law was enacted to address continuation of health insurance coverage in healthcare. This important legislation gives the patient more control over personal medical information and how it is used or released.
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24
Q

Five different forms are required to protect patient information:

A
  1. The privacy notice
  2. The signature of patient indicating that he or she received the privacy notice
  3. The patient’s permission to provide his or her medical information to otherpeople (such as a relative) or entities (such as an insurance company)
  4. A trading partner agreement specifying the parties involved (i.e., physicianand patient)
  5. A contractual statement between the physician or facility and the patient
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25
Q

What was the two aims of HIPPA?

A
  • The first aim was to improve conditions when individuals change health insurance programs, including portability.
  • The second aim was to make sure that as long as there is no lapse of coverage, preexisting conditions are covered.
26
Q

What is portability?

A

that no lapse of healthcare coverage occurs when a person changes from one job to another, even when insurance carriers change.

27
Q

What is preexisting conditions?

A
  • are ailments or diseases that the patient has before health insurance coverage begins.
  • Preexisting conditions often limit healthcare coverage, and this component was designed to help the patient get coverage needed to receive medical care.
28
Q

Before the HIPAA laws were enacted, a person moving from one job to another had to go for a period of time with no healthcare insurance. This might happen because there was a gap between the two jobs and/or because the new insurance might take a few months to take effect. What allows preexisting allowance in the law permits continuous coverage?

A

Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)

29
Q

What were the “add-ons” in the final HIPAA legislation

A

include protection of private medical information, standardization and simplification of forms, and strategies to prevent fraud, waste, and abuse.

30
Q

Acting upon the legislation of the Clinton administration, the George Herbert Walker Bush administration and Congress chose to introduce the law in three phases:

A
  1. Implementation of federal privacy regulations
  2. Implementation of insurance claims
  3. Implementation of a clearinghouse of electronic medical claims
31
Q
  1. Though HIPAA was written into law in 1996, phases concerning insurance and clearinghouse implementation did not take effect until when?
  2. The phase concerning federal privacy legislation did not take effect until when?
  3. What were the delays due to?
A
  1. 2002
  2. 2003
  3. to complications in implementation, and had to be addressed to make the legislation practical. In other words, it was unclear whether the bill, in its original form, would be practical to carry out.
32
Q

T/F: Access to a patient’s medical record does not give automatic permission to view the record.

A

True

  • If you do not need to read the record to assist in serving the patient, you should not access it at all.
33
Q

If you do not need to read the record to assist in serving the patient, you should not access it at all.

  • What is the clause in HIPPA according to this sitution?
A

need to know

34
Q

There are five primary components of the HIPAA law:

A
  1. Title l: Insurance Portability
  2. Title II: Administrative Simplification
  3. Title III: Medical Savings and Tax Deduction
  4. Title IV: Group Health Plan Provisions
  5. Title V: Revenue Offset Provisions
35
Q

What is Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)

A
  • mandates that those businesses with 20 employees or more must provide employees who leave that business extended health insurance for up to 18 months.
  • This insurance can be at the expense of the company but usually is paid for by the employee. Many employees are provided health insurance free of charge through the company.
  • If the employee leaves that place of employment, he or she may then decide to purchase the coverage until other coverage takes effect
36
Q

What is an example of how COBRA can affect healthcare insurance?

A
37
Q
  • What is the privacy rule?
  • When did go into effect and when was it fully implemented?
A
  • went into effect in 2001 and was fully implemented in 2003.
  • It is the portion of HIPAA that refers to personal data (past, present, and future), otherwise known as protected health information (PHI)
38
Q

What is protected health information?

A
  • PHI is specific medical information pertaining to the patient, such as name, date of birth, and social security number.
  • One crucial treatment of PHI is that concerning the patient and health insurance companies, also known as vendors.
  • Health insurance companies may obtain medical information about a patient, but only if the patient signs a release of information.
39
Q
  • PHI can come in three primary forms?
  • What are the exceptions to PHI?
A
  • written, electronic, and oral
  • including suspected abuse (including elder, child, and spousal abuse), medical research, and certain contagious diseases
40
Q

What are the limitations of PHI?

A
  • It does not include information a person shares with law enforcement officials, bankers or creditors, insurance representatives, schoolteachers or administrators, or employers.
  • Although it is not legally mandated, it would be professionally sound and ethical conduct for all professionals to protect the personal information of any client.
  • This lack of protection might prompt many people to limit their sharing of confidential health information to the healthcare provider, who is legally obligated to keep medical information in the strictest of confidence.
  • Failure to do so could result in the healthcare professional being punished, ranging from a fine to imprisonment. Keep in mind that health information includes pharmacy records and mental health records and is not limited to the con- fines of a hospital or physician’s office.
41
Q

HIPAA does not cover the following:

A

■ Financial documents (credit information, banking records)
■ Information as maintained by the Central Intelligence Agency (CIA), as outlined in the Privacy Act of 1974 (U.S. Department of Justice, 2003)
■ Educational records (including vaccinations and other information)
■ Subpoenas for medical records needed in court cases
■ The electronic database files of private companies
■ Employment records, including any employer-sponsored health program in which you may participate or information needed by your employer for the Family and Medical Leave Act (FMLA) (It is important to also know that if a company is self-insured for medical coverage of employees, the handling of insurance claims and other health-related information is covered by HIPAA.)

