HIPAA: Rules,
Regulations, and Special Cases nurses should be aware of
It is dire
for nurses to know the rules, regulations, and special circumstances of the HIPAA
law. There have been many nurses in the field questioning what to do in
specific cases, and become frustrated with the confusion of the law. HIPAA is
relatively new, first documentation begun in 1996 and has continuously been
changing. HIPAA stands for The Health Insurance Portability and Accountability
Act, in short, this law is to protect a patient’s medical information, it
restricts people from obtaining a patient’s medical information without certain
documentation or certification. There is an immense amount of information
pertaining to this law that nurses should know however there is no research
piecing all of the rules, regulations, as well as special circumstances
together in to one piece of data which could be where all of the confusion is
coming from.
This research should interest those
who work in the medical field and deal with HIPAA in their everyday work
environment because they have to deal with patient information on a daily
basis. Nurses should specifically care about this information because they are
what is known as “front line” workers in the medical field, they work hand in
hand with patients, and their medical information. Another party that should
care is nursing professors, because they are the leaders of the nursing field,
they have the power to conduct research, and communicate data to nurses,
however; my point should speak to anyone who cares about the larger issue of
the HIPAA law.
Ultimately, what is at stake here
is less violations of HIPAA. Violations of the HIPAA law start from one hundred
dollar penalties and reach up to fifty thousand dollar penalties (National Nurse
23). Violating this law could also result in termination of your job. In a 2011
article from Hospital Laws Regan Report a nurse Jing Zhu violated HIPAA,
unaware she was breaking the law, and this resulted in a court case which ended
in termination of her current nursing job for violating HIPAA. With this
research there would be more understanding of the law in the medical field
including special cases and circumstances the law affects. There would also be
better communication between nurses, and understanding this information will
make patient confidentiality safer.
Knowledge
of the HIPAA law has great importance for nurses in the medical field, as well
as the nursing professors who conduct research. The many properties of the HIPAA
law are still not completely understood.
Studies have suggested that there is confusion on HIPAA, with my
personal interview with Nurse Sharon Love she states “HIPAA is a very confusing
topic for anyone who works with patient information, it takes an extraneous
amount of effort to protect every little aspect of a patient’s information, you
have to constantly be aware of your surroundings, you can’t even leave your
computer unattended”. Something as
simple as a dietary plan of a patient has to be kept confidential, this is the
kind of information hospitals, nursing homes, and doctors’ offices need to
communicate with the nurses and staff. I am covering as much information as I
can on HIPAA but one thing that is important for nurses to know is that every
medical facility has different kinds of patients, and it is important for a
leader, possibly a head nurse, to sit down with fellow nurses, and explain
their expectations and regulations. HIPAA is pretty basic and you should follow
the guidelines, but is important to know what guidelines affect your specific
medical setting.
One of the
most important aspects of this research is special cases. There is the HIPAA
law but there are special circumstances that nurses should be aware of. One of
these special cases includes child abuse and neglect. Parents have rights to
their children if they are under the age of eighteen years old, but what is not
always known is that in cases where a child is suspected of being abused and/or
neglected medical personnel are not required to give out a child’s information,
for the protection of that child. There is also confusion when the media is
brought in to the picture; nurses are confused on what they should do.
The gap in
this research is that there is no research piecing HIPAA together, there are
pieces of research stating rules and regulations, but they fail to mention
special cases. In this article I argue that there is not enough research
piecing HIPAA laws and regulations together while including special
circumstances. This paper describes laws of HIPPA, regulations of HIPPA,
consequences of violation of HIPAA, and special cases of HIPAA.
Aspects of HIPAA:
One of the
first articles I came across was a child abuse and neglect article. What I
learned from analyzing this article is that HIPAA has exceptions for certain
circumstances, in cases of child abuse and neglect HIPAA permits medical
information being disclosed for a child’s safety and intervention (Committee on
Child Abuse and Neglect 198). Also stated is that if child abuse or neglect is
suspected, or mentioned it is required for a nurse to contact law enforcement
or the appropriate investigative agencies; even if the nurse is not a reporter
they are still able to report suspected abuse or neglect. If a case is fatal
there is also an exception for further investigation on the death of the child
(Committee on Child Abuse and Neglect 199). In some cases child abuse cases may
be released to the media, if there is an arrest warrant the information in the
warrant is allowed to be released to the media; however medical staff is not
allowed to release any information about a patient to the media, they cannot
control what is on a warrant therefore the staff themselves are not disclosing
any information. The article should have described in more depth the media
aspect, as well as given examples of cases.
