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Ethical Challenges in the Management of Health Information

by: Harman, Laurinda Beebe, Ph.D.

Ethical Challenges in the Management of Health Information

by: Harman, Laurinda Beebe, Ph.D.

ISBN 13:
9780834212299
ISBN 10:
0834212293
Format: Hardcover
Copyright: 04/01/2001
Publisher: Jones & Bartlett
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Summary

Published in conjunction with the American Health Information Management Association (AHIMA), this new edition addresses HIPAA and contains new chapters on research, advocacy and specialty sites to include dialysis, correctional, dental, mental health, long-term care, home hospice and rehabilitation. HIM professionals who work on behalf of patients to protect privacy and healthcare providers who treat patients and patient care advocacy groups will find this book to be a unique and invaluable resource.

Contributors

xiii

Foreword

xvii

Preface

xix

Acknowledgments

xxiii

Part I---PROFESSIONAL ETHICS

(46)

Professional Code of Ethics and Values

(22)

Laurinda B. Harman

Ethical Dilemmas for the HIM Professional

(2)

The Health Information System: Then and Now

(1)

The Patient and the Health Care Environment

(1)

Documentation

(1)

Access to and Release of Information

(1)

Coding and Reimbursement

(1)

Technology

(1)

Role of the HIM Professional

(1)

Professional Code of Ethics

(2)

Professional Values

(4)

Patients and the Health Care Team

(2)

Employer

(1)

Public Interest

(1)

Professional Associations and Oneself

(1)

Building an Ethical Health Information System

(2)

Intersection of HIM and Ethics

(1)

Chapter Summary

(9)

1957 Code of Ethics for the Practice of Medical Record Science

(1)

1977 American Medical Record Association Bylaws and Code of Ethics

(2)

1988 American Medical Record Association Code of Ethics and Bylaws

(1)

1998 American Health Information Management Association Code of Ethics and Bylaws

(3)

Ethical Decision-Making Guidelines and Tools

(14)

Jacqueline J. Glover

Documentation and DRG Assignment

(1)

What Is an Ethical Issue?

(1)

Why Is It Important To Identify and Address Ethical Issues?

(1)

But You Can't Teach Ethics, Can You?

(1)

The Process of Ethical Decision Making

(3)

Justification in Ethical Reasoning: How Do You Know What Is Best?

(4)

Classic Ethical Theories

(2)

Current Ethical Approaches

(1)

The Bioethicist's Toolbox

(1)

Moral Distress

(1)

Retrospective Documentation To Increase Reimbursement

(1)

Ethics Resources

(1)

Conclusion

(1)

Chapter Summary

(3)

Privacy and Confidentiality

(8)

Laurinda B. Harman

Lora A. DeWald

Dianne Vollgraff-Rushton

Family and Friends: Should I Tell?

(1)

Privacy and Confidentiality

(1)

Release of Information

(1)

Blanket Authorization

(1)

Patient Concerns

(1)

Professional Concerns

(1)

Conclusion

(1)

Chapter Summary

(2)

Part II---USES OF HEALTH INFORMATION

(126)

Compliance, Fraud, and Abuse

(18)

Ann Hubbuch

Documentation Does Not Justify Billed Procedure

(1)

The Traditional Regulations Guiding Us

(5)

False Claims Act

(1)

Qui Tam Statutes

(1)

Voluntary Disclosure Protocol

(1)

Antikickback Statutes

(1)

Antireferral Statutes: Stark I and II

(1)

``Safe Harbors'' and Stark Exceptions

(1)

Mail and Wire Fraud

(1)

The New Regulations Guiding Us

(2)

HIPPA Administrative Simplification Standards

(1)

Security Standards

(1)

Privacy Standards

(1)

Enforcement Programs

(1)

False Claims Penalties

(1)

Roles for HIM Professionals

(1)

Compliance Programs To Prevent Fraudulent Behaviors

(2)

Dilemmas in Practice

(1)

Fraudulent Documentation Practices

(1)

Disclosure of Health Information

(1)

Accepting Money for Information

(1)

Retrospective Chart Analysis

(1)

Retrospective Documentation To Avoid Suspension

(1)

Coding Turnaround Time

(1)

Coder Assigns Code Without Physician's Documentation

(1)

Conclusion

(1)

Chapter Summary

(3)

Coding

(24)

