Ethical challenges in the management of health information / [edited by] Laurinda Beebe Harman.

Format:

Book

Contributor:

American Health Information Management Association.

Harman, Laurinda B.

Language:

English

Subjects (All):

Health--Information services--Management--Moral and ethical aspects.

Health.

Medical care--Information services--Moral and ethical aspects.

Medical care.

Information Management--ethics.

Medical Records--standards.

Confidentiality--ethics.

Ethics, Professional.

Medical care--Information services.

Health--Information services.

Management.

Medical Subjects:

Information Management--ethics.

Medical Records--standards.

Confidentiality--ethics.

Ethics, Professional.

Physical Description:

xxix, 655 pages ; 26 cm

Edition:

Second edition.

Place of Publication:

Sudbury, Mass. : Jones and Bartlett Publishers, [2006]

Summary:

Published in conjunction with the American Health Information Management Association (AHIMA), Ethical Challenges in the Management of Health Information, Second Edition addresses HIPAA and contains new chapters on management, e-HIM, clinical decisions at the end of life, and issues related to working with vendors. The protection of privacy and confidential information is the primary ethical obligation of the health information management (HIM) professional and this obligation is central to the decisions that are made on behalf of patients. This extensive revision is an ideal resource for students and practitioners in many disciplines-HIM, healthcare professions (physicians, nurses, therapists), ethicists, information technology, healthcare administration, and public health. HIM professionals who work on behalf of patients to protect privacy, healthcare providers who treat patients, and patient care advocacy groups will find this book to be a unique and invaluable resource. This book aids all of these readers in exploring professional values and obligations, with guidance from the AHIMA Code of Ethics.

Contents:

Part 1 Professional Ethics 1

Chapter 1 Professional Values and the Code of Ethics / Laurinda B. Harman, PhD, RHIA, Virginia L. Mullen, RHIA 3

Ethical Dilemmas For The HIM Professional 4

The Health Information System: Then And Now 5

Role of the HIM Professional 8

Professional Code of Ethics 9

Professional Values 10

Building an Ethical Health Information System 15

The Intersection of HIM and Ethics 16

Appendix 1-A 1957 Code of Ethics for the Practice of Medical Record Science 19

Appendix 1-B 1977 American Medical Record Association Bylaws and Code of Ethics 20

Appendix 1-C 1988 American Medical Record Association Code of Ethics and Bylaws 22

Appendix 1-D 1998 American Health Information Management Association Code of Ethics and Bylaws 23

Appendix 1-E 2004 American Health Information Management Association Code of Ethics 25

Chapter 2 Ethical Decision-Making Guidelines and Tools / Jacqueline J. Glover, PhD 33

Scenario 2-A Documentation and DRG Assignment 34

What Is an Ethical Issue? 34

Why Is it Important to Identify and Address Ethical Issues? 34

But You Can't Teach Ethics, Can You? 35

The Process of Ethical Decision-Making 35

Justification in Ethical Reasoning: How Do You Know What Is Best? 38

Moral Distress 42

Scenario 2-B Retrospective Documentation to Increase Reimbursement 43

Ethics Resources 43

Ethical Decision-Making Matrices

Appendix 2-A Blank Ethical Decision-Making Matrix 50

Chapter 3 Privacy and Confidentiality / Laurie A. Rinehart-Thompson, JD, RHIA, CHP, Laurinda B. Harman, PhD, RHIA 51

Scenario 3-A Family and Friends: Should I Tell? 52

Privacy and Confidentiality 53

Release of Information 54

The HIPAA Privacy Rule 54

Blanket Authorizations 59

Patient Concerns 60

Professional Concerns 61

Ethical Challenges 61

Ethical Decision-Making Matrix

Part II Uses of Health Information 67

Chapter 4 Compliance, Fraud, and Abuse / Laurie A. Rinehart-Thompson, JD, RHIA, CHP 69

