Confidentiality Privileged Communication

1. ConfidentialityPrivileged Communication

2. Confidentiality • Healthcare workers are obligated to keep all patient/client information confidential “secret” • http://www.youtube.com/watch?v=Hpp1Po3diJk&feature=fvw

3. A good rule of thumb is to discuss the patient/client only when it effects his or her care in some way… • 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 • Even information not pertaining to his or her care is subject to confidentiality

4. Privileged Communication • Privileged communications comprise all information given to health care personnel by a patient, that is relevant to his or her care.

5. Privileged Communication • This information can not be told to anyone else without the written consent of the patient.

6. Health Care Records • Are considered privileged communication • Can be used as legal records in a court of law • Erasures are not allowed

7. Correcting an error on a health care record • Errors should be crossed out with a single line • Correct information should be inserted, initialed, and dated.

8. HIPAAHealth Insurance Portability and Accountability Act • All 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…

9. HIPAA Health Insurance Portability and Accountability Act

10. Not a HIPPO! It’s HIPAA – 1 P and 2 As

11. Confidentiality in… • Hospitals • Skilled Nursing Facilities • Doctor’s Offices • Employers • Schools • Anyone with your health information must keep it confidential and abide by HIPAA.

12. HIPAA is… • Related to all medical records. • Written • Computerized • In use or stored.

13. Why HIPAA? • Health information continues to grow and become more sophisticated. • It requires more protection than ever. • Helps protect against Identity theft. • Puts in place penalties for violations of the law.

14. When HIPAA? • Mandated to be in place by April 2003. • Although the actual law was on the books much earlier…

15. So tell me what you know… • Who has to obey HIPAA laws? • What does HIPAA stand for? • Where does HIPAA apply? • When was HIPAA mandated to be in place?

16. HIPAA Compliance • 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.

17. 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…

18. 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.

19. Consents

20. Consents • 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.

21. Consents • Life insurance • Family records • Family physician

22. Consents • Some releases or authorizations require a non-staff member to sign as a witness. • Students may not fulfill this request.

23. Covered Entities & Business Agreements

24. Covered Entities • 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.

25. Covered Entity – Example of sharing information appropriately. 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.

26. Why a Business Agreement? 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-covered entity.

27. What is a Business Agreement? • 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.

28. What is a Business Agreement? • 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

29. There are always exceptions…

30. Information exempt by law that MUST be reported • Births • Deaths • Injuries caused by violence (assault and battery, abuse, stabbings, gunshot wounds) • Drug abuse • Communicable diseases (TB) • Sexually transmitted diseases

31. http://www.youtube.com/watch?v=jdg_qphWrk0 Extra Credit opportunity: Create your own HIPAA video www.Xtranormal.com