Blog Segment Title: The Strength of Standard Practices

Examine a situation where a report must be filed with proper authorities, such as providing care to an HIV-positive patient. Highlight the personal challenges of dealing with such a sensitive issue, emphasizing the importance of maintaining standards of care to all patients.

With the increased survival of HIV positive patients, the management of care has becoming increasingly common in primary care facilities; because of this guidelines for primary care have been created by the Medical Foundation for AIDS & Sexual Health. (PMC 2015) When dealing with the presence of HIV the whole staff must be sensitive to all aspects of care and any patient finding out for the first time may need more emotional support than someone coming in for follow up care, as they may have be unaware of their risk until they were diagnosed. (PMC 2015)  Everyone in any facility should become aware of both state and regional HIV testing laws as well as an HIV patient’s rights to privacy. (PMC 2015)   The standard of care for all patients is highly important and no one person regardless of their health issues should be treated any different. (Fremgen B. 2012) For example HIV patients have an increased risk for cardiovascular disease, diabetes and women are more prone to human papillomavirus-related diseases; so the need for many other specialist are common even though the patient is HIV positive, this does not mean you can just call the specialist and say “by the way the patient I am referring to you is HIV positive” you have an obligation to the patient to protect their privacy so you must explain and get consent from the patient and let the patient know that you are informing the provider that he/she is positive for HIV as this is your ethical obligation as a medical professional to protect all other medical professionals by offering limited information to ensure they can protect themselves from any infectious disease.(PMC 2015)

Highlight the importance of well-kept medical records by "recalling" a fictional scenario you overheard in a doctor's office where you once interned, when a patient's record contained information gaps. Examine the information required in a medical record, correct ways to make record alterations, and ramifications for mismanagement of medical records. 

My fictional scenario as an intern is, I was going through and scanning paperwork in to the EMR of many patients from an employee that had walked of the job earlier that week she had worked for the office for over 18 years and when the EMR’s became a factor she was making many mistakes that went unknown for many years until everyone from the receptionist , billing department and anyone needing access to chart to treat the patient stared seeing all the mistakes and it was brought up to the office managers attention she was so upset she just left one day and never came back. There were many mistakes and improper alterations to the charts. Well-kept medical records in health care facilities should follow the standards set forth by the Joint Commission (previously known as the Joint Commission on Accreditation of Healthcare Organizations) for what should be included in the medical record. (Fremgen B. 2012)  These requirements include legal documents that serve as protections for the medical provider, including the following: consents to treatment and/or procedures, financial agreements, personal identifying information, all laboratory, X-ray, and procedure records, acknowledgement of disclosure of privacy practices, records of communication between physician and patient, physician, nurse, and any other health care provider involvement, consultations, assessments, diagnoses, and treatment/medications recommended, discharge summary. (Fremgen B. 2012) When you make alterations to any medical chart you should never use white out and never scribble the information you are changing, drawing a line through the information you want to change along with your initials is the best policy. (Fremgen B. 2012) For example; if a physician receives notice of a lawsuit and looks into the chart to “clarify” certain points and he/she finds alteration, the alterations are considered a deliberate misrepresentation of facts and during medical liability litigation it seriously impacts the ability to defend the claim. (Fremgen B. 2012) The ramifications for mismanagement of medical records are lawsuits, mismanagement of medical records are consider malpractice and the results are punitive damages or nominal damages and can overall affect the doctors reputation along with any of his patients. (Fremgen B. 2012)

Blog Segment Title: Addressing Patient Concerns Regarding Confidentiality

Define for students the Health Insurance Portability and Accountability Act (HIPAA) and its everyday applications in the workplace. Highlight the required permissions necessary to disclose patient information, and the penalties for non-compliance with HIPAA regulations. To help students better relate the issues to a real-world scenario; summarize a legal case where HIPAA regulations were violated.   

The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), is to standardize the electronic exchange of data between health care organizations, providers and clearinghouses and to protect the security and confidentiality for patient’s health information. (Fremgen B. 2012) The required permission necessary to disclose patient information must be in writing from the patient that stated who you can receive such information and what amount of information;  health information cannot be used or shared without your written permission unless this law allows it. (Fremgen B. 2012) The penalties for non-compliance with HIPAA regulations are: civil penalties which are$100-$50,000 for each violation up to a maximum of $1.5 million for identical provisions during a calendar year. (Fremgen B. 2012) criminal penalties which are; up to 10 years in jail/prison plus fines up to $250,000.  (Fremgen B. 2012)

Here is a legal case where HIPAA regulations were violated; in July a jury in Marion County, Indiana awarded $1.44 million to a Walgreens customer based on allegations that the customer's pharmacist used her information for personal reasons. (Fox C. 2013) The pharmacist's husband had previously been involved with the customer which resulted in the birth of a child when the customer demanded child support from said husband, he in returned used the information that his wife (pharmacist) provided him with to intimidate her. (Fox C. 2013)

Explore patient confidentiality from both a legal and ethical standpoint. Compose a brief case study for students, written from a patient's perspective, in which the patient expresses concerns over his or her records being shown to a third party.    

My case study is; Jane is a 28 year old female who has been diagnosed with genital warts.

Doctor I am so worried that my family and my boyfriend’s family is going to find out. What are you going to tell the insurance company regarding treatment, will my employer find out because the insurance I have is through them, do you sell any information to drug companies or anyone else or can they track me based on meds you prescribed.

Highlight the many rights of the patient, such as informed consent, and the legal responsibilities a medical professional has to honor those rights.   

The patient has the right to be treated with dignity regardless of the situation they are in and receive standard of care no matter their sex, religion or race. (Fremgen B. 2012) Informed consent not only protects the provider but the patient as well, it basically means the doctor does not have the right to treat or touch a patient without their approval. (Fremgen B. 2012) The legal responsibilities a medical professional has to honor regarding the rights of patients are; HIPAA, as HIPAA was put in place to protect ones privacy regarding personal or medical information.  (Fremgen B. 2012)

As a patient, what concerns do you have regarding confidentiality, and how can medical professionals put those concerns to rest?      

I personal do not have any big concerns regarding a medical professional keeping my confidential information private even though I am aware things like this do go on. I think the way medical professionals can put these types of concerns to rest is to inform their patients with what are all the safe guards, and inform them with what violating HIPAA would do to a practices and a provider.

Fremgen B. (2012) Medical Law and Ethics. Fourth Edition. Retrieved From: Pearson Education, Inc.

PMC. (2003) GPs should encourage more HIV testing says AIDS foundation. Retrieved From: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1140377/

Fox C. (2013) United States: HIPAA Violation Results In $1.44 Million Jury Verdict Against Walgreens. Retrieved From: http://www.mondaq.com/unitedstates/x/258310/Professional+Negligence/HIPAA+Violation+Results+in+144+Million+Jury+Verdict+Against+Walgreens+Pharmacist