Scenario 4-A Documentation Does Not Justify Billed Procedure 70

Traditional Regulations that Guide HIM Professionals 71

More Recent Regulations That Guide HIM Professionals 76

HIPAA Administrative Simplification Standards 77

Roles for HIM Professionals 79

Compliance Programs to Prevent Fraudulent Behaviors 79

Dilemmas in Practice 81

Scenario 4-B Accepting Money for Information 81

Scenario 4-C Retrospective Documentation to Avoid Suspension 82

Scenario 4-D Coder Assigns Code Without Physician's Documentation 84

Chapter 5 Clinical Code Selection and Use / Lou Ann Schraffenberger, MBA, RHIA, CCS, CCS-P, Rita A. Scichilone, MHSA, RHIA, CCS, CCS-P, CHC 97

Scenario 5-A Coding an Inappropriate Level of Service 98

HIPAA and Billing Activities 101

Ethical Approaches to Coding Situations 102

Applying the AHIMA Standards of Ethical Coding 104

Ethical Dilemmas for the Coding Professional 109

Scenario 5-B Discovering Misrepresentation in Physician Documentation 109

Scenario 5-C Miscoding to Avoid Conflicts 110

Scenario 5-D Discovering of Miscoding by Other Staff Members 114

Scenario 5-E Lacking the Tools to do One's Job 115

Scenario 5-F Being Required by the Employer to Engage in Negligent Coding Practices 116

Scenario 5-G Supporting Application Software that Facilitates Questionable Results 118

Professional Practice Solutions 120

The Future of Coding 122

Questionable Results 136

Chapter 6 Quality Review / Patrice L. Spath, BA, RHIT 139

Quality Management 140

Scenario 6-A Inaccurate Performance Data 142

QM Ethical Issues Facing HIM Professionals 142

Scenario 6-B Home Health Care and Central-Line Infections 143

Ethical Standards Affecting QM Activities 144

Scenario 6-C Failure to Check Physician's Licensure Status 146

Scenario 6-D Hiding Incomplete Medical Records 147

Making Ethical Decisions 148

Scenario 6-E Audit Results Indicate Inappropriate Health Care 149

QM Situations that Raise Ethical Questions 149

Enabling Ethical Conduct 151

Scenarios-Survey Results and Ethical Decision-Making Matrices

Chapter 7 Research and Decision Support / Merida L. Johns, PhD, RHIA, J. Michael Hardin, PhD 175

Scenario 7-A Designing a Survey to Bias the Results 176

Roles of the RS and DSS 177

Ethical Responsibilities of the RS and DSS 181

Chapter 8 Public Health / Babette J. Neuberger, JD, MPH 199

Scenario 8-A Reporting HIV Status 200

Public Health: An Overview 201

Ethical Challenges in Public Health 210

Scenario 8-B When Duty to One's Employer Conflicts with a Duty Owed to the Public 216

The HIM Professional's Role and Responsibility as an Advocate 219

Emerging Issues: Bioterrorism and Global Infections 221

Scenario 8-C The Terrorism Preparedness Act 222

Chapter 9 Managed Care: Lessons of Integration / Ida Critelli Schick, PhD, MS, FACHE 231

Scenario 9-A Complexity of Choosing a Managed Care Plan 232

What Is Managed Care? 233

Growth of Managed Care 234

Managed Care Strategies 235

The Role of Information and HIM Professionals in a Managed Care Environment 240

Ethical Dilemmas for HIM Professionals 241

Scenario 9-B Provision of Information by Physician Practices 243

Scenario 9-C HIM Professionals in Provider Organizations 245

Policies for Which the HIM Professional Can Advocate 246

Chapter 10 Clinical Care: End of Life / James F. Tischler, MD 257

Scenario 10-A Bad News 258

Aging, Frailty, and Information Ethics 258

Evolution of Autonomy 259

Cultural Influences on Autonomy 259

Physician Bias and Equity: A Systems Issue 259

Scenario 10-B Treatment Choices 260

Information Across a Healthcare Continuum 261

Treatment Goals and Beneficence 261

Scenario 10-C Advance Care Planning 262

Advance Care Planning: An Opportunity 263

The Meaning of Terminal 263

Advance Care Planning and Law 264

Scenario 10-D Palliative Care 264

Managing Pain 265

Ethics Committees 265

Palliative Care 265

Emerging Issues 266

Part III Computerized Health Information 277

Chapter 11 Electronic Health Records / Mary Alice Hanken, PhD, CHP, RHIA, Gretchen Murphy, MEd, RHIA, FAHIMA 279

