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Patients Rights and Regulations
- 1. Human Resources Presentation to the Board of Directors Team A Jester Jotie, Mayra Lariosbriones, Jordan Padilla, Adepter Manalo, Miguel Romero February 7, 2014 Donna Lupinacci 1
- 2. Agenda State and Federal and Regulatory enactments related to patient’s rights and responsibilities Current principles of patient consent and the resulting implications for the health care industry The current state and future trends of physicians’ rights and responsibilities in the delivery of health care Current components and implications of the Health Insurance Portability and Accountability Act (HIPAA) Brief summary of current and future trends for statutory, regulatory, and common law requirements of confidentiality in the health care industry Current and future legal and ethical obligations relating to the documentation, retention, storage, and use of medical records
- 3. Statutory and Regulatory Enactments Patients responsibilities Patients must complete a medical history Follow a treatment plan Comply with organization rules
- 4. Patients Rights Right to treatment Advance medical directives Privacy and confidentiality 4 Statutory and Regulatory Enactments
- 5. Principles of patient consent Current principles of patient consent Principle of respect of autonomy Integrity and totality Principle of full disclosure
- 6. Physician's Rights and Responsibilities Physician’s Rights Learn about a patient’s lifestyle Withdrawal of treatment Privacy Vacations and time off from practice Physician’s Responsibilities Discussing with diagnosis, test, and treatments with patient Recommends alternative treatments or medication Professionally competent Know when to ask for a second opinion
- 7. Physician’s Rights and Responsibilities Future trends No hiring discrimination based on type of graduate MD, DO, IMG Right to higher reimbursement rates from Medicare Responsible to correctly complete EHR entry for a patient
- 8. Health Insurance Portability and Accountability Act (HIPAA) Privacy rule Security rule Privacy for covered consumers, covered entities, and business associates. Protected health information (PHI) Consent for information use and disclosure
- 9. Confidentiality Current Health Insurance Portability and Accountability Act (HIPAA) Medical Record Number More Verification Electronic Medical Records E Prescribing Electronic prescription Paperless Wireless
- 10. Confidentiality Future Ease of transmission Telemedicine Cloud Storage Requires certification to access
- 11. Current Legal and Ethical Obligations for Medical Records HIPAA HITECH Act State of California Law for medical records Storages are located at regional and local areas Completed document medical records are essential in quality care.
- 12. Future Legal and Ethical Obligations for Medical Records The Recovery Act Storage Documentation Retention Uses Affordable Care Act Laptop View Records at home Reduce errors and money
- 13. Conclusion State and Federal and Regulatory and patient’s rights and responsibilities Patient consent and the resulting implications for the health care industry Physicians’ rights and responsibilities in the delivery of health care Health Insurance Portability and Accountability Act (HIPAA) Future trends for statutory, regulatory, and common law requirements of confidentiality in the health care industry Current and future legal and ethical obligations
- 14. References Babafemi, O. (2007). Should caregivers be compelled to disclose patients' HIV infection to the patients' sex partners without consent? Studies in Family Planning , 38(4), 297-306. Retrieved from http://www.jstor.org/stable/20454425 Centers for Medicare and Medicaid Services. (2013). Electronic Prescribing Incentive Program. Retrieved from http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/ERxIncentive/index.html?redirect=/ERXIncentive/ Health Information Technology . (2014). State medical record laws: Minimum medical record retention periods for records held by medical doctors and hospitals. Retrieved from http://www.healthit.gov/sites/default/files/appa7- 1.pdf Kliff, S. (2010, October 10). The future of electronic medical records, in one doctor’s visit. The Washington Post. Retrieved from http://www.washingtonpost.com/blogs/wonkblog/post/the-future-of-electronic-medical-records-in- one-doctors-visit/2011/10/04/gIQA1ufQNL_blog.html Rockart, J. F. (1972, Winter). Medical record storage. Health Services Research, 7(4), 276-287. US National Library of Medicine National Institutes of Health. Tesfa, A. (2008, June). Roles and responsibilities of health care agents: Views of patients and agents. Journal of Gerontological Nursing, 34(6), 8-14. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/204168699?accountid=458 The National Committee for Quality Assurance. (2014). Guidelines for medical record documentation. Retrieved from http://www.ncqa.org/Portals/0/PolicyUpdates/Supplemental/Guidelines_Medical_Record_Review.pdf Panting, G. (2010, December). Informed consent. Orthopaedics and Trauma, 24(6), 441-446. doi:http://dx.doi.org/10.1016/j.mporth.2010.08.009 Powell, J. (2013). The fourth obamacare shock wave is about to reach us. Forbes. Retrieved from http://www.forbes.com/sites/jimpowell/2013/11/13/the-fourth-obamacare-shock-wave-is-about-to-reach-us/ Pride Performance Mobility. (2014). You and your doctor: Rights and responsibilities. Retrieved from http://www.pridemobility.com/resourcecenter/articles_youandyourdoctor.asp U.S. Department of Health & Human Services. (2014). Understanding health information privacy. Retrieved from http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html
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- Briefly cover the role of HR in Healthcare VS Other State which Team Member will cover which topic: bullet 1 and 2 - Miguel bullet 3 and 4 - Jester bullet 5 - Jordan bullet 6 - Mayra intro/conclusion – Peter
