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HIPAA and Patient Privacy Laws

HIPAA and Patient Privacy Laws

In the scenario presented, a recent incident was reported in the Radiology Department at St. Valentine’s Hospital, which led to a complaint from a patient and a possible involvement of the Hospital Ethics Board. This has also raised concerns about how patient information is being handled, given that the hospital is bound by the Health Insurance Portability and Accountability Act (HIPAA). This paper provides a detailed analysis of HIPAA and patient privacy laws, how HIPAA was violated in the scenario, a comprehensive plan to avoid the violation in the future, possible legal penalties the hospital might be facing, and how the hospital and I would respond to the patient is discussed.

HIPAA and Patient Privacy Laws Analysis

The Health Insurance Portability and Accountability Act of 1996 is one of the most important laws associated with healthcare privacy since it provides all patients with an unavoidable and direct privacy right. HIPAA is a federal regulation that established the creation of national protocols and standards to guard sensitive patient health information from getting into the hands of unauthorized people without the patient’s consent (Centers for Disease Control and Prevention, 2022). The HIPAA privacy rule, issued by the US Department of Health and Human Services (HHS), was put in place to implement the HIPAA requirements. The Privacy Rule protocols address the use and issue of an individual’s Protected Health Information by entities bound to the Privacy Rule. Protected Health Information includes data like name, birth date, address, social security number, medical history, healthcare payment, and healthcare provided (Centers for Disease Control and Prevention, 2022).

Other patient privacy laws include the Genetic Information Nondiscrimination Act (GINA) and the Health Information Technology for Clinical Health Act (HITECH). GINA was passed in 2008 and was enacted to be the legal standard for the gathering, use, and release of genetic information (Theodos & Sittig, 2020). Clinical patient information was found to be less sensitive than genetic information, for it entails the identification of individual patients and even their family members. GINA not only focused on genetic data but also further developed in the health information privacy laws evolution. The HITECH Act, on the other hand, amended parts of the HIPAA privacy provisions. Apart from redefining crucial terms in the HIPAA Act, the HITECH Act created an official protocol for policy and standard governance relating to healthcare security and security (Theodos & Sittig, 2020).

Why the Above Scenario Violate the HIPAA

In the case scenario, several HIPAA violations can be noted. First, there was unauthorized disclosure of protected health information, whereby the staff member revealed Julian’s x-ray results in a public setting, breaching Julian’s confidentiality in medical information. Secondly, the staff failed to respect patient preferences. The staff member disregarded the name the patient preferred by using the birth name (Jilian) instead. HIPAA underscores the importance of respecting patient preferences in managing their health information. Lastly, the staff violated the HIPAA by having inappropriate discussions of patient information. The staff conversation about Julian’s preferred name and their sarcastic comments violated the principle of keeping patient information and demonstrated unprofessional behavior.

How the Office can be Retrained to not Violate this in the Future

There are different ways that the hospital may prevent future violations. First, the hospital should conduct regular training on HIPAA training. All the staff members should take comprehensive and regular HIPAA training sessions with the aim of reinforcing the importance of patient privacy and the repercussions of violating HIPAA rules and regulations. Secondly, the staff should be trained about cultural competency. This provides further training on cultural sensitivity and competency to diverse patient populations, including those with differing gender identities. Also, the importance of respecting patients’ chosen pronouns and names should be emphasized. Lastly, staff can have simulation and role-playing exercises. In these exercises, scenarios are created where staff can practice managing sensitive patient data and challenging situations. This hands-on approach can enhance their skills in maintaining professionalism and confidentiality.

Possible Legal Penalty the Hospital will be Facing

Violation of HIPAA can result in penalties, which can be criminal or civil. Civil penalties have four tiered ranges of penalties where the maximum penalty is capped at $1.5 million for all violations of the same provision within the same year. The four tiers include culpability of reasonable cause, no knowledge, willful neglect that is timely corrected, or willful neglect that is not timely corrected. On the other hand, HIPAA violations can result in criminal penalties. Depending on the severity of the charge, the individual may be charged up to $250,000 and a 10-year jail term if they violate the privacy rule. The hospital may be penalized for violating the privacy rule, which may lead to loss of money and reputation damage.

How the Hospital Should Respond to the Jones

The hospital should respond to the Jones family by apologizing first. On behalf of the hospital, I would acknowledge the mistake and give a sincere apology to the Jones family for the unprofessional behavior and breach of privacy. Also, the hospital should carry out a thorough investigation into the incident, point out the responsible parties, and take suitable disciplinary action, which may include termination, suspension, or retraining of the staff. Furthermore, the hospital may review and revise the current policies to strengthen patient privacy protection and reinforce the consequences of HIPAA violations. Lastly, the hospital can offer remedial measures to the Jones family, such as counseling services, more privacy safeguards, or any other accommodations that may be deemed necessary.

In conclusion, upholding patient privacy is not only a legal obligation but also an essential aspect of providing quality healthcare. The case scenario portrays the importance of continuous education, diligence, and sensitivity in upholding patient confidentiality. By implementing retraining strategies and responding to the patient’s complaints, the hospital can rectify the mistake and develop measures to improve patient privacy.

References

Centers for Disease Control and Prevention. (2022, June 27). Health insurance portability and accountability act of 1996 (HIPAA). Centers for Disease Control and Prevention. https://www.cdc.gov/phlp/publications/topic/hipaa.html

Theodos, K., & Sittig, S. (2020). Health Information Privacy Laws in the Digital Age: HIPAA Doesn’t Apply. Perspectives in Health Information Management, 18(Winter). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883355/

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Question 


You are working as an Office Manager in the Radiology Department at St. Valentine’s Hospital. You have been there for ten years and you are used to the chatter from other staff as patients check-in and/or are called. You vaguely remember that each year you sit through a privacy lecture on HIPPA but it doesn’t change any behaviors. The office is super busy and you don’t really think about changes.

HIPAA and Patient Privacy Laws

Last week, you received a complaint from a patient. The patient’s brother was in the waiting room when he overheard a call to his sibling. Jack Jones’ sibling is transgender and identifies as Julian. Jack hears the staff make a phone call to Julian (whose name on his birth certificate is Jillian). The staff calls Jillian and refers to her as Jillian. After loudly informing Julian of the results of her x-ray, the tech got off the phone and loudly stated to her fellow staff “I can’t believe that patient constantly wants me to call her Julian. As if I am supposed to remember every nickname someone wants to be called.” Other staff members giggled and made sarcastic comments. Jack heard every one of them and has reported them all to you.

You need to determine what to do as his next step is to go to the Hospital Ethics Board. Your HR Director has asked you to create a plan to explain what happened, why it was wrong, and how we can make a better plan for the future.

Included in your plan should be

A thorough analysis of HIPAA and patient privacy laws
Why the above scenario violated HIPAA
How the office can be retrained to not violate this in the future
What kind of legal penalty is the hospital facing
How should the hospital and you respond to the Jones
This plan should be approximately 3-4 pages and include clear information that will be useful in this scenario and any scenarios that occur with patient privacy. Please cite your sources.

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