Assessing the Issue of Patient Privacy

Case Study—Assessing the Issue of Patient Privacy

Beth is a recent graduate of an allied health program at the local community college. While in school she had taken a course from a professor who she really admired and liked. In her first job out of school as a registration clerk at the hospital’s clinic, she happened to be assigned the professor to register as an outpatient for radiation therapy for a recently diagnosed cancer treatment. The two chatted as Beth input the professor’s information into the hospital’s EHR system. They talked about the course and how much Beth liked the course and the professor as a teacher. Beth thought about the professor all day and felt terrible to learn the Professor was being treated for cancer. She knew many of her classmates also liked the professor, so after work she decided to contact her friends about the professor and suggest they send the professor a card. Beth shared the professor’s home address.

Assess what Beth has done in terms of the privacy, confidentiality and security of the professor’s health information. Why shouldn’t Beth share the information with her classmates?

Scenario 2

Jan Geisler is the HIM director at Hillside Medical Center. The administration at Hillside has just approved the budget which includes a new electronic health record. They assign Jan as the project manager and give her the task of reviewing and selecting the company (vendor) with the EHR that best suits the hospital’s needs. Jan immediately thinks of her college roommate Ana. Ana also majored in HIM and now works for a large EHR vendor in California. Jan sends a quick email to Ana to catch up and asks about her company’s EHR system. Ana responds immediately with updated pictures of her family and some general information about the EHR her company sells. Ana offers for her company to fly Jan to California so she can see the system and have a live demonstration. As an added bonus, Ana cannot wait to see her friend, take her to dinner and catch up. Jan goes to California and enjoys her time with Ana, but she is a little disappointed with the EHR system. She just doesn’t think it will meet the needs of her hospital. Jan has a meeting with the chief information officer today and is expected to present her recommendations. She feels obligated to recommend Ana’s company but she also has major concerns about their product.

1. What ethical issues can be found in Jan’s investigation of an EHRs?
2. Was it a conflict of interest for Jan to do business with her personal friend Ana?
3. Using the ethical decision making model found in this chapter, analyze the scenario and recommend a decision.

Ethics Scenario

Terri Schiavo was a woman in a persistent vegetative state following a cardiac arrest in 1990. She died in 2005 after her feeding tube was withdrawn per court order. At the center of the dispute were Terri’s husband, who asked the courts for removal of the feeding tube, and her parents and siblings, who objected to the removal. This case presents a legal and ethical situation relating to the separation of powers among the judicial, legislative and executive branches of government. Both the Florida legislature and the US Congress intervened in the Schiavo court battle by creating laws that were signed by the governor and president, respectively, to compel reinsertion of the feeding tube. These laws were ruled to be unconstitutional intrusions in judicial matters and the decisions of the courts, supporting removal of the feeding tube, eventually prevailed. (Note: This case is addressed in chapter 8 of the text.)

1. What is the purpose of the separation of powers concept?
2. What forces are at play that led to an ethical tension in this situation?
3. Setting aside personal beliefs about the removal of a feeding tube and the death that will follow, do you believe the courts should have considered the laws passed by both the Florida legislature and the US Congress?

Ethics Scenario

A health record technician has brought a patient’s record to the attention of the HIM director because the technician feels there are some suspicious sections in the record where the physician did not document certain treatments or purposes for treatment which may have led to an adverse outcome suffered by the patient. The HIM director has reviewed the record and agrees with the technician that a potential adverse event may have occurred. Subsequently, the physician recognizes he should have been more specific in documenting the patient’s care. He is now asking the HIM director, who is a personal friend, to let him add additional documentation to the patient’s record, which has since been placed on legal hold.

1. Since the director is a friend of the physician and knows he should have been more specific in his documentation, should the HIM director allow the physician access to the record to add the documentation? Why or why not?

Sample Solution