1. Confidentiality & HIPAA
Health Insurance Portability and Accountability Act of 1996

2. 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?

3. 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!

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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.

11. 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.

12. RESEARCH
Ethics Articles

13. 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.

14. 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

15. 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

16. 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.

17. 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