Compliance Management Case Study

Healthcare providers rely on ethical codes to establish guidelines and standards for addressing issues that arise. Associations representing the professional organization are tasked with the duty of developing and tailoring a code of ethics to assist its members to understand expectations in their professional role. For example the American Health Information Management Association and the American Physical Therapist Association established a code of ethics for its members. Each association considers the relation of the health professional obligations and constructs a code of ethics to serve as guidance to the professional.

There were specific situations that led to the cause of Julie Thao's actions of medication error and the death of Jasmine. The situation could have completely been avoided had Julie followed the code of ethics and avoided shorts to provide proper care for the patient. The state claimed that Thao's mistake was caused by actions, omissions and unapproved shortcuts, however, there were other factors that played a role in her carelessness as well. While failure to comply with procedure has been a factor in the medication administration error, other factors contributed as well. For example, failure to properly use the information system, or to ignore alerts or warnings have also resulted in preventable errors (Nelson, Evan, & Gardener, 2005). At the time of the event, a bar coding system for all medication had been in effect for a duration of two weeks, however, Thao had been gone one of those crucial weeks. Because of her absence, she did not receive the adequate training, instead, she received a sped

On April 16, 2007, America experienced its deadliest shooting by a single gunman. Seung-Hui Cho, a senior at Virginia Polytechnic Institute and State University, shot and killed 32 people and then turned the gun on himself (CNN). Cho had a history of mental health problems. Mental illnesses are defined as “diseases that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines” (Mental). Common mental health disorders include bipolar disorder, schizophrenia, depression, and dementia. Some signs and warnings that show that one might have a mental illness are: social withdrawal, suicidal thoughts, depression and anxiety, and trouble concentrating. Sadly, Cho

Compliance management in a complicated and ever expanding portion of the Health Information Management (HIM) field. As federal, state and local laws are created and revised, HIM professionals must stay current of not only the regulations but also the consequences of non-compliance. Along with federal, state and local laws, attention must be paid to the guidelines of various accreditation and credentialing bodies.

The Joint Commission’s tracer methodology is used to ensure compliance standards are met, as well as to “trace” and document the level of care provided to patients in order to make improvements to the facility’s health care delivery system. Patients requiring services that utilize the entire continuum of care spectrum are selected in an effort to gather sufficient information needed to identify areas with potential risks and safety concerns. As the patients’ course of care progresses across the system, Joint Commission surveyors evaluate each department 's policy and procedure on data management, infection control and medication management process.

The Health Insurance and Portability and Accountability Act ( HIPAA) of 1996 provides security provisions and data privacy for protecting a patient’s medical information. HIPAA has guidelines to ensure that a patient’s confidentiality is maintained while allowing the communication of a patient’s medical records between certain bodies or people or officials. Officials that a patient’s medical records can be shared with are other health care providers, health plans, business associates, and health care clearinghouses. HIPAA protects all “ individually identifiable health information”. There is a specific protocol to follow when sharing a patient’s medical information. Theses steps are imperative to maintaining the patient’s privacy.

If you work in healthcare, anywhere from a small medical office to a big hospital to an insurance company, you need to be in compliance with HIPAA. This is a long, complicated document and even big insurance companies struggle to keep the rules fresh in everyone 's mind and everyone on top of the most critical functions. Here are a few things to make sure you are doing right:

Health care includes preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, and counseling, services, assessment, or procedure with respect to the physical or mental condition, or functional status of an individual. Health Care Clearinghouse, Businesses that process or facilitate the processing of health information received form other businesses. It includes groups such as physician and hospital billing services. Health Plans, Individuals or group plans that provide or pay the cost of medical care and includes both Medicare and Medicaid programs. HIPAA protects an individual’s health information and their demographic information. This is called protected health information or PHI. Information meets the definition of PHI if, even without the patient’s name, if you look at certain information and you can tell who the person is then it is PHI. The PHI can relate to past, present or future physical or mental health of the individual. PHI describes a disease, diagnosis, procedure, prognosis, or condition of the individual and can exist in any medium files, voice mail, email, fax, or verbal communications. defines information as protected health information if it contains the following information about the patient, the patient’s household members, or the patient’s employers, Names, Dates relating to a patient, i.e. birth dates, dates of medical treatment, admission and discharge dates, and dates of death, Telephone numbers, addresses (including city, county, or zip code) fax numbers and other contact information, Social Security numbers, Medical records numbers, Photographs, Finger and voice prints, Any other unique identifying

