Patient Confidentiality

1. Patient ConfidentialityIt’s a matter of trust! Linda McClintock

2. Patient Confidentiality • Confidentiality is inherent in preserving relationships. • Confidentiality means that in all relationships privacy is paramount.

3. Patient Confidentiality • A hospital’s relationships include: • The employee, the employee’s family • Co workers • Physicians • Therapists • Social Workers • Pharmacists • Volunteers • Hospital Board Members • Students • Our patients (famous or not) • Our patients’ family

4. Patient Confidentiality • Everyone has the right to have confidentiality regarding any information that is obtained from patient care records or verbal information exchanges. • Everyone has the right to have personal and medical information protected by each and every: • Organization that maintain protected health information (PHI) • Physician • Hospital employee • Hospital volunteer • Student • Dentist • Pharmacist • Insurance Plan

5. Patient Confidentiality • Protected health information is any information verbal, written, recorded in any medium or forum that is created or received by a health care provider and relates to any individuals past, present or future mental health or physical treatments or medical conditions

6. Patient Confidentiality • Protected Health Information (PHI) includes demographic information or any information that is individually identifiable and is transmitted in any media form. • Protected Health Information (PHI) includes demographic information or any information that is individually identifiable and is transmitted in any media form.

7. Protected Health Information (PHI)

8. Patient Confidentiality • Regardless of whom you are and regardless of who they are, we must share the ethical obligation to protect all healthcare and protected information

9. Patient Confidentiality • Breaches of confidentiality in the media • In 2007-40 employees investigated for accessing a celebrity’s PHI • In 2007-At Park Nicollet Clinic 100 employees suspended for three days for accessing relatives and friends medical records • In 2008-At Mayo Clinic hospital, the Chief Surgery resident took a picture of a patient during surgery and was placed on administrative leave

10. Patient Confidentiality • In 2008-Three employees of the UCLA Health System accessed high-profile patient medical records. UCLA cited for confidentiality deficiencies by the California Department of Health including the following law enforcement agencies: • State Attorney General • County District Attorney • City Attorney • Office of Civil Rights

11. Patient Confidentiality • The unauthorized access resulted in: • 13 employees terminated • An Administrative Specialist employee was indicted by the Federal Government for: • Accessing records • Selling the records to the media • Facing incarceration

12. Patient Confidentiality • A breach of confidentiality is when information is disclosed: • To a person who is not providing care • Or, has no authorization to access • Or, a need to access records • Or a legitimate need to know.

13. Patient Confidentiality • A legitimate need to know is an employee accessing information that is pertinent to caring for patients or fulfilling the employee’s job requirements.

14. Patient Confidentiality • Confidentiality Concepts • Never harm means that sensitive or healthcare information will never be disclosed to someone who has no legitimate need for the information. • Honesty is always the best policy • Information exchanges are irreversible and once shared, the information is shareable with others via word of mouth, the internet, media or social media • Breaches may occur due to a lack of attention to detail or surroundings

15. Patient Confidentiality • Examples of breaches include, but not necessarily limited to: • Leaving patient information in public accessible areas • Leaving a computer unlocked or unsecured • Faxing protected health information to the wrong number • Giving patient information that was intended for another patient • Discussing patient information in public accessible areas

16. Patient Confidentiality • Ways to Avoid Breaching Confidentiality: • Shift change report should be given in areas that are not publically accessible • Patient information should never be discussed in the cafeteria, halls, hallways, stairs, elevators or any public areas • Patient information should only be discussed with appropriate staff • Direct media inquiries to the manager or Public Relations • Inquiries from law enforcement should be directed to medical records • Copies should never be made of patient information • Shift records should be placed in the bin for shredding; as well as, any patient identifiable information that is not part of the medical record

17. Patient Confidentiality • Patient Privacy • Patients have the right to decide who they want they information share with • Patients have the right to decide how and whom information should be shared with • Patients have the right to physical privacy • Patients have the right to decline observers watching their procedures, treatments or care

18. Patient Confidentiality • Observers are not members of the patient’s family, as long as the patient does not object. Observers are not vendors or contractors or students who are affiliated with the organization. • Examples of observers, but not limited to: • A hospital’s employee’s friend, such as a police officer; who, wants to observe the organizations’ custody procedures. • A visiting medical student who want to observe a patient procedure or observe a physician conducting a patient interview • In these circumstances, the patient must be informed and consent to be observed

19. Patient Confidentiality • A confidentiality breach may occur due to curiousness or concerns such as: • Accessing addresses or birth dates of friends, relatives or fellow employees • Accessing a patient record due to being curious about treatments or procedures; even when, the information is not shared with anyone • Accessing a celebrity, VIP or famous persons medical records

20. Patient Confidentiality • A confidentiality breach may occur due to gain or malice. Examples of the following are severe infractions, but not limited to these examples: • Downloading and selling PHI • Divulging passwords or computer identifier information

21. Patient Confidentiality • Federal Law HIPPA • Hospitals must ensure the confidentiality of all protected health information they create, receive, maintain or transmit [§164.306(a) (1)] • Hospitals must have and apply sanctions against employees who fail to comply with privacy policies and procedures [§165.530 (e) (1)] • Every healthcare provider must monitor their employees’ electronic access to medical information • Breaches must be reported to the State and Patient within five days of discovery • Personal fines can be levied upon employees up to $250,000 per violation • Patients may sue the employee and the provider for negligent release of confidential information

22. Patient Confidentiality • Federal Law HIPPA • Hospitals must ensure the confidentiality of all protected health information they create, receive, maintain or transmit [§164.306(a) (1)] • Hospitals must have and apply sanctions against employees who fail to comply with privacy policies and procedures [§165.530 (e) (1)] • Every healthcare provider must monitor their employees’ electronic access to medical information • Breaches must be reported to the State and Patient within five days of discovery • Personal fines can be levied upon employees up to $250,000 per violation • Patients may sue the employee and the provider for negligent release of confidential information

23. Patient Confidentiality • Code of Ethical Conduct • Employees, physicians and volunteers or other individuals who have access to confidential information are expressly prohibited from revealing or discussing protected health information in any unauthorized fashion or manner • Any breach of confidentiality results in the failure to meet the professional, legal and ethical standards which constitutes a violation of the standards of confidentiality conduct; and, are subject to discipline which includes; but not limited to, termination from employment.

24. Patient Confidentiality • Confidentiality is serious and must never be broken. If you have questions or concerns, discuss them with your manager or the Compliance Officer.

25. Patient Confidentiality • References • Adventist Health Care. (2010). Refresher Training. Retrieved from http://www2.bakersfieldcollege.edu/alliedhealth/studentpages/RNpages/HIPAA.RefresherTrainingRev11-2010_3.PPT • Fox News. (2008, August 6). Report: Over 120 UCLA hospital staff saw celebrity health records. Retrieved from http://www.foxnews.com/story/o,2933,398787,00.html • Health Insurance Portability and Accountability Act. (20http://www.hhs.gov/ocr/privacy/03). Retrieved from http://www.hhs.gov/ocr/privacy/ • Oram, M. (2004). Maintaining confidentiality. Retrieved from http://excellenceinlearning.net/courses/117.doc

26. Thank you