Legal and Ethical Considerations in Healthcare BAT 1Shadow charts were developed to gather data and information for additional departments and medical personnel that need access to part of a patient’s file or records. The original records should always remain in the patient’s primary chart allow copies may be available to ancillary departments that may need access to the information.
The same level of confidentiality and security applies to the shadow charts. They must be in a secure location with access by authorized personnel only. Additional information that should be included in shadow charts is a formal recording process to document those who access the information. Furthermore, a consistent system of upgrading the shadow charts from the primary records as they change is important.The information technology staff can help decrease incidents of security breaches in multiple ways. The most important is to provide ongoing and up-to-date training to the staff. This training would include the importance of not sharing passwords with others as well as ensuring their workstations are secured every time they leave them. It would not only be prudent to explain the ways to keep patient information secured by the repercussions if the company policy or HIPPA is violated.
If needed, the IT staff could monitor individual workstations to ensure compliance but this would only need to happen in the case of suspected negligence. Additionally, IT staff could use data encryption technology, firewalls, and intrusion detection systems to further decrease incidents of security breaches. One situation from Montana Code 41-1-402 that may result in criminal liability to the organization if not followed is if a minor who emergency needs care without which the minor’s health will be jeopardized. If emergency care is rendered, the legal guardian/parent must be notified as soon as possible.Medical personnel steps in as guardian during the medical emergency. Failure to treat a minor in critical need could result in medical malpractice and negligence.
Health Insurance Portability and Accountability Act (HIPPA) Privacy Rule and Security Rule defines criminal liability as anyone who “knowingly and in violation of HIPPAA obtains individually identifiable information relation to an individual”http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_021100.hcsp?dDocName=bok1_021100. The HIPPA Act applies to health care personnel or those associated with health care organizations who have access to patient records. The part of Montana Code 41-1-402 that would directly impact actions of clinical staff relates to the treatment of minors who are pregnant or who are concerned they have a sexually transmitted disease, and/or a drug or substance abuse problem.The medical personnel are required to provide referrals for counseling if they have accepted responsibility for the minor’s treatment.
The documentation of this information is expected to remain confidential. One situation from Montana Code 50-16-603x that my result in a legal claim against the organization if not followed is section two that applies to the written consent of the patient to release specified information and the person (or entity) that the information may be released to. Failure to get consent before releasing any patient information is a direct violation of HIPPA and can result in liability by the healthcare organization. A confidentiality policy should be incorporated in the healthcare organization’s practice such as: We are committed to protect our patient’s confidentiality and operate in accordance with Montana Law as well as HIPPA.
All patients have the right to a written request the release of their medical records to themselves or to their designee. A patient’s medical information can be used, without written permission from the patient, for treatment or payment. A patient’s medical records will not be released by any member of this organization except in the following situations: Statistical purposes (no personal identification will be used) Written consent given by the patientTo prevent or intervene in the spread of a highly threatening infection or disease Medical emergencySuspected abuse (if patient is a minor)Court order or enforcement of a state statueThe Montana Codes to the HIPAA laws as they refer to the release of information have several areas for comparison.
Although in most situations HIPAA takes precedence, the ruling falls in favor of the most protection of an individual’s rights. Three areas of comparisons are as follows: Both HIPPA and Montana law requires health care providers to release medical records to you within a ten day period after receiving your request. There are stipulations when it comes to mental health treatment. Mental health and psychotherapy are not governed in the same manner as medical treatment is under HIPPA. Therefore, states dictate how these particular records are handled. The Montana Codes allow for the release of medical records if seen by a psychiatrist but patients may not access records from treatment facilities for substance abuse.
Lastly, HIPAA does not govern the release of records after death. Instead, they leave this up to the individual state to determine. Montana allows the release of records after death to the spouse, parent, adult children, adult siblings and lawyers. In the event a release of information policy statement is needed for a policy book for Montana Code 50-16-541, the following could be used: This healthcare organization, in accordance with Montana law, releases patient information after a written request is made by the patient to gain access to all or part of their records. Within a ten day period, our organization will make all information available to the patient during regular business hours for no charge.
If copies are requested by the patient, a fee may be charged. If the records cannot be located or if the organization does not maintain the records, the patient will be notified. If there are any delays due to unforeseen circumstances, the patient will be notified in writing with an anticipated delivery date. If the patient requests an explanation of any codes or abbreviations used in the records, our organization will provide an explanation to the patient.Referenceshttp://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_021100.hcsp?dDocName=bok1_021100http://www.healthitechlaw.com/2012/05/16/criminal-liability-under-hipaa-is-significant/http://www.ehow.com/list_6847622_montana-hipaa-requirements.htmlhttp://codes.lp.findlaw.com/mtcode/50/16/5/50-16-541