Module 2 Workbook 2,5,6,11 completed

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Chapter 2 Legal Issues in Health Information Management- Noell Davila One of the most hotly contested “right-to-die” cases involving the lack of an advance directive was that of Terri Schiavo, a disabled Florida woman who was in a persistent vegetative state and received nutrition and hydration through a feeding tube. On March 31, 2005, following years of legal battles involving her husband (who supported the removal of the feeding tube) vs. her parents and siblings (who supported the continued use of the feeding tube), Schiavo passed away after her feeding tube had been removed 13 days earlier. a. What are the differences between a living will and a durable power of attorney for healthcare decisions? A living will in health is the primary healthcare directive for how a person plans to be cared for in a situation when they cannot speak for themselves, so the document should be as specific as possible. Like the case of Terri Schiavo, it is not often that we know when and where we may fall ill and need these things, so it is important to make sure that it is created and given to someone that is trusted to ensure that the person receives his or her preferred medical treatment. Included in a living will should be a clear outline of any treatments you do not wish to receive to avoid instances like the Schiavo case. Additionally, a living will can include extreme measures, and topics like resuscitation, desired quality of life, and end of life treatments. In the event that a person does not have a living will prepared, the secondary option is that a durable power of attorney is given to the person you want to make medical decisions for you in an emergency; think of it as a “plan B”. Although what is written in a living will can always triumph a durable power of attorney, the idea is that the person that you have chosen is trusted as your proxy, and it is their duty and responsibility to answer unforeseen circumstances for you. b. Terri Schiavo had neither a living will nor a durable power of attorney for healthcare decisions. Do you think that one of these documents vs. the other would have been more effective to clarify her wishes? To minimize the dissension between her husband and her blood relatives? In Terri Schiavo’s case, a living will would have been the most effective document to carryout her medical wishes. Because spouses and families often believe that they know what is best for their loved ones, having a durable power of attorney could have just created more issues and distain amongst the people who cared about her the most. The best thing for this case would have been hearing what she wanted from her own words. She would have had to go through some estate planning with an attorney to create the document, so they can trust that the decision was what she really wanted and it would not be taken lightly. I believe that people deserve to go with dignity and that if that have a choice or a preference, it should be acknowledged.

Chapter 11 Data Privacy, Confidentiality, and Security- Noell Davila 1. In 2011-2012, the Department of Health and Human Services conducted HIPAA audits to evaluate the current level of HIPAA compliance among healthcare organizations, health plans, and clearing houses. The findings indicated that small healthcare organizations were often found to be out of compliance with the HIPAA regulations. What do you think are the biggest barrier(s) to compliance with the HIPAA regulations among this population of healthcare organizations? According to research, the biggest barriers to compliance as it relates to the population of healthcare organizations are; Use of free tools that provide security such as online applications, mail accounts, and free EHR software put patient information at risk of being unprotected. In order to be in compliance, both HIPPA and HIM requirements should be understood and abided. The lack of education and support for the individual people responsible for compliance is what their suffrage stems from. HIPPA was created to protect the confidential information given by and for healthcare patients in organizations; the expectation is that the Department of Health and Human Services holds organizations to those standards and provides them with the support to knowledge to be successful within the guidelines. 2. A small counseling center received notification that a laptop that contained patient information was stolen out of a workforce member’s care. Upon investigation, it was determined that information on the workforce member’s laptop contained the following information on approximately 980 individuals:  Social Security number  Date of birth  Address  Treating physician name  Diagnosis and clinical information  Phone number  Email address  Demographic information  Financial information  Health insurance information  Treatment information  Medication information The laptop that was stolen was password protected; however, it did not contain any encryption software. While no reports of identity theft have been reported, it is unknown what has been done with the laptop or the information on the laptop. All

individuals impacted by the data breach were notified by written letter of the data breach. Each of the individuals impacted are encouraged to continue to monitor their credit reports to watch for suspicious activity. Questions: a. What could have been done to prevent this data breach from occurring? It is my understanding that such information regarding patients should not be available in a portable manner in any case. Laptops are very accessible and easy to steal, so the reasonable action would have been to use desktops in the organization. Typically, encryption software should be on computers with sensitive information as well; the sole purpose for this type of software is to protect digital information on computers in small organizations so that they do not have to outsource. b. What should the organization do to prevent data breaches like this from happening again? In the future, the organization should be proactive in protecting its patient’s information. By using desktop computers, adding security cameras, and using security key cards to restrict access to individuals that are not privy to the information, patient information would be better protected. Even when switching information over to desktops, the computers should have encryption software implemented .

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