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Administrative Ethics

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Administrative Ethics
Jeff Andrews
HCS/335
March 18, 2012
Gail Garren, MSN, RN, CPHQ

Administrative Ethics In administrative health care today, there are constant occurrences of ethical issues in the everyday behaviors. As health care administrators, we have responsibilities to ourselves, the organization, the patients, and our employees. The increasing information technology, which is the future, can be an ethical concern to administrators of the confidentiality of information on patients. Confidential information is private or privileged information, and should be that luxury. In health care, the confidential information that is stored into an information system, such as a patient health record, will need the ethical awareness, knowledge, and decision making skills of managing confidential information is the administrator’s responsibility. Managing confidential records will require the education of all staff within the facility. This would be the education on the Health Insurance Portability and Accountability Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act. HIPAA and HITECH laws will be mentioned in this report as well as, an article from a local news station on a breach of patient confidential records, the issue and the impact is had on the population, the facts that are used to support the article and its solution, the ethical and legal issues for the administrative issue, the managerial responsibilities that are related to the administrative ethical issues, and the proposed solutions.
Loma Linda University Medical Center Breach A local news station had reported a breach of patient records on December 29, 2011. The worker at the Loma Linda University Medical Center had 1,336 patient medical records that he took home, which included names, birth dates, home or work addresses, medical record numbers, driver’s license numbers and some social security numbers that were endangered. The facility thinks that this happened on or around December 19th. The facility states that the files were secured and the employee has been terminated (KABC, 2011).
Loma Linda University is not the only facility that has these issues of employees taking home medical records of patients or looking into a patient’s medical record. This has happened to my wife. About two (2) months ago, she received a letter from St. Jude’s Medical Center, stating that her medical record had been compromised. An individual had stolen computers with their hard-drives, which had not only hers, but others as well. The information on these computers had over 2,000 records that were stolen and may be compromised. She too has been told to check here credit to avoid any false transactions. This happens all the time and one does not need to quote or do research on this.
Health Information Technology for Economic and Clinical Health (HITECH) The Health Information Technology for Economic and Clinical Health (HITECH), passed on part of the American Recovery and Reinvestment Act of 2009 (ARRA). This was implemented and the significant use of health information technology. Under the HITECH law and under its subtitle D, it addresses the privacy and the security concerns that are associated with the electronic transmission of health information and the requirements that support the civil and criminal enforcement of the HIPAA rules and regulations (HHS, 2011). The use of these laws, the Secretary of the Department of Health and Human Services (HHS), will post a list of the breaches of unsecured protected health information that affect more than 500 or more individuals. The hospital itself will need to notify the Secretary of HHS immediately and notify the media within the jurisdiction of the patients whose medical records were breached. The breaches that have occurred, example of the Loma Linda employee, are now posted in a new, more accessible format that will allow users to search and sort the posted breaches. This format will include brief summaries of the breach cases that the Office for Civil Rights (OCR) has investigates and closed, as well the names or private providers who have reported breaches of unsecured protected information to the Secretary of HHS. (HHS, 2011).
Impact on the Population The impact that these 1,336 people who had their medical records taken and viewed, not just by the former employee, but others he may have been in contact with. Of course, this is frustrating to the patients, because now they will have to monitor their credit to make sure that nothing is suspicious. This is just another busy task for the individuals involved. This can add more stress and even much busier lives, other than what they might have now.
