HRM FPX 5401 Assessment 3 Legal and Ethical Considerations in Healthcare Privacy: Brief

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Capella University

HRM-FPX5401 The Legal, Ethical, and Regulatory Environment of Health Care

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Introduction

This briefing will explore research on best practices for preventing violations of the Health Insurance Portability and Accountability Act (HIPAA). The Health Insurance Portability and Accountability Act of 1996 (HIPAA) safeguards the privacy of personal medical information, prohibits discrimination based on health status in group health plans, and provides special enrollment opportunities for group health plans (Society for Human Resource Management, n.d.). Vila Health has experienced multiple HIPAA violations, prompting the HR director to seek improved processes. The HR professional aims to achieve this by adhering to HIPAA regulations and aligning the organization’s mission with legal compliance and ethical standards.

HIPAA Impacts on Regulatory Environment and Healthcare Industry

The healthcare industry is service-oriented and requires regulation to enforce government mandates. A regulatory system is essential for monitoring compliance with contractual obligations and legal requirements, thereby protecting public interest (Dr. L, 2021). Regulations play a crucial role in safeguarding healthcare professionals and ensuring that public health welfare is adequately served through health programs. HIPAA is vital for standardizing and overseeing the healthcare industry, ensuring compliance with public health policies, and providing safe care to all patients and visitors within the healthcare system.

HIPAA breaches can occur even in well-prepared healthcare organizations, but understanding common failings can enhance the likelihood of maintaining compliance with the Office for Civil Rights (OCR) (Hoskins, 2019). Recent incidents highlight the mistakes organizations have made. For instance, attorney Melissa Soliz reported that the OCR imposed a $2.15 million civil monetary penalty on a health system that lost paper records for over 1,400 patients, allowed a reporter to share a photograph of an operating room containing patient health information on social media, and had an employee who had been inappropriately accessing and selling patient records since 2011 (Hoskins, 2019). These errors could have been prevented through regular reviews of the organization’s security safeguards and by emphasizing to employees the importance of not taking health information outside the facility unless necessary and in accordance with established policies.

According to the Hospital Access Management, even the best policies can lead to HIPAA violations (Hoskins, 2019). Effective data management and restricted access can mitigate some of the human errors that contribute to HIPAA breaches. Strategies to achieve this include prohibiting access to and storage of health information on personal devices, such as laptops, cell phones, or tablets that are not approved for organizational use. Additionally, training staff on how to avoid cyberattacks, such as phishing emails, is essential to protect the organization’s protected health information (PHI). If employees have limited or no access to PHI, they cannot inadvertently release it (Hoskins, 2019).

Legal and Ethical Basis for Patient Privacy

A primary objective of the Privacy Rule is to ensure that individuals’ health information is adequately protected while allowing the necessary flow of information to provide and promote high-quality healthcare and protect public health and well-being (U.S. Department of Health and Human Services, n.d.). Respecting patient confidentiality is both an ethical and legal obligation for healthcare professionals and is fundamental to care excellence (Teg, 2022). Confidentiality involves restricting personal information from unauthorized individuals, and every patient has the right to confidentiality and private communication that is not disclosed without their consent.

Healthcare professionals are legally required to handle all patient information securely and privately. Improper disclosure of sensitive data can jeopardize patient safety. Upholding confidentiality not only reflects ethical behavior but also fosters positive and professional trust between patients and healthcare providers. In 1998, the Data Protection Act was enacted, establishing guidelines and principles for maintaining the integrity of patient privacy.

The Data Protection Act and Its Importance

The Data Protection Act was established to safeguard personal data and provide guidelines for its handling (Teg, 2022). Ensuring the confidentiality of information not only fulfills the legal obligations imposed on healthcare institutions but also represents a fundamental moral duty that underpins ethical healthcare delivery.

HIPAA Compliance and Quality Healthcare Delivery

As previously mentioned, HIPAA guidelines restrict the use and disclosure of protected health information to prevent unauthorized access. HIPAA offers patients a level of protection for their healthcare data, which is crucial for fostering trust and encouraging full participation in their healthcare. This trust enables healthcare providers to make accurate diagnoses and develop effective treatment plans, as patients feel secure discussing their most private information without fear of exposure. “By taking a more active role in their healthcare, patients are more likely to comply with the advice their healthcare providers give them and make healthier lifestyle choices, which improves patient outcomes. Studies have shown that patients who do not believe their privacy will be protected are much less likely to fully participate in the diagnosis and treatment of medical conditions” (Stevens, 2023). Although HIPAA compliance is an ongoing process that can be challenging to manage, it has proven beneficial for patients, healthcare organizations, healthcare professionals, and the healthcare industry as a whole by enhancing relationships and increasing job satisfaction.