Lou Ann Schraffenberger

Rita A. Scichilone

Coding and Inappropriate Level of Service

(3)

Ethical Approaches to Coding Situations

(2)

Utilitarian Approaches

(1)

Deontological Approaches

(1)

Applying the Standards of Ethical Coding

(4)

Ethical Dilemmas for the Coding Professional

(1)

Discovering Misrepresentation in Physician Documentation

(1)

Miscoding To Avoid Conflicts

(4)

Discovering Miscoding by Other Staff

(1)

Lacking the Tools To Do One's Job

(1)

Being Required by the Employer To Engage in Negligent Coding Practices

(2)

Professional Practice Solutions

(2)

Coding Compliance Plans

(1)

Established Coding Guidelines

(1)

Responses to Fraudulent Activity

(1)

The Future of Coding

(1)

Chapter Summary

(2)

Quality Review

(22)

Patrice L. Spath

Quality Management

(2)

QM Ethical Issues Facing HIM Professional

(1)

Ethical Standards Affecting QM Activities

(4)

Patient Safety and Professional Ethics

(2)

Inconsistencies among Professional Conduct Codes

(1)

Organizational Values

(1)

Personal Convictions

(1)

Making Ethical Decisions

(1)

QM Situations That Raise Ethical Questions

(1)

Enabling Ethical Conduct

100

(1)

Inaccurate Performance Data

101

(1)

Home Health Care and Central-line Infections

101

(2)

Failure To Check Physician's Licensure Status

103

(2)

Hiding Incomplete Medical Records

105

(1)

Audit Results Indicate Inappropriate Health Care

106

(3)

Role of the Profession

108

(1)

Role of the Employer

109

(1)

Conclusion: Facing QM Ethical Dilemmas

109

(2)

Chapter Summary

111

(2)

Research and Decision Support

113

(18)

Merida L. Johns

J. Michael Hardin

Karel M. Weigel

Designing a Survery To Bias the Results

114

(1)

Roles of the RS and DSS

115

(3)

Ethical Responsibilities of the RS and DSS

118

(8)

Ensuring Data Integrity and Confidentiality

118

(5)

Human Subject Research

123

(3)

Maintaining and Enhancing Professional Competence

126

(1)

Conclusion

126

(3)

Chapter Summary

129

(2)

Public Health

131

(24)

Babette J. Neuberger

Reporting HIV Status

132

(1)

Public Health: An Overview

133

(9)

The Evolution of Public Health and Governmental Access to Private Medical Information

134

(6)

Sexually Transmitted Disease (STD) Contact Tracing and Partner Notification

140

(1)

State Use of Health Data for Planning Purposes

141

(1)

Ethical Challenges in Public Health

142

(6)

When the Public's Right To Know Conflicts with the Individual's Right to Privacy

142

(6)

When Duty to One's Employer Conflicts with a Duty Owed to the Public

148

(2)

The HIM Professional's Role and Responsibility as an Advocate

150

(2)

A Reciprocal Duty Owed Society

151

(1)

Superior Knowledge

151

(1)

An Unambiguous Duty To Protect Patient Privacy

151

(1)

Resources for Advocacy

152

(1)

Conclusion

152

(1)

Chapter Summary

153

(2)

Managed Care

155

(18)

Ida Critelli Schick

Complexity of Choosing a Managed Care Plan

156

(1)

What Is Managed Care?

157

(1)

Growth of Managed Care

158

(1)

Ethical Issues in Managed Care Strategies

159

(3)

Pricing

159

(2)

Access

161

(1)

Quality

161

(1)

The Role of Information and HIM Professionals in a Managed Care Environment

162

(1)

Ethical Dilemmas for HIM Professionals

163

(2)

Limiting Access to Information by Managed Care Organizations

163

(2)

Provision of Information by Physician Practices

165

(2)

Access to Information about Patients

166

(1)

HIM Professionals in Provider Organizations

167

(1)

Policies for Which the HIM Professional Can Advocate

168

(1)

Managed Care Plans

168

(1)

Provider Organizations

169

(1)

Federal Legislation

169

(1)

Conclusion

169

(1)

Chapter Summary

170

(3)

Part III---COMPUTERIZED HEALTH INFORMATION

173

(98)

Electronic Patient Record

175

(22)

Mary Alice Hanken

Gretchen Murphy

Patient Record Integrity and Patient Security

176

(1)