The media
is another difficult aspect to understand. In hospitals nurses are faced with
media wanting to know the conditions of a patient. If this occurs, the nurse or
whoever the medical personnel may be is allowed to give the media a patient’s
name, and the condition of the patient, unless a patient chooses to opt out,
meaning that they want no information disclosed, if a patient requests this
then no information is allowed to be disclosed.
It is also important for nurses to know who their spokesperson is for
his or her hospital; this is the person who should be speaking to the media.
When speaking to the media about a patient’s condition the spokesperson is
allowed to disclose six forms of the condition; undetermined meaning the
condition of the patient is not yet known, good meaning the patient is conscious
and functioning normally, fair meaning the patient is conscious but has minor
complications, serious meaning the patient is badly ill, critical meaning the
patient is badly ill with major complications, and death however the date,
time, or cause of death may not be revealed without consent of the coroner.
(Guide to News Media Relations for Colorado Hospitals and Healthcare Facilities
and the Media 1-4). The article fails to communicate that in order for media to
have any information disclosed the reporter must first have the patients name
and location in the hospital for any information to be disclosed.
In another
article it states aspects the medical staff should now be aware of including a
patient’s rights to restrict certain information from being disclosed,
obtaining their medical documents, look at and make copies of their health
records, etc. There are lists of ways you as the medical staff can protect a
patients’ rights, while still abiding with the HIPAA law. Another important
issue in the article is that medical personnel should be communicating to the
patient their specific rights and help them understand them therefore all
medical personal should be prepared at all times to answer questions patients
have about HIPAA. If a person of the medical staff does not abide with the HIPAA
rules and regulation legal action could be taken, as well as termination of
your job, and loss of credibility to media and patients. (Dougherty 26-28). The
important thing to understand about this information is that each medical
setting varies, so if you work in a nursing home, this is different than
someone who works in a pediatric hospital, it is important each medical staff
go over HIPAA guidelines and how their medical environment should handle
situations.
My next
source that I analyzed is The Health Insurance Portability and Accountability
Act: Does It Live Up to the Promise? The aspect of this article is to state the
original claims of HIPAA that were released in 1996, it shows how HIPAA has
changed and if it has successfully accomplished what it originally was put in
the medical field to do, but this is far from accurate. One of the first claims
that were made in this article is that one of the goals of HIPAA was to make
the healthcare administrative process simpler; however this has proven to be
far from the truth. HIPAA requires such extraneous effort in the healthcare
environment that much more paperwork is required, the amount a medical staff
member must do to abide with the rules and regulations of HIPAA makes their job
a much more difficult task. This article also brings up that HIPAA promised
cost-savings to the medical environment, but with as much paperwork, extraneous
work, and effort the HIPAA law has been very expensive. (Banks 45-50) As you
can see in the previous articles, much effort is required to abide with this
law, making it much more extraneous and difficult on medical staff.
Finding my sources: In my research what I immediately wanted to
research was the HIPAA law. So approaching this topic I went on the UCF library
page and searched “HIPAA” in articles and data bases. To narrow my search I
made sure all of the sources were peer reviewed, and to make sure they were
credible and reliable. So when I started gathering data, trying to make a
conversation with all of the data, my first thought was communicating this
information to society, so they were aware of their rights. The problem I had
with this particular issue is that no one from society was doing research on
HIPAA or asking for the information. So when I furthered my research to search
for a new issue on a topic that intrigued others I came across one important
issue, nurses are very confused on HIPAA and its laws and regulations. There
have been question and answer forums where nurses with higher degrees and who
have greater knowledge of the law communicate questions to nurses who are
confused. I also noticed that some nurses tell the negative parts of HIPAA in
their articles, but there are solutions to these issues in other articles.
Analyzing the Data: After figuring out my topic I analyzed many
pieces of data. I looked at each piece of data and critically analyzed what
they were communicating, writing down the thought process, and then asked what
was missing in each one. I examined what each of them had in common, how a
piece of information goes with the other and what could go against certain
information. For example, HIPAA sets guidelines for minors, but in cases of
child abuse and neglect, parents have no rights.
What I want to
communicate: When I finally came to the decision of my audience being
nurses, I had to formulate a way to give information on the HIPAA law to them.
My goal of my research and paper is to create a document in which I gather a
chunk of information from HIPPA, from issues such as child care, rights, and
special situations that HIPAA can affect. To start my original claim I started
researching many different forms, and situations the law can affect. I found
articles on the rights parents have on their children, and what rights a child
has in an abusive situation. I then found research on how HIPAA affects
research, and how you can go about finding the research you need while still
abiding with HIPAA.