- The patient has the responsibility to inform the health care treating patients with a thorough medical background, so that the health care organization can be informed of what issues might occur while treating the patient and so that they are aware what the best treatment is. The patient has the obligation to tell the healthcare organization what their needs are while they are evaluating and treating their patients. Providing to the best of his/her knowledge accurate and complete information about the patients medical history including current conditions such as diseases, hospital stays, medications, vitamins including herbal products and previous surgery treatments. Patients must cooperate with their physicians to determine the best treatment plan. “If patients are to communicate their treatment wishes to their agents, they need to know the roles and responsibilities of agents in making treatment decisions on their behalf” (Tesfa, 2008, p. 8). Patients and doctors must build trust and handle expectations on both sides of the equation. Patient/customer must be considerate to your physician and staff, treating everybody with respect and dignity. Follow the organization rules and report any unexpected changes of his/her condition.
- A customer/patient has the right to be treated in an emergency situation, regardless of their ability to pay. If a circumstance is likely to cause disability, injury, or death if not attended as soon as possible, it is an emergency. Some example include heavy bleeding, cardiac arrest, severe head injuries and accurate psychotic states. If the health organization is unable to furnish emergency services, it must make an arranged a referral for appropriate treatment. Clinics and hospitals cannot deny to treat a customer/patients on the basis of religion race or national origin, or deny to treat patients with AIDS or HIV. “To shield them from form these and other disadvantages that may inhibit them from undergoing HIV status, their rights to privacy must be protected” (Babafemi, 2007, P. 297). Advanced medical directives are credentials and documents that are made at the time when the patient has a full decision making capabilities that are used to direct medical care in the near future when this capacity is diminished or lost. Confidentiality is important so that the healthcare providers and nurses have the knowledge to all the facts, regardless of the patient. Patient must feel that it is safe to communicate their information freely although this theory drives physicians/patients confidentiality, the reality is that many people have legitimate and routine access to people records, including physicians, nurses, therapist, and nutritionist.
- Gaining informed consent is an ethical and legal necessity prior evaluating and treating a patient. It derives from the doctrine and principle of autonomy; one of the four mainstay of medical ethics. (Beneficence, autonomy, equality, and no maleficence) touching or treating the patient without authorization/consent could be considered battery or assault under criminal and civil law, even if the patient was assisted by your actions. Informed consent is employed not just in the medical field but in any other area where an individual well being and/or heath are at risk. When accepting to undergo experimental treatments or clinical trials and individual has the right to be informed of all risks involved. “To safeguard the patient’s interests in achieving his own determination on treatment, the law itself must set the standard for adequate disclosure” (Panting, 2010, p. 441). A physician must acknowledge that each patient has the right to self-determination. This means that after receiving complete disclosure, the patient or guardian has the right to accept or reject medical advice. Embracing individual freedom is one of the defining qualities of humanity. Treating their patients/customers, physicians must take into account the overall well being of the patient, this contains viewing the individual as a complete human being with will and conscience. Patient consent requires that the patient be made fully aware of his/her diagnosis, the nature of the treatments, the potential benefits and risks, alternative treatments, and the potential benefits and risks of forgoing treatment.
- -A physician has the right to learn about a patient’s lifestyle if it has any impact on the injury or treatment for the patient (Pride Performance Mobility, 2014). -A physician has the right to withdraw treatment if it is deemed unethical or conflicts with the patient beliefs (Pride Performance Mobility, 2014). May also withdraw treatment if physician believes there nothing more they can do. Physicians have the right to withdraw care if the patient is noncooperative or refuses to pay bills when able to do so. -A physician has the right to privacy. This means they can keep patient information private at the patient’s request. Physician has the right to privacy in order to comply with HIPAA. -A physician has the right to take a vacation and time off from their practice. They have the right to arrange for coverage on their patients while they are absent. Physicians can arrange for other physicians to cover them while they are on vacation. It is good practice to notify their patients that they will be out of the office for a period of time. -A physician has the responsibility to discuss everything with a patient including diagnosis, test and examinations, and treatment plans (Pride Performance Mobility, 2014). -A physician has the responsibility to recommend alternative treatments or medication if a patient does not agree with the previous treatment. - A physician has the responsibility to be professionally competent in their practice. They are responsible to continually keep up with changes in medicine and in their education. It is their responsibility to their limit when practicing medicine. -A physician has the responsibility to ask for second opinion for the safety of a patient. It is important that a physician recognize where their knowledge is limited and know when to ask for help (Pride Performance Mobility, 2014). This is in the patient’s best interest because it prevent harm and possible negligence.