EHR Systems: Functions and Expected Features

177

(5)

EHR Technology and Ethical Issues

182

(3)

Patient Privacy

182

(1)

Data Quality

183

(1)

Patient Interest

184

(1)

Institutional Values

184

(1)

Making Ethical Decisions

184

(1)

Ethical Issues in Implementation Planning

185

(3)

Patient Record Integrity

185

(1)

Security

185

(1)

Additional Ethical Issues in Implementation Planning

186

(2)

Differences When Linking EHR Systems

188

(6)

User Access

191

(1)

Security Practices

192

(1)

Data Quality

192

(1)

Confidentiality Agreements

193

(1)

Notifying Patients about Information Practices

193

(1)

Audit Trails and E-Mail

193

(1)

Conclusion

194

(1)

Chapter Summary

194

(3)

Information Security

197

(18)

Karen Czirr

Karen A. Rosendale

A Curious Human Resource Employee

198

(1)

The Health Care Information Revolution

198

(1)

Concepts in Information Security

199

(5)

Privacy, Confidentiality, Disclosure, Need To Know

199

(4)

Data Integrity, Authenticity, and Security

203

(1)

Responsibilities of the Information Security Manager

204

(3)

Addressing System Vulnerabilities

204

(3)

Failure To Log Off of the System

207

(1)

Managing the Partnerships

208

(2)

Patient Notification and Informed Consent

209

(1)

Secondary Sharing of Data

210

(1)

Storing Data on a Laptop Computer

210

(1)

A Model Outline for an Information Security Program

211

(1)

Chapter Summary

212

(3)

Software Development and Implementation

215

(14)

Susan H. Fenton

Competing Interests

216

(4)

A Collaborative Approach to Decision Making

220

(1)

Conclusion

221

(6)

Chapter Summary

227

(2)

Data Resource Management

229

(16)

Frances Wickham Lee

Andrea W. White

Karen A. Wager

The Physicians Resist a New Password Policy

230

(2)

Data Resource Management in Health Care

232

(1)

Impact of HIPAA Regulations on Data Resource Management

232

(2)

Data Resource Management Tools

234

(3)

Database and Data Decision Tools

234

(2)

Computer-Based Patient Records and Electronic Medical Records

236

(1)

Ethical Dilemmas for Data Resource Managers

237

(1)

Password Use and ``Timing Out''

237

(1)

Threat to Integrity of the CDR

238

(2)

Research Access to Admission/Discharge/Registration Data

240

(3)

Conclusion

243

(1)

Chapter Summary

243

(2)

Integrated Delivery Systems

245

(10)

Brenda Olson

Karen Gallagher Grant

Donna M. Fletcher

Scheduling Clerk Has Access to All Clinical Information

246

(2)

Confidentiality Issues in the IDS

248

(1)

Data Quality Issues in the IDS

248

(3)

Inconsistencies in the MPI

251

(1)

Skills for HIM Professionals in the IDS

252

(1)

Conclusion

253

(1)

Chapter Summary

253

(2)

E-Health

255

(16)

Cynthia Baur

Mary Jo Deering

Equity and Privacy

256

(3)

E-Health and the Changing Health Care System

259

(2)

E-Health and the Health Information Management Profession

261

(1)

Some E-Health Ethical Issues

262

(1)

Choice and Equal Access

262

(1)

Ensuring On-line Quality and Privacy Protections

263

(3)

Conclusion

266

(1)

Chapter Summary

267

(4)

Examples of Federal Agencies and Their E-Health Activities

269

(1)

Sources for Information About E-Health Ethical Issues and Conduct

270

(1)

Part IV---MANAGEMENT OF SENSITIVE HEALTH INFORMATION

271

(48)

Genetic Information

273

(14)

Barbara P. Fuller

Kathy L. Hudson

Genetic Privacy

274

(1)

The Issue of Genetic Information

274

(2)

The Relationship Between Genetic Information and Generic Medical Information

276

(1)

What Do We Mean by Privacy of Medical Information?