My Plan: My plan
on piecing the conversation together is to write in a genre in which nurses
find credible and reliable. I will use headers. I will cite the credible
sources from professors and researchers who have researched this topic. My goal
to actually giving this information to the nurses is to post my findings on a
nurse’s blog, to start a conversation and give nurses the information they have
been searching for.
The Gap: All in all, my method was finding a variety
of sources on the HIPAA law and trying to find the need for new research,
trying to figure out a way of filling in the gap. The gaps come in place when
nurses do not have a giant piece of research covering various topics of HIPAA.
I gathered numerous data on many aspects of HIPAA from credible sources,
researched the stakeholders, and I am formulating a method of giving nurses my
findings in a credible way.
Results:
Concerning special cases one
includes child abuse. One of the regulations of HIPAA is to protect a patient’s
medical information; child abuse is one exception to this specific regulation.
In cases of child abuse and neglect HIPAA permits to medical information being
disclosed for a child’s safety and intervention (Committee on Child Abuse and
Neglect 198). Also if child abuse or neglect is suspected or mentioned it is
required for a nurse to contact law enforcement or the appropriate
investigative agencies; even if the nurse is not a reporter they are still able
to report suspected abuse or neglect. If a case is fatal there is also an
exception for further investigation on the death of the child, medical records
and information is able to be disclosed to the appropriate parties to further
investigate the case (Committee on Child Abuse and Neglect 199). In some cases
child abuse cases may be released to the media, if there is an arrest warrant
the information in the warrant is allowed to be released to the media; however
medical staff is not allowed to release any information about a patient to the
media, they cannot control what is on a warrant therefore the staff themselves
are not disclosing any information. However with this information said, nurses
should be aware of media policies relating to HIPAA.
In hospitals
nurses are faced with media all of the time and it can be confusing. Through my
time in volunteering in the hospital and speaking to nurses its hard to know
what, and what not to do. If put in a media situation, it is important for
nurses to know who their spokesperson is for his or her hospital; this is the
person who should be speaking to the media, the spokesperson is allowed to give
media a patient’s name, and the condition of the patient, however the patient
can opt out if wanted, meaning that they want no information disclosed, if a
patient requests this then no information is allowed to be disclosed, if a
patient is unconscious the information of the patient can be delayed. When speaking to the media about a patient’s
condition the spokesperson is allowed to disclose six forms of the condition:
1 1)
Undetermined:
the condition of the patient is not yet known
2 2)
Good: the patient is conscious,
comfortable, and functioning normally
3)
Fair: the patient is conscious but has
minor complications
4)
Serious: meaning the patient is badly
ill
5)
Critical: meaning the patient is badly ill
with major complications
6)
Death:
the patient is dead, but the date, time, or cause of death may not be revealed
without consent of the coroner. (Guide to News Media Relations for Colorado
Hospitals and Healthcare Facilities and the Media 1-4).
Nurses should be aware of their
spokesperson, and know that they do not have to speak to the media because it
is not their duty.
HIPAA
affects medical staff as well as patients, it is important that nurses know how
HIPAA affects them and their patients. Patients now have the right to restrict
certain information from being disclosed, obtaining their medical documents,
look at and make copies of their health records, amend their health record.
Sometimes it may be difficult to comply with all of these rules so some things
nurses should be aware of every day are, leaving a patient’s chart unattended,
leaving a patient’s information on a computer screen that others may be able to
see, talking with a patient’s family or coworkers without the proper
permission, discussing a patient’s medical condition with a colleague where other
patients can hear you, accessing information of a patient you are not treating
or assuming a family member is aware of the patient’s medical information.
Medical personnel should be communicating to the patient their specific rights
and help them understand them therefore all medical personal should be prepared
at all times to answer questions patients have about HIPAA. If a person of the
medical staff does not abide with the HIPAA rules and regulation legal action
could be taken, as well as termination of your job, and loss of credibility to
media and patients. (Dougherty 26-28)
Consequences of Violation:
When
thinking about HIPAA there is vocabulary nurses should be aware of including
civil penalties, criminal penalties, covered entity and specified individuals,
and enforcing agencies. Nurses should also be aware of the consequences of
violating HIPAA. If a nurse or medical personnel was not aware they violated
HIPAA the minimum penalty is $100, and the maximum penalty is up to $50,000. If
the HIPAA violation was due to willful neglect but the problem is corrected
within the required time period, there could be a minimum penalty of $10,000
and a maximum penalty of $50,000, and if the HIPAA violation is due to willful
neglect and it is not corrected, there could be a minimum fine of $50,000.
