Lesson 3: Policies, Procedures, and Regulatory Affairs

Finally, we will take a look at the legal elements associated with Health Information Management. By now you should be familiar with HIPAA regulations and you may find yourself quoting regulations from memory. Guess what? That's the goal! Now let's give it one last run.

HIPAA - the Privacy Rule

(information that follows is used with permission from epcc.edu)

History

In 2000, many patients that were newly diagnosed with depression received free samples of anti-depressant medications in their mail. Many of these patients were concerned about how the pharmaceutical companies were notified of their disease. After much investigation, the Physician, Photo of a healthcare worker at a desktop computer in an office. the Pharmaceutical company, and a well-known Pharmacy chain were all indicted on breach of confidentiality charges.

HIPAA: Health Insurance Portability and Accountability Act

Much of the patient's health information is documented in a computerized format. Protecting this information has become vitally important. This is the first federal legislation (effective April 14, 2003) that attempts to protect a patient's right to privacy and the security and access to personal medical information and usage. As of April 2003, all hospitals across the nation were required to comply with this new federal regulation. It was designed to assist in protecting the patient's privacy in this age of technology. Much of the patient's health information is documented in a computerized format. Protecting this information has become vitally important.

Privacy Rule

Imposes restrictions on the use/disclosure of personal health information
Gives patients greater protection for their medical records
Hopefully provides patients with greater peace of mind related to the security of their information

HIPAA targets how healthcare professionals use and or disclose the patient's personal health information. It hopefully assists the patient in feeling more at ease in regard to maintaining the privacy of their records.

Confidentiality

Deals with:

Communication or information is given to you without fear of disclosure
Legitimate Need to Know & Informed Consent

Potential breaches of confidentiality can occur

When a patient discusses their personal information with you (the healthcare provider), they should with no fear of you and anyone else finding out their personal information.

Please watch the following presentation.

Notice of Privacy Practices

Patients have the right to adequate notice concerning the use/disclosure of their PHI.

The Notice of Privacy Practices must contain the patient's rights and the covered entities' legal duties. Notice of the mandated privacy practices must be provided to all patients. Patients are told and provided written information and they are required to sign a statement that they were informed and understand privacy practices.

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