- -Medical facilities should not discriminate against physicians because of where they graduated. This include MD graduate from a top-tier or low ranking medical school, DO graduate from a osteopathic school, IMG (international medical graduate) from a Caribbean medical school or out of country medical school. Hiring a physician should be based on skills, interviews, and recommendations. Many physicians face lower reimbursement rates from Medicare. Physicians have the right to higher Medicare reimbursement rates because currently they are receiving about 40% less than private insurance rate (Powell, 2013). More and more physicians are not accepting Medicare and Medicaid because of a possible 24% cut in reimbursement. Possible adjustment can be made in Medicaid programs to pay the same rate as Medicare. The Patient Protection and Affordable Care Act requires the change from paper charting to EHR. Physicians are responsible to convert and learn how to use EHR properly. They are responsible to correctly complete an entry on everything that is done on a patient.
- -privacy rule is to properly protect health information while allowing flow of the information that is needed to protect an individual’s wellbeing (U.S. Department of Health & Human Services, 2014). (protect patient information but releasing it to other medical professionals with consent to properly treat patient) -Security rule is to ensure that appropriate administrative, technical, and physical safeguards are put into place to protect a patients PHI (U.S. Department of Health & Human Services, 2014). -HIPAA covers consumers (patients), hospitals or health care professionals, and business associates. -physicians practices, hospitals, SNFs, labs, hospices, different health practices, rehab centers, etc. -As mentioned before, HIPAA covers PHI of patient. This includes names, numbers, email, biometrics, and other identifiers. -Consent is required by the patient in order to do procedures and treatments. Disclosure of information would need consent as well.
- -The current trend of accessibility to patients records has gone through drastic changes over the years. What was once all paper transmission is now mostly electronically transmitted. -HIPAA is an act that helps protect patients rights and information (Centers for Medicare and Medicaid Services, 2013). Patients are now being identified by medical record numbers. Health care providers are currently having to use two patient identifiers to identify a patient. Electronic medical records are being utilized now at most health care facilities. Health care providers can access a patients chart with ease and the system can track who accessed the file. E Prescribing is also a current trend to electronically file for a prescription. It saves time and prevents a patient from losing hand written prescriptions. Medicare has an incentive RX programs for those that qualify. -Most facilities are headed towards paperless filing. Most of the technology is wireless and patient records are protected by the facility security software.
- -The future of the confidentiality is making all patients records more difficult to access. As mentioned in the previous slide, any health care worker that accesses a patients file is being tracked and documented automatically. Most facilities are having annual compliance checks to ensure there is no violation of HIPAA. Health care workers are constantly being trained on remaining in compliance earth HIPAA and using two patient identifiers. -Telemedicine is increasingly gaining popularity. This allows a physicians to meet with patients over a network. The patient can stay in the comfort of their own home. This also is another way to keep information confidential. - A new trend is Cloud storage. This method transfers files over a shared destination. This prevents the use of storing on a main a large hard drive.
- Medical Record Retention Adult patients 7 years following discharge of the patient. Minor patients 7 years following discharge or 1 year after the patient reaches the age of 18 (i.e., until patient turns 19) whichever is longer. Cal. Code Regs. tit. 22, § 70751(c) (2008). According to John F Rockhart, the storages that are used for electronically medical records are more expensive than keeping the physical medical records. Medical records that are inactive are sent to a regional place not to far away from the hospital to keep the active files more closer to the facility. Patient Documentation is important for patients and for doctors. Correct documentation of medical records is important and it starts out with having the correct name of the patient, age, date of visit, diagnoses, allergies, the writing is eligible on the medical record. Other unique identifiers are the patients marital status, address, past medical history, treatments, and much more (The National Committee for Quality Assurance, 2014).
- The Recovery Act alone puts 19 billion incentive programs to reward doctors who meet “meaningful use” standards for electronic records. Electronic storage for medical records is higher than storage space for physical records, programs to initiate electronic medical records takes a long time and money. Retention of the medical records would be necessary with the amount of data storage that needs to be filed in the system. The affordable care act adds more funds for doctors to go digital.
- Review all topics covered Summarize main ideas Briefly discuss Affordable Care Act/Obamacare Questions and Answer