Health Insurance Portability and Accountability Act established in 1996 sets standards for health care information. These laws protect patient’s sensitive health information. The purpose of this discussion is to review a former UCLA employee’s HIPAA violation. Additionally, HIPAA laws and penalties for violation up for examination. Ending this discussion with the possible charges that the employee may receive.

Organizational managers are the ones who plan, organize, lead, and control what resources they have. On top of all of that, they are also responsible for enacting HIPAA into their day to day routine. HIPAA is clearly a huge deal, so the employees must understand what it is and what it entails so they do not turn out like Jamie Knapp. First off, the manager must teach employees about how to secure medical records. Not only do records need to be kept from people outside the workplace, but also from employees that aren’t authorized to see the information. The Small Business Chronicle states that “employees who handle health-related information must also maintain a log that details any release or transfer of information” (Symes, 2016). Obviously the records need to be kept in a safe place. If they are paper files, they should be kept in a filing cabinet which requires a key. If they are saved electronically, there needs to be a password in order to access the files. There needs to be a password to the computer workstation, but also a password that is used to access just the health information. A manager in the health industry needs to give training to all new employees about the company’s policies, rules, and regulation, but the employees also need training on HIPAA’s policies. If you don’t give proper training, and the employee discloses information, “you may be found liable for the disclosure and may then be sued by

It does not matter the reason you got, give directly or indirectly patient information to someone or the simple thing to check any patient information without a consent form is illegal. HIPAA do not play with that. Any violation to HIPAA occurring on or after 2/18/2009 will have a penalty of $100 to $50,000 or more per violation. A person who knowingly obtains or discloses individually identifiable health information in violation of the Privacy Rule may face a criminal penalty too. HIPAA is not about the money, is about people lives, people safety, people privacy and rights. We are all people, we all get sick; we all go through some stuff that we might not want anybody to know, from my point of view as a person, as a patient that would be awful for me if somebody else know what I am passing through. So I will use that as a medical assistant, and my priority will be my patient safety, confidentiality and trust. Why would you do something that you would not want for yourself? Simple, follow the HIPAA privacy

There is a controversial issue in regards to the violation of the HIPAA privacy rule concerning a client who was received at a small town hospital emergency rule. As a privacy officer, this issue has been bought to my attention. HIPPA violations are serious offenses, and ultimately, it is my responsibility to take corrective actions to resolve this matter upon this investigation.

Implementing a medical compliance plan limit our liability by reducing innocent billing mistakes and exposure to fraud and abuse allegations, which helps avoid governmental audits. It also helps

Technology has become an essential part of our everyday life therefore, it makes sense that doctors and hospitals get rid of the old fashioned paper charting and use technology to access patient records. Electronic health records (EHR) provide quick access to information, as doctors no longer have to wait for other providers to fax previous records to them. The accessibility of Electronic Health Records assist medical providers to make quick medical care decisions, by accessing previous care provided to patients including treatment and diagnosis. Quick access to information through EHR enables health care providers to treat patients faster as there is no need for records to be mailed or

There are different kinds of data standards used for data collection and reporting in healthcare field. Among them uniform ambulatory data set is also one of the important set used in healthcare field for recording the medical and surgical care provided to patient with the same day service. (LaTour, Maki, Oachs, 2013). As the time changed the procedure for Ambulatory setting is changing day by day due to various reason like advance improvement on therapeutic and instrumental procedure. Different kind of medication, surgical tool, and trained healthcare provider made everything possible to do in ambulatory facilities.