An Overview of the Law
Health Insurance Portability and Accountability Act (HIPPA) was enacted in 1996 with the aim of addressing health issues of patients. Its enactment was meant to make it easier for Americans to have access to insurance or renew their insurance policies without facing any reprisal after change of an employer. A critical feature of this law is that it made it possible for persons with preexisting conditions to access insurance The Act also seeks to protect the security and privacy of patient information (Murray, Calhoun, & Philipsen, 2011).However, the enactment of the Affordable Care Act in 2010 saw the role of some the provisions of HIPPA become irrelevant.
One of the prominent provisions of HIPPA is the Privacy Rule. This provision was motivated by increased diversity of entities in the healthcare marketplace. Entrenched in the Act by Congress in 2000, the Privacy Rule prohibits the unauthorized disclosure of patient health information by covered entities (Hsieh, 2014).HIPPA provides minimum standards for storing and auditing of patient health records. Since patient health information is shared between covered entities, the rule spells out conditions under which electronic medical records (EMRs) can be transferred from one entity to another(Hsieh, 2014; Murray, Calhoun, & Philipsen, 2011).According to Murray et al. (2011), these guidelines apply to clearinghouses, staff, providers, health plans, and volunteers.
Challenges Associated with Compliance with HIPPA
Modern technological developments have created new tools for patients and physicians to communicate with each on online platforms linked to systems of healthcare organizations. Since most patients and providers use their own, unsecured devices to access electronic medical data, it becomes difficult for healthcare organizations to regulate individual actions (Hsieh, 2014). This exposes the patients data to the threat of unauthorized access through hacking.
Even within the context of the hospital, there is the risk of nurses and physicians accessing data of patients without their consent. Once the medical officers log into an EMR system, they can view information regarding a particular patient even if that was not their primary reason for logging into the systems in the first place (Chen & Benusa, 2017). This security breach has been noted with celebrity patients where enthusiasts have accessed their medical data without formal authorization. For instance, in 2005, UCLA Medical Center staff accessed Britney Spearss medical record by an EMR when she delivered at the hospital in 2005.As a result, 13 employees were dismissed for violating HIPPA (Hsieh, 2014).Many other cases go unreported or undiscovered in this regard.
Since several entities are involved in the facilitation and provision of health care, accountability along the chain can be a significant challenge (Chen & Benusa, 2017). For instance, HIPPA does not require a health care entity to obtain consent from patients for uses and disclosures of their health records for treatment and payment (Murray et al. (2011).This creates a loophole for unauthorized access in the pretext of facilitating treatment or making remittances.
Ethical Dilemma and HIPPA
An ethical dilemma results from two conflicting positions regarding the consequences of actions of medical officers. These positions are motivated by factors such as experiences, life situations, values, religion, and socioeconomic factors, among others. For instance, a physician may be said to go through an ethical dilemma if they struggle to decide as to whether to tell a patient about a diagnosis error or not (Levin, 2010). With HIPPA, the law spells out circumstances under which patient information can be disclosed. However, employees of covered entities may access information through fellow employees or when processing medical payments. For instance, an employee who has handled confidential information on an HIV positive colleague may experience a dilemma in deciding as to whether to reveal the information to third parties (associated with the patient) whose lack of such information could lead to harm.
Handling an Ethical Dilemma from a Christian Worldview
The Bible provides several illustrations regarding ethical dilemmas. In the book of First Corinthians, it is recorded that all things may be lawful but not all of the mentioned things may be helpful. It continues to say that let no one seek their own good, but the good of their neighbor, and whatever they do should be in accordance with the will of God (chapter 10:2324). Further, the Bible records that though some acts may be lawful, one needs to ask whether the activity is beneficial or enslaving. In other words, the activity should be assessed as to whether it defiles ones conscience or hinders the growth of a fellow believer (chapter 8:7-13).These verses offer an insight to medical officers on how to handle ethical dilemmas.
In the context of the case highlighted, it is important to consider ones conscience and also whether the course of action glorifies Christ. The law should not take precedence over what is right and good. Perhaps finding more information about awareness of the spouse/lover of the patient can provide more information on how to handle the issue in question. Seeking background can assist in deciding on what to reveal to the people who could be harmed for lack of the HIV status of the patient in question while protecting the privacy of the privileged position of this information. This can be helpful as it appears beneficial and may not be offending to ones conscience.
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References
Chen, J. Q., & Benusa, A. (2017). HIPAA security compliance challenges: The case for small healthcare providers. International Journal of Healthcare Management, 10(2), 135-146. doi:10.1080/20479700.2016.1270875
Hsieh, R. (2014). Improving HIPAA enforcement and protecting patient privacy in a digital healthcare environment,. Loyola University Chicago Law Journal, 146(1), 176-223.
Levin, A. (2010). Do I have an ethical dilemma? Oman Journal of Ophthalmology, 3(2), 49. doi:10.4103/0974-620x.64226
Murray, T. L., Calhoun, M., & Philipsen, N. C. (2011). Privacy, confidentiality, HIPAA, and HITECH: implications for the health care practitioner. The Journal for Nurse Practitioners, 7(9), 747-752. doi:10.1016/j.nurpra.2011.07.005
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