Electronic Storage and Access of Medical Records

Electronic medical records (EMR) significantly improve patient care and convenience for healthcare providers in medical planning and treatment. “The EMR technology gives healthcare providers information in formats that were not possible with paper charts. Primary care providers can now view and print graphs of values such as weight, cholesterol levels, and blood pressure, tracking changes over time” (Donner, 2015). Access to EMR allows physicians and other healthcare professionals to efficiently obtain information and resources for screening, prevention, and management. “The structured EMR data provides the potential to access point-of-care data that can be used to inform practice and conduct research” (Pozgar, 2020). Retaining patient records is essential for providing continuous care, regardless of the care setting (e.g., inpatient, outpatient, emergency). Maintaining these records creates a comprehensive history of a patient’s treatment plans, which is particularly important for long-term care and quality assurance. Additionally, retained records are valuable for medical malpractice lawsuits, licensing board complaints, and medical billing audits. Legal requirements dictate that patient records must be kept for a specified duration based on state laws. Failure to preserve medical records can lead to lawsuits, as demonstrated in the case of Rodgers v. St. Mary’s Hospital of Decatur. “In the absence of specific state requirements, providers should keep health information for at least the period specified by the state’s statute of limitations or for a sufficient length of time for compliance with laws and regulations” (Pozgar, 2020).

Aligning HIPAA Compliance with Organizational Standards

Achieving HIPAA compliance can be daunting, particularly given the potential fines of up to $250,000 for noncompliance. Vila Health has experienced multiple HIPAA violations and has now implemented a plan to enhance processes and align compliance with the organization’s mission and ethical standards. Key components of this plan include:

Hiring a HIPAA compliance champion who focuses on security standards and oversees staff handling patient-protected health information (PHI). This individual will lead a team of trained employees responsible for compliance in healthcare.
Implementing robust security measures to protect medical records.

System Security Measures

The proposed system will incorporate encryption techniques, robust firewalls, and secure storage solutions. Regular risk assessments will be conducted to promptly identify threats and mitigate them before a significant data breach occurs. Employee training and awareness regarding HIPAA regulations, privacy policies, and security measures are essential. Staff must understand the importance of their roles and responsibilities in protecting patient privacy and maintaining organizational standards.

Additionally, all employees will be informed about whom to contact for HIPAA-related inquiries, who to reach out to if they suspect unauthorized use or disclosure of health information, and where to find the organization’s HIPAA policies and procedures.

References

Alder, S. (2023, January 20). Editorial: Benefits of HIPAA for healthcare professionals. Retrieved from The HIPAA Journal: https://www.hipaajournal.com/benefits-of-hipaa-for-healthcare-professionals/#:~:text=Through%20HIPAA%20compliance%2C%20healthcare%20organizations,to%20deliver%20high%2Dquality%20care.

Hospital Access Management. (2019, December). Avoid most common HIPAA violations with best practices, education. Retrieved from https://www.proquest.com/docview/2315025419?accountid=27965&parentSessionId=f70dzlSQX4YYnecVsdY8mv6sAyR%2FFAQEaRXrOFyYtdM%3D

Manca, D. P. (2015, October). Do electronic medical records improve quality of care? Retrieved from PMC PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607324/

Pozgar, G. D. (2020). Legal and ethical essentials of health care administration (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

SHRM. (n.d.). Health Insurance Portability and Accountability Act (HIPAA). Retrieved from https://www.shrm.org/resourcesandtools/tools-and-samples/hr-glossary/pages/health-insurance-portability-and-accountability-act-hipaa.aspx#:~:text=The%20Health%20Insurance%20Portability%20and%20Accountability%20Act%20of%201996%20(HIPAA,RETURN%20TO%20THE%20

Tegegne, M. M. (2022, March 14). Health professionals’ knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: A cross-sectional study. Retrieved from https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-022-00765-0#citeas