276

(1)

Research Records

277

(1)

The Misuse of Genetic Information and Discrimination

278

(1)

State Legislative Protections

279

(1)

Federal Legislative Protections

280

(1)

Legislation on Research Record Privacy

281

(2)

Ethical Issues for the HIM Professional

283

(1)

Chapter Summary

284

(3)

Adoption Information

287

(16)

Martha L. Jones

Seeking Information Many Years Later

288

(2)

Adoption: Historical and Emerging Ethical Issues

290

(3)

Who's Who in Adoption: Some Explanations of Terminology

293

(1)

Ethical Issues for HIM Professionals

294

(2)

Adoptive Parents Seek Information on Their Adopted Child

295

(1)

An Adoptee Seeks Information on Her Biological Family

296

(2)

A Birth Mother Seeks Information on Her Biological Son

298

(1)

Future Issues

299

(3)

Chapter Summary

302

(1)

Drug, Alcohol, Sexual, and Behavioral Health Information

303

(16)

Sharon J. Randolph

Laurie A. Rinehart-Thompson

The Arrest Warrant: Is This Person in Your Facility?

304

(1)

Behavioral Health Information and the Law

304

(1)

Ethical Challenges in Behavioral HIM

305

(2)

Law Enforcement Requests Patient-Identifying Information

306

(1)

Law Enforcement Requests Patient Information for Public Safety Reasons

307

(1)

Safety of a Citizen versus Privacy of a Patient

307

(2)

A Behavioral Health Patient Confesses to a Staff Member That He Has Committed a Crime

309

(1)

Patient Confesses to a Psychiatrist

309

(1)

Patient Confesses to the Nurse's Aid

310

(1)

Protecting Information about a Patient's Admission to a Behavioral Health Unit of a General Hospital

311

(1)

Verifying Admission Can Violate Privacy

311

(2)

Requests for Information on Sexually Transmitted Diseases

313

(1)

A Prisoner with Possible AIDS

313

(1)

Requests about Employees and Children

314

(1)

Workers' Compensation Case

314

(1)

Children's Protective Services

315

(1)

Conclusion

316

(1)

Chapter Summary

316

(3)

Part V---EMERGING ROLES

319

(48)

Entrepreneur

321

(28)

Marie Gardenier

Competing Constituencies

322

(2)

Entrepreneurship in Health Information Management

324

(3)

Defining the Entrepreneur

325

(1)

Entrepreneur versus Intrapreneur

326

(1)

Business Ethics: Concepts and Principles

327

(4)

Contracts

328

(1)

Advertising

329

(1)

The Profit Motive

330

(1)

The Case for Ethics in Business

330

(1)

The Intersection of Ethics and HIM Entrepreneurship

331

(9)

Function-Based Issues for the Consultant

333

(5)

Relationship-Based Issues for the Independent Contractor

338

(2)

Negotiating Contracts

340

(1)

Unrealistic Client Expectations

341

(1)

Discovering Sensitive Information about a Client or Competitor

342

(3)

Conclusion

345

(1)

Chapter Summary

346

(3)

Advocate

349

(18)

Susan Helbig

Violating Privacy of a Prominent Citizen

350

(1)

Advocacy: The Choice of Ethics in Action

350

(1)

Advocating for Patients

351

(3)

The Patient's Bill of Rights

351

(1)

Health Information: Individual Patient and Collective Patients' Stories

352

(2)

Compassion in Action for an Alcoholic Peer

354

(1)

Advocating for Peers

354

(1)

Cockroaches in the HIM Department

355

(1)

Advocating for Staff

356

(1)

Unfair Treatment of Part-time Workers

357

(1)

Advocating for the Health Care Organization

358

(1)

Small Print on a Consent Form

358

(1)

Advocating for the Larger Community and Society

359

(1)

The Data Warehouse Wants To Sell Patient Information

359

(1)

Advocating for One's Self

360

(1)

Conclusion

361

(1)

Chapter Summary

361

(6)

A Patient's Bill of Rights

363

(2)

Example of Organizational Engagement in Societal Advocacy

365

(1)

Precepts of Effective HIM Advocacy

366

(1)

Abbreviations

367

(2)

Glossary

369

(10)

Index

379

Amazon no longer offers textbook rentals. We do!

Ethical Challenges in the Management of Health Information

Ethical Challenges in the Management of Health Information

9780834212299

0834212293

Summary

Table of Contents

Supplemental Materials

Write a Review

Amazon no longer offers textbook rentals. We do!

Ethical Challenges in the Management of Health Information

Ethical Challenges in the Management of Health Information

9780834212299

0834212293

Summary

Table of Contents

Supplemental Materials

Write a Review

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