Nurses should be aware of these penalties at all times and to prevent things
like this from happening they should set guidelines for themselves. Nurses
should always be aware of who is around their computer, who could be looking at
paperwork, and should never let another employee use their computer. It is so
easy to slip up, and break HIPAA without even realizing you did something
wrong, that is why it is so important for nurses to be aware every second.
(National Nurse 20-27)
During
my interview with Nurse Sharon Love she agreed that HIPAA is very confusing and
many people are confused with it. Nurse Love is currently a nurse in a nursing
home in Kerrville, Texas and has also worked in nursing homes in Florida as well.
She said that nurses have to take extra precaution with almost everything; even
dietary charts have to be monitored to protect patient information. She states
that you cannot leave your computer unattended at any time because someone
could look at patient information saved in your computer. Also, she brings up
the point that HIPAA is unfair; it is unfair that HIPAA does not make special
cases for elderly patients with diseases such as schizophrenia who are not in
their right minds to make decisions by themselves. This is why it is important
for nurses to be aware of their surroundings, and why medical staff should
communicate their expectations of their hospital, home, or office to nurses.
All
in all, HIPAA is a very confusing topic, nurses should be fully aware of the
aspects of this law. There are so many different aspects and it is important
that nurses understand their surroundings and what is expected of them. The gap
in this research is that no one is piecing information together, a nurse could
be faced with a child abuse case and not realize he or she disclosed
information to the abusive parent, or faced with media asking questions and
disclosing inappropriate information. Being a nurse you always have to know how
to handle these situations, and know the consequences of violating the law.
HIPAA has constantly been changing to help society, and continues to change, it
is important for staff to communicate these changes as much as possible.
References:
·
"Policy Statement--Child Abuse, Confidentiality,
And The Health Insurance Portability And Accountability Act." Pediatrics 125.1 (2010): 197-201. CINAHL Plus with Full Text. Web. 27
Sept. 2012.
·
Dougherty, M. "Health Care Advocate.
Creating A Safe, Secure Health Care Environment: Understanding HIPPA &
Exploring Its Implications." AWHONN
Lifelines 8.1 (2004): 26-28. CINAHL
Plus with Full Text. Web. 27 Sept. 2012.
·
Giacalone, RP, and GG Cacciatore. "HIPPA
And Its Impact On Pharmacy Practice." American
Journal Of Health-System Pharmacy 60.5 (2003): 433-445. CINAHL Plus with Full Text. Web. 27
Sept. 2012.
·
Conn, J. "HIPPA, 10 Years After." Modern Healthcare 36.31 (2006): 26-28. CINAHL Plus with Full Text. Web. 26
Sept. 2012.
·
Maradiegue, A. "From Research To Policy In
Pediatric Nursing. The Health Insurance Portability And Accountability Act And
Adolescents." Pediatric Nursing
28.4 (2002): 417-420. CINAHL Plus with
Full Text. Web. 28 Sept. 2012.
·
Frimpong, JA, and PA Rivers. "Health
Insurance Portability And Accountability Act: Blessing Or Curse?." Journal Of Health Care Finance 33.1
(2006): 31-39. CINAHL Plus with Full
Text. Web. 28 Sept. 2012.
·
Banks, DL. "The Health Insurance
Portability And Accountability Act: Does It Live Up To The Promise?." Journal Of Medical Systems 30.1 (2006):
45-50. CINAHL Plus with Full Text.
Web. 27 Sept. 2012.
·
Wipke-Tevis, DD, and MA Pickett. "Impact Of
The Health Insurance Portability And Accountability Act On Participant
Recruitment And Retention." Western
Journal Of Nursing Research 30.1 (2008): 39-53. CINAHL Plus with Full Text. Web. 27 Sept. 2012.
·
Bova, C, D Drexler, and S Sullivan-Bolyai.
"Reframing The Influence Of The Health Insurance Portability And
Accountability Act On Research." Chest
141.3 (2012): 782-786. CINAHL Plus with
Full Text. Web. 27 Sept. 2012.
·
"MA: Hospital Employee Violates HIPPA:
Suspension And Termination Upheld By Court. (Hospital Law Decisions Of
Note)." Hospital Laws Regan Report
51.12 (2011): CINAHL Plus with Full Text.
Web. 27 Sept. 2012.
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