Scenario 11-A Patient Record Integrity and System Security 280

EHR Systems: Functions and Expected Features 281

EHR Systems in the Twenty-First Century 285

EHR Technology and Ethical Issues 286

Scenario 11-B Differences when Linking EHR Systems 293

Chapter 12 Information Security / Karen Czirr, MS, RHIA, CHP, Karen A. Rosendale, MBA, RHIA, Emily West, RHIA 307

Scenario 12-A A Curious Human Resource Employee 308

The Healthcare Information Revolution 308

The Role of the ISO 310

Concepts in Information Security 310

Privacy-Related Security 310

Establishing a Security Baseline 312

Scenario 12-B Failure to Log Off of the System 315

Scenario 12-C Storing Data on a Laptop Computer 318

Chapter 13 Software Development and Implementation / Susan H. Fenton, MBA, RHIA 329

Scenario 13-A Planning the EHR: Competing Interests 330

Consultant's Approach 330

Information Gathering 331

Chapter 14 Data Resource Management / Frances Wickham Lee, DBA, Andrea W. White, PhD, Karen A.

Wager, DBA, RHIA 341

Data Resource Management in Health Care 341

Impact of HIPAA Regulations on Data Resource Management 342

Data Resource Management Tools 342

Scenario 14-A The Physicians Resist a New Password Policy 346

Ethical Dilemmas for Data Resource Managers 347

Scenario 14-B Threat to Integrity of the CDR 349

Scenario 14-C Research Access to Admission/Discharge/Registration Data 350

Chapter 15 Integrated Delivery Systems / Brenda Olson, MEd, RHIA, CHP, Karen Gallagher Grant, RHIA, CHP 363

Scenario 15-A Scheduling Clerk Has Access to All Clinical Information 364

Privacy and Security Issues 365

Data Quality Issues 368

Scenario 15-B Inconsistencies in the MPI 372

Required Skills for HIM Professionals 373

Chapter 16 E-Health for Consumers, Patients, and Caregivers / Cynthia Baur, PhD, Mary Jo Deering, PhD 381

Scenario 16-A Equity and Privacy 382

E-Health and the Changing Healthcare System 386

E-Health and National Policy 388

E-Health and the HIM Professional 389

Some E-Health Ethical Issues 390

Scenario 16-B Ensuring Online Quality and Privacy Protections 391

Emerging Issues 393

Appendix 16-A Examples of Guidelines, Policies, and Codes of Conduct for Health Websites 397

Chapter 17 E-HIM: Information Technology and Information Exchange / Meryl Bloomrosen, MBA, RHIA 403

Scenario 17-A The HIM Professionals' Role in eHIM 411

Part IV Management of Sensitive Health Information 421

Chapter 18 Genetic Information / Barbara P. Fuller, JD, RHIA, Kathy L. Hudson, PhD 423

Scenario 18-A Genetic Privacy 424

The Issue of Genetic Information 424

The Relationship Between Genetic Information and Generic Medical Information 426

What Do We Mean by Privacy of Medical Information? 427

Research Records 427

The Misuse of Genetic Information and Discrimination 428

Federal Legislative Protections 429

State Legislative Protections 430

Legislation on Research Record Privacy 431

Ethical Issues for the HIM Professional 433

Chapter 19 Adoption Information / Martha L. Jones, PhD, LSW 439

Scenario 19-A Seeking Information Many Years Later 440

Adoption: Historical and Emerging Ethical Issues 442

Who's Who in Adoption: Some Explanations of Terminology 445

Ethical Issues for HIM Professionals 447

Scenario 19-B An Adoptee Seeks Information on Her Biological Family 448

Scenario 19-C A Birth Mother Seeks Information on Her Biological Son 450

Future Issues 451

Chapter 20 Drug, Alcohol, Sexual, and Behavioral Information / Sharon J. Randolph, JD, RHIA, Laurie A. Rinehart-Thompson, JD, RHIA, CHP 463

