Confidential Is Essential:

1
Confidential Is Essential

• How Do We Make That Happen?

By Beth Hjort, RHIA, CHPS
2
Whats the status?

• In the midst of an important healthcare industry
  transformation
• Taking steps to transition health information
  from paper to electronic
• Bound for technology-rich operations that
  enhance the quality of patient care
• Working in collaborative circles to make advances
  with many industry stakeholders

3
Who Are We?

• We are us!
• Everyone interacting within the healthcare
  industry
• Consumers
• Healthcare leadership and workforce
• Privacy and security officials

4
Trust Is a Balance

• Trust Confidentiality High Quality Info

5
What Is the Challenge?

• Balance
• Availability of patient information
• Optimal quality care
• Privacy rights upheld
• Technology use to enhance privacy
• Privacy and security programs keeping pace

6
How Do We Make It Happen?

• Understand participative roles
• Stay informed
• Be observant
• Speak up

7
Consumers

8
Understand Roles Stay Informed

• Be an educated consumer
• Know what the law provides
• Read privacy related materials
• Read before signing

9
Be Observant Speak Up

• Ask questions
• Recognize?if we lock down our information too
  tight it cant be released to the caregivers to
  use in our care
• Point out concerns
• Find out if our information arrived on time

10
Healthcare Leadership and Workforce

11
Understand Roles Stay Informed

• Be confident in role knowledge
  policies/procedures
• Pay attention to privacy alerts and reminders
• Decipher impact of changes/updates on job role

12
Be Observant Speak Up

• Does policy/procedure cover a situation in
  question?
• Know first contact for privacy challenges
• 1. Supervisor
• 2. Privacy official/Security official
• 3. HIMS release of information staff

13
When in DoubtAsk

• Am I interpreting correctly?
• Will patient care be impeded?
• Does the patient have a voice?
• Is policy/procedure flexible and clear?
• Is it law or practice?
• Whos my go-to person in this situation?

14
Privacy/Security/Release of Information Staff

15
Traditional Privacy Protections

• State Laws
• State Licensing Act
• HIV/AIDS
• Behavioral Health
• Adoption
• Federal Laws
• Medicare
• Alcohol/drug confidentiality
• HIPAA in 2003
• Accreditation Standards
• The Joint Commission
• AAAHC

16
PaperWho Looked?

• File room is locked
• Keys are controlled
• Staff is trained in confidentiality
• Nurses monitor charts on care units
• HIM monitors post discharge activity
• However, we have no retrospective way to know who
  viewed the record when no one was looking

17
ElectronicallyWho Looked?

• Access management
• Systems privileges
• Application privileges
• User tracking?Auditing
• Immediate alerts
• Date/time capture

18
Privacy Security Confidentiality

• Privacy and Security must work together for
  information to be confidential!

19
Privacy and Security Overlapping

• Privacy policies set the requirements
• Security safeguards help manage privacy

20
Internal Change?Ripples

• New care services
• System implementations
• Improvements and updates

21
We All Make a Difference!

22
Resources

• www.MyPHR.com