42
Q

It would seem that any personal record would be covered, but often information is covered by other laws such as what?

A

the Gramm-Leach-Bliley Act (GLB)

43
Q

When was the Healthcare Integrity and Protection Data Bank (HIPDB) operational and what is it?

A
  • became fully operational in 2000.
  • This national data bank was an aggressive move to prevent fraudulent and/or abusive healthcare practitioners and suppliers from being able to practice
44
Q

Areas being monitored, as outlined in the Social Security Act, include:

A

■ Licensure and certification actions
■ Exclusion from participation in federal and state healthcare programs (e.g., Medicare)
■ Civil judgments related to healthcare
■ Criminal convictions
■ Revocation or suspension of lab certification

45
Q

Centralized data banks such as the HIPDB were designed to do what?

A
  • improve not just the ethical standards and practices of the healthcare industry, but also to provide a go-to place to prevent unethical persons from being allowed to serve patients.
  • Think of the HIPDB, in some ways, as a “Better Business Bureau of Healthcare.”
46
Q

What is a release of information

A
  • a document that allows the healthcare provider to share certain information—not necessarily the whole record
  • Even if you are referred to a specialist by your physician, you must give your permission for your medical information to be shared with that specialist. Your medical record is private, and the document itself is considered a legal document.
47
Q

What is the Patient Safety and Quality Improvement Act of 2005 (PSQIA)

A
  • is another important piece of legislation in the area of patient rights.
  • This law was published in 2005 but did not go into effect until January 2009.
  • It launched a reporting system for violations of patient safety. To encourage reporting of any violations, the identities of people who file reports are kept private.
  • By protecting those who report, it was hoped that more reports would surface to further improve safety conditions within the healthcare setting (U.S. Department of Health and Human Services, n.d.).
48
Q

The following is a direct quote from the Health and Human Services (1999) website about the PSQIA:

A

The confidentiality provisions will improve patient safety outcomes by creating an environment where providers may report and examine patient safety events without fear of increased liability risk. Greater reporting and analysis of patient safety events will yield increased data and better under- standing of patient safety events.
[The Office for Civil Rights] works in close collaboration with the Agency for Healthcare Research and Quality (AHRQ) which has respon- sibility for listing patient safety organizations (PSOs), the external experts established by the Patient Safety Act to collect and analyze patient safety information.

49
Q

there are certain instances where some medical information should be released?

A

Such instances include child abuse cases, elder abuse cases, mental health patients who may become violent, and matters concerning the greater good.

50
Q

What is child abuse?

A
  • harm of a person younger than 18 years of age who is not an emancipated minor
  • It can involve physical harm, emotional harm, exploitation, and neglect.
51
Q

Child abuse is defined by federal law in the following ways:

A
  1. “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse, or exploitation.”
  2. “An act or failure to act which represents imminent risk of serious harm.
52
Q

Every _ seconds in America, a report is made concerning the maltreatment of a child

A

10

53
Q

The following professionals are legally required to report suspected child abuse:

A
  • Physicians
  • Nurses
  • Dentists
  • Mental health professionals
  • Social workers
  • Teachers
  • Day care workers
  • Law enforcement personnel
  • In some states, clergy, foster parents, attorneys, and camp counselors also are required to report abuse.
  • In 18 states, any person who suspects abuse is required to report it.
54
Q

When a healthcare professional recognizes any sign of abuse (including sus- pect bruises or fractures, and/or the child being withdrawn or upset), he or she is legally obligated to report to the suspicions to where?

A
  • the county’s Department of Human Services and the police department.
  • Reports can also be made to the 24-hour Child Abuse National Hotline: 1-800-4-A-CHILD (1-800-252-2873).
55
Q

What is the general definition of elder abuse?

A
  • “any harmful treatment of an elderly person.”
  • Harmful treatment can include physical, emotional, or sexual abuse; neglect; financial exploitation; and self-abuse.
56
Q

According to the National Research Council Panel to Review Risk and Prevalence of Elder Abuse and Neglect (2003), how many elders have been abused?

A

It has been estimated that between 1 and 2 million Americans 65 years or older have been injured, exploited, or otherwise mistreated by someone on whom they depended for care or protection

57
Q

If a healthcare professional suspects elder abuse, he or she should immediately contact who?

A
  • the local police department and the local Department of Human Services.
  • In 16 states, reporting is mandated. In those states, not reporting could result in criminal charges, just as in instances of not reporting child abuse.
58
Q

Mental illness affects at least one in _ Americans

A

Five (1 in 5)

59
Q

Any healthcare professional has a legal and ethical obligation to report what?

A

even a suspicion of a mental patient in self-harm or one who is harming others

60
Q

What does it mean when the matters of greater good?

A

Though confidentiality is decidedly one of the highest priorities in healthcare, there are times when the best interest of the public outweighs the protection of a patient’s private medical information.

61
Q

What is an example of not keeping medical info in total confidence to help the greater good?

A

Alerting the public to a potential danger can help ensure their safety. In the William Gladstone case study, reporting the botulism (food poisoning) certainly helped those who attended the picnic and could have saved lives. Normally a patient’s medical information is kept in total confidence, but sometimes the benefits to the general public warrant reporting.

Ethics (9 decks)

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