Confidentiality & HIPAA Health Insurance Portability and Accountability Act of 1996

Scenario Imagine you are taking care of a patient and a lady claiming to be his daughter calls on the phone to see how the patient is and what is going on with him. The patient in this scenario is asleep. Do you answer her questions? What do you say? What does HIPAA say you can do?

What is HIPAA and what/ who does it protect? Health Insurance Portability and Accountability Act of 1996 HIPPA protects CONFIDENTIALITY HIPPA protects the patients and is a LAW Non compliance can be a civil or criminal offense depending on severity– that means fines up to $250,000 and possible jail time!

Confidentiality Not to be shared or told Privileged information is confidential data and includes all medical and personal data, that is disclosed within the health care facility Diagnosis, medical history and lifestyle needs to be kept private Confidentiality is the most longstanding, consistent component in all Codes of Ethics/ Dates back to the Hippocratic Oath

Privileged Communications This is all information given to health care personnel by a patient; by law this must be kept confidential! Examples of information exempt: Injuries caused by violence/ Abuse Threats Emergencies Births & Deaths Injuries resulting from Drug/ Alcohol abuse Communicable Diseases & STDs

Reportable Communicable Diseases: Know that Laws vary by state Examples of Communicable Diseases: Tuberculosis, hepatitis, AIDS, syphilis, gonorrhea, chlamydia Some states require other diseases to be reported to track incidence i.e. Cancer

Confidentiality Client information can only be discussed with other health care providers who are involved in the care Confidentiality must be maintained in order to preserve human dignity Trust is built between the client and health professional by maintaining confidentiality

Confidentiality Confidentiality is an ethical and legal responsibility Disclosure to Insurance companies only with patient consent Pre-employment physicals do not signify doctor-patient relationship- the Dr. has been hired and works for the company– exempt if treatment is given MINORS- allowed to verbally consent Confidentiality of minors can be breached when parents need to be informed of treatment or serious illness

Computers and Confidentiality Many different people in hospitals have access to medical records- safeguards must be made to maintain computer confidentiality. Limit personnel who have access Use of passcodes to prevent access Constant monitoring

Confidentiality How can Confidentiality be protected? Never disclose information to a 3rd party without signed consent (insurance companies, attorneys, neighbors, employers) Never reveal financial information When talking on the phone to a patient, do not say their name if others are around When leaving a message, simply ask the patient to return your call– don’t say what office you are from (ie. Oncologist) Do not leave medical charts where patients or office visitors can see them.

Medical Records Medical Records are LEGAL DOCUMENTS All information recorded must be factual Questionable information should be labeled as opinion or assumption Any information that is not relevant to the care of the client should not be recorded Erasures are not allowed- single line crossed out, correct if needed, initial and date.

RESEARCH Ethics Articles

Informed Consent A signed document stating that patient understands the medical procedure and the risks involved. All consents require a witness 21 years or older Signed in ink Possible over the phone, but 2 people have to listen in.

Informed Consent Implies that the Patient Understands: Proposed methods of treatment Why they need treatment Potential risks of treatment Alternative methods of treatment Projected outcome of treatment

Individuals Who Cannot Give Informed Consent Minors Exception: emancipated or self supporting Mentally Incompetent Under the Influence Speak a foreign language and may not understand

Patient Education is vital to the issue of informed consent Patient Education is vital to the issue of informed consent. Healthcare professionals should be sure that the patients understand all forms and treatments before signing the consent.

Advance Directives for Health Care Advance directives are legal documents that allow an individual to state what medical treatment they want or do not want. Living Will- document stating what measures can or cannot be taken to prolong life. DNR- do not resuscitate