OLeesky Case 16 v1
HIM 6018 – E-HEALTHCARE ETHICS – CASE STUDY ACTIVITIES
Name:
Unit #:
Unit Title:
Kim O’Leesky
8
Internal Confidentiality Matters
Qu. 1. What internal and external forces impact Selena’s concerns in this case?
The primary factors relate to Health Insurance Portability and Accountability Act (HIPAA),
Privacy, accurate and appropriate coding, billing, reimbursement and compliance concerns relative to Medicare / Medicaid and CMS guidelines.
Internal forces include the following:
Community hospital with a small number of HIM staff including two (2) Inpatient (IP) coders; Coding staff has history of distrust and lack of camaraderie;
One of the IP coders, Brenda, experienced a hospitalization encounter and has requested privacy of her information from her coworkers and to have her record sequestered;
Shirley, HIM director, initially commits to sequester Brenda’s record until Brenda’s return to work that might be construed as special treatment;
Integrity, credibility, conflict of interest, and potential honesty values and actions related to privacy and confidentiality;
Organizational dynamics, reputation, and viability;
Adherence to appropriate ethical and principled professional guidelines concerning coding, billing practices and services rendered e.g. timeliness, conflict(s) of interest;
Potential conflict of interest if Brenda were to do her coding, inappropriate place to code if Brenda is still a patient;
Coding accuracy and timeliness related to Brenda’s admissions;
Completeness, competency and compliance with organizational policies and procedures for coding, privacy and confidentiality of patient’s information and designation or lack thereof for same, electronic, paper, and hybrid health record systems.;
Patient counseling or lack of same concerning legal or ethical rights for medical confidentiality protections;
Existence of organizational, educational programs for employees with annual compliance checks re confidentiality;
Potential job
Name:
Unit #:
Unit Title:
Kim O’Leesky
8
Internal Confidentiality Matters
Qu. 1. What internal and external forces impact Selena’s concerns in this case?
The primary factors relate to Health Insurance Portability and Accountability Act (HIPAA),
Privacy, accurate and appropriate coding, billing, reimbursement and compliance concerns relative to Medicare / Medicaid and CMS guidelines.
Internal forces include the following:
Community hospital with a small number of HIM staff including two (2) Inpatient (IP) coders; Coding staff has history of distrust and lack of camaraderie;
One of the IP coders, Brenda, experienced a hospitalization encounter and has requested privacy of her information from her coworkers and to have her record sequestered;
Shirley, HIM director, initially commits to sequester Brenda’s record until Brenda’s return to work that might be construed as special treatment;
Integrity, credibility, conflict of interest, and potential honesty values and actions related to privacy and confidentiality;
Organizational dynamics, reputation, and viability;
Adherence to appropriate ethical and principled professional guidelines concerning coding, billing practices and services rendered e.g. timeliness, conflict(s) of interest;
Potential conflict of interest if Brenda were to do her coding, inappropriate place to code if Brenda is still a patient;
Coding accuracy and timeliness related to Brenda’s admissions;
Completeness, competency and compliance with organizational policies and procedures for coding, privacy and confidentiality of patient’s information and designation or lack thereof for same, electronic, paper, and hybrid health record systems.;
Patient counseling or lack of same concerning legal or ethical rights for medical confidentiality protections;
Existence of organizational, educational programs for employees with annual compliance checks re confidentiality;
Potential job
References: AHIMA. Code of Ethics, 1957, 1977, 1988, 1998, 2004, and 2011.