Transcript Privileged Communication and Advance Directives

Confidentiality
Privileged Communication
Confidentiality
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Healthcare workers are obligated to
keep all patient/client information
confidential “secret”
http://www.youtube.com/watch?v=Hp
p1Po3diJk&feature=fvw
A good rule of thumb is to discuss the patient/client
only when it effects his or her care in some way…
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Examples:
– When you find candy belonging to a
diabetic
– When you find alcohol or medications
with the belongings of a patient
– Stress in their personal life i.e. financial or
relationship problems
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Even information not pertaining to his or her
care is subject to confidentiality
Privileged
Communication
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Privileged communications comprise
all information given to health care
personnel by a patient, that is relevant
to his or her care.
Privileged
Communication
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This information can not be told to anyone
else without the written consent of the
patient.
Exempt Information
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Although patient information is
considered privileged there are certain
events or conditions that are exempt
and MUST be reported…
Exempt Information
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Births
Deaths
Suicide attempts
Injuries resulting from a crime (gsw, stabbings)
Rape
Abuse
Communicable diseases
STI’s
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Report all or any illegal or unethical
behavior
Report information that may impact
health of patient
Health Care Records
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Are considered privileged
communication
Can be used as legal records in a court
of law
Erasures are not allowed
Correcting an error on a
health care record
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Errors should be crossed out with a
single line
Correct information should be
inserted, initialed, and dated.
HIPAA
Health Insurance Portability and
Accountability Act
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All
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medical information of a patient/client is confidential
Information on medical records
Diagnostic images
Conversations between health providers about patient
care and treatment
– Health Insurance information
– Patient billing information
Violations of confidentiality can result in a
law suit, firing, fines…
HIPAA
Health Insurance
Portability and
Accountability Act
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Confidentiality in…
Hospitals
Skilled Nursing Facilities
Doctor’s Offices
Employers
Schools
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Anyone with your health information
must keep it confidential and abide by
HIPAA.
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HIPAA is…
Related to all medical records.
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Written
Computerized
In use or stored.
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Why HIPAA?
Health information continues to grow
and become more sophisticated.
It requires more protection than
ever.
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Helps protect against Identity theft.
Puts in place penalties for violations of
the law.
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When HIPAA?
Mandated to be in place by April 2003.
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Although the actual law was on the books
much earlier…
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So tell me what you
know…
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Who has to obey HIPAA laws?
What does HIPAA stand for?
Where does HIPAA apply?
When was HIPAA mandated to be in
place?
HIPAA Compliance
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Read only charts and
information you need to do your
job or assignment.
Ensure any questions you ask of
others to enhance your learning
are done when others are not
within hearing range.
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HIPAA Compliance
•
When discussing patient conditions in the
classroom, do not use names or anything that
would allow others to pick the patient out of a
room.
• Good: A male in his mid-forties had…
• Bad: The male in room 224.
• Good: A teenage girl…
• Bad: The 16 year old girl, with brown hair
wearing a plaid skirt…
HIPAA Compliance
 Discuss
patient information/
condition only with those who
need to know as a part of their
job.
 Do not discuss patient information
in the halls or in public areas.
 You never know who may be
listening.
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Consents
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Consents
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Patients (only) may request their
records be released to others for any
number of reasons.
All consents must be in writing and
need to be kept with the medical
record.
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Consents
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Life insurance
Family records
Family physician
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Consents
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Some releases or authorizations
require a non-staff member to sign
as a witness.
Students may not fulfill this request.
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Covered Entities & Business
Agreements
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Covered Entities
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If a facility bills their sources of
payment (insurance companies,
MediCare, etc.) via electronic means,
they become a covered entity.
Covered Entities may share
information, as needed to do their
job, without the consent of the
individual.
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Covered Entity – Example of
sharing information
appropriately.
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For example, the hospital bills MediCare
for a patient’s stay. MediCare request
additional medical records to support the
reason for the length of stay at the
hospital.
The hospital may send the information to
MediCare without consent.
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Why a Business Agreement?
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If a healthcare provider does business
with another who is not a covered
entity.
The non-covered entity requires
information about patients in the
healthcare facility to do their job
properly.
The healthcare provider may enter into a
Business Agreement with the non-
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What is a Business
Agreement?
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A contract between a non-covered entity and a
healthcare provider.
Non-covered entity agrees to use patient
information strictly as a part of their job (i.e. billing,
providing home health services, etc).
Non-covered entity will not use information
inappropriately (sell info to marketing company, to
solicit patient, etc).
Non-covered entity will protect information, destroy
information properly, and abide by HIPAA rules and
laws.
What is a Business
Agreement?
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The Agreement must be reviewed and
approved by the appropriate Officer
within the organization, often the
Privacy Officer or Compliance Officer.
An example would be a DME company
who provides custom wheelchairs to
rehabilitated patients.
DME → Durable Medical Equipment
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There are always
exceptions…
Information exempt by law
that MUST be reported
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Births
Deaths
Injuries caused by violence (assault
and battery, abuse, stabbings,
gunshot wounds)
Drug abuse
Communicable diseases (TB)
Sexually transmitted diseases
http://www.youtube.com/watch?v=jdg_qp
hWrk0
Extra Credit opportunity:
Create your own HIPAA video
www.Xtranormal.com