Scenario 20-A The Arrest Warrant: Is This Person in Your Facility? 464

Substance Abuse Treatment, Health Information, and the Law 464

Ethical Challenges in Behavioral Health and Substance Abuse Treatment 465

Scenario 20-B Safety of a Citizen versus Privacy of a Patient 469

Scenario 20-C Patient Confesses to a Psychiatrist 470

Scenario 20-D Patient Confesses to the Nurse's Aide 472

Scenario 20-E Verifying Admission Can Violate Privacy 473

Scenario 20-F A Prisoner Who May Have AIDS 475

Scenario 20-G Workers' Compensation Case 476

Scenario 20-H Children's Protective Services 477

Part V Roles 497

Chapter 21 Management / Cathy Flite, MEd, RHIA, Sharon Laquer, MS, RHIA 499

Scenario 21-A Lateness and Absenteeism 500

Moral Development and Awareness 500

Scenario 21-B National Convention Misadventures 507

Orientation of New Employees 508

Scenario 21-C Avoiding the Employee Who Will Be Fired 510

The Code of Ethics is Not Enough 511

When Leadership Fails 511

Scenario 21-D Failure to Document Poor Work Performance for a Friendly Employee 513

Moral Muteness 514

Chapter 22 Entrepreneurship / Marie Gardenier, MBA, RHIA, CHPS 529

Scenario 22-A Competing Constituencies 530

Entrepreneurship in Health Information Management 532

Entrepreneur versus Intraprenuer 534

Business Ethics: Concepts and Principles 535

The Intersection of Ethics and HIM Entrepreneurship 540

Scenario 22-B Negotiating Contracts 549

Scenario 22-C Unrealistic Client Expectations 550

Scenario 22-D Discovering Sensitive Information about a Client, Competitor, or Colleague 552

Chapter 23 Vendor Management / Keith Olenik, MA, RHIA, CHP 567

Scenario 23-A Vendor Request 568

Vendor Relations 568

Scenario 23-B Vendors as Friends 570

Scenario 23-C Gifts 570

Scenario 23-D Preferred Vendors 572

Request for Proposals 573

Scenario 23-E Negotiating 576

Negotiation 577

Enhancement of Vendor Relationships 579

Ethical Behavior 579

Appendix 23-A Sample Gifts Policy 582

Chapter 24 Advocacy / Susan Helbig, MA, RHIA 595

Scenario 24-A Violating Privacy of a Prominent Citizen 596

Advocacy: The Choice of Ethics in Action 596

Advocating for Patients 596

Scenario 24-B Compassion in Action for an Alcoholic Peer 600

Advocating for Peers 600

Scenario 24-C Cockroaches in the HIM Department 602

Advocating for Staff 602

Scenario 24-D Unfair Treatment of Part-time Workers 603

Scenario 24-E Small Print on a Consent Form 604

Advocating for the Healthcare Organization 605

Scenario 24-F The Data Warehouse Wants to Sell Patient Information 606

Advocating for the Larger Community and Society 606

Advocating for One's Self 607

Appendix 24-A Example of Organizational Engagement in Societal Advocacy 610

Appendix 24-B Precepts of Effective HIM Advocacy 611

Ethical Decision-Making Matrices.

Notes:

"AHIMA, American Health Information Management Association."

Includes bibliographical references and index.

ISBN:

0763747327

OCLC:

61285570

Publisher Number:

9780763747329