Ethical and Legal Issues A breach of private patient information and release to another party, without a patient permission or court ordered subpoena. This kind of release can be written, fax, or electronically, such as, e-mail or health information networks. The legal source for the execution of the liability for a breach of a private medical record is widespread within the ethical guidelines for hospitals, and it is right thing to do and to comply with the hospital organizations policies and procedures on patient confidentiality. According to the Department of Health and Human Services guidelines on HIPAA, protecting patients' private information is included in the summary of federal and state privacy regulations. In the regards of the release of a patient's medical record and the information that is contained in privacy of the patient's medical record may be released to a third party only if the patient has agreed to any release of their private information (AMA, 2011). The patient shall have immediate and prompt authorization of the release of their private medical record is required before the medical records can be released. The following parties per the HIPAA rules and regulations, can be released to the patient's attorney, family member that has been appointed the patient's Power of Attorney (POA), court ordered subpoena, the legal guardian of a minor child and government agencies. Another authorization of the release of a patient’s medical record the patient's employer, and if it is a worker's compensation claim is involved, State laws particularly allow the release of the medical record to the individual upon the consent of the patient. Once the patient has given the permission to release their medical record, the release requirement will be mandatory for the hospital, who will possess the medical record and will be purely non-judgmental on the conference with the parties that are involved (AMA, 2011). State laws add other details, such as the specifications of the form and the reasons for the release will have a warning that the authorization may be withdrawn. The failure to get the appropriate authorization to discharge the medical record of the patients information, will have serious consequences by taking disciplinary action by the governing authorities of the HIPAA rules and regulations (AMA, 2011).
Managerial Responsibilities The managerial responsibilities of protecting patient confidentiality limit the entry to private patient information to authorized individuals only. This will guarantee that the organization’s policies on privacy and security of the release of information are uniform with regulations and laws. The continuous education of healthcare professionals on the HIPAA and HITECH Acts, and to take steps to help safeguard all privacy rules and make the health care employees aware and comprehend their responsibilities to keep patient information confidential and secure. Enforcing encryptions so that unauthorized persons, such as hackers cannot access the protected medical record files (HHS, 2011).
Safeguards
Some safeguards that will need to be planned and that the hospital organization should have their contracts with system vendors, i.e. Business Associates, and the hospital facility that will participate in a data storage will need to reviewed by a legal representative of the hospital, which will need to comply with the guidelines of HIPAA and HITECH. They should have the privacy and security policies and implement these policies on private patient information. The hospital should maintain safe security systems. Education on HIPAA regulations to all hospital staff on the privacy and security of patient information should be considered to prevent any breaches of security. This will help the hospital become less vulnerable to breaches of private medical records and reduce the cost of having the facility pay thousands of dollars. This will be beneficial and so that he facility will not be on the Department of Health and Human Services website of breaches, i.e. Loma Linda’s fate. A good safeguard to have in place and practice regularly is to assess the security of the clinical data that is inputted into the system and monitor all users of the electronic medical system. Hospitals should incorporate a checklist which indicate the date of the request and the date that the medical record was authorized and who the requester is. The organizations duty of privacy at times must give way to a stronger community interest (HHS, 2011).

Conclusion HIPAA has initiated to the public to observe the release of information to others, and the public still remains a concerned threat and the protection of their private information. These concerns that may patients have, and that is why the administration of HIPAA was put into effect. Patients are now learning more about privacy and how they are protected by the internet and the media. The hospital should incorporate education, execution, and supervised identification of problems that may arise from employees losing patient information or stealing this vital information. The Privacy Rule affects both paper and electronic documentation. The developing electronic medical record will be carried out by the first part of 2014. HIPAA can solve all the problems related to privacy, but we as health care providers, need to enforce and educate each other to protect this information from being dispersed or looked through. Nurses and medical records management employees should always uphold patient privacy as part of their roles and responsibilities. The protection of private information is not an easy job, but it is not unmanageable and we all should work every day of our lives to protect information out of a sense of respect and proficiency.

References
KABC Broadcasting. (2011). Breach at Loma Linda University Medical Center. Retrieved from www.abclocal.go.com/kabc/index Retrieved March 16, 2012
U.S. Department of Health and Human Services. (2011). HIPAA and HITECH. Retrieved from www.hhs.gov Retrieved on March 15, 2012
American Medical Association. (2011). Patient Confidentiality. Retrieved from www.ama-assn.org Retrieved on March 16, 2012

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