Health IT data ethics

This article discusses the legal and ethical issues related to health IT data ethics. It covers topics such as HIPAA violations, medical malpractice, and confidentiality breaches. The article also provides solutions to prevent such issues from recurring.

Running head: HEALTH AND IT DATA ETHICS
Health IT data ethics
Name of the Student:
Name of the University:
Author Note:

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MCQ

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Question 1
b. Stark
Question 2
c. Medical malpractice for failure to warn
Question 3
d. Openness, because the doctor hid the side effect of liver damage from her
Question 4
a. Technical Safeguards
Question 5
b. Privacy and Confidentiality
Question 6
b. Yes, the record was not made in a timely manner.
Question 7
c. Security; Confidentiality; Private
Question 8
b. Birdland as the Covered Entity, Hillbottom as the Business Associate, PopHealth as the
subcontractor, and UMBC as the Institutional Review Board holder.
Question 9
c. Beneficence and Legitimate Infringement

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Question 10
a. True

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Section 2 (Essay type answers)

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Question 1
a. The action of Jane coder’s treatment of Brenda and her records has raised legal issues.
The actions that the Jane coder did has violated and breached the Health Insurance Portability
and Accountability Act 1996 (HIPAA). The standards of the privacy rule states that the
disclosure and the use of the individual health information is called the protected health
information is a subject of privacy information. The major or the vital part of the privacy rule is
to provide assurance to the individuals regarding the health information and to see that it is
properly protected (McGraw, 2013). At the same time the privacy rule also mentions that the
flow of the health information is carried out in a proper way and it promotes the higher quality of
the healthcare. Thus, fostering the protection of the public health information and wellbeing of
the patient. The privacy rule provides information regarding the usage of the information and at
the same time provides protection of the privacy of the people that are seeking the provisions of
healthcare. Provided that the market place of healthcare is diverse, the rule has been designed to
be comprehensive as well as flexible. Thus, it covers the disclosures and the usage of what needs
to be addressed (Luxton, Kayl & Mishkind, 2012).
The privacy rule of the HIPAA states have a basic principle and it defines the
circumstances that limit the disclosure and the usage of the health information. HIPAA provides
protection to the health information of a patient and it covers the entities to which the
information is disclosed. Thus, the entity that is using the health information can disclose the
information only under the two circumstances (Wu, Ahn & Hu, 2012). Firstly, the information
can be disclosed only when the privacy rule permits the disclosure. Secondly, the individual who
is the subject of the information authorizes the usage of the information in writing. A covered
entity can disclose the information only on two different occasions. Firstly, it is disclosed to an

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individual only when a request is processed regarding its access. Secondly, when an authority is
conducting an investigation or an enforcement action. Thus, from the above mentioned
information, it can be concluded that actions of Jane coder regarding the disclosure of the
treatment and records of Brenda is a legal violation (Greene, 2012).
b. Medical malpractice for failure to warn is a legal issue that regarding Brenda’s OB/GYN
and her delivery of a premature baby and preterm labor. This sure raises the issue of the Arbutus
Hospital and the department of OB/GYN. In this particular scenario, it is important to mention
that the anti-retroviral drug prescribed by the OB/GYN is though safe for the general population
but it has complication with the mothers that are taking this medicine during their pregnancy.
The OB/GYN is unaware of the issue of the birth defects and the OB/GYN also ignored the
alerts of the HER warning of the birth defects. The OB/GYN also did not provided any
discussion on the potential side effects of the drug which is prescribed to Brenda. The legal
procedures can be followed both against the OB/GYN and Arbutus Hospital (Pradarelli,
Campbell & Dimick, 2015).
This means that even though the OB/GYN department had the idea that the drug has
potential to cause injury to the Brenda, the OB/GYN failed to warn, report the same information
to Brenda. Thus, considering the scenario Brenda can sue OB/GYN and the other associated
health professionals for failing to warn Brenda and the significant health issues associated with
the medication. The cases are known as failure to warn issues and the cases are highly technical.
Thus, to successfully register case against the OB/GYN, it must be shown that the outcome has
some of the known risks of procedure. While it is also important to include the fact that the risk
is not insignificant and the doctor has failed to warn against the risk. Thus, even if there is a

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breach in the duty of care, a claim cannot be established if the patient is unable to establish the
evidence of his or her suffering or loss.
c. The billing office submitted the medical records to the Medicaid, which is the insurer of
Brenda’s Heath coverage till Brenda gets enrolled into the employer-sponsored health plan. The
billing officer was under the pressure from the upper financial management. Thus, the billing
officer ensured that the codes are submitted with the best interest of the hospital in mind. The
billing officer entered some extra codes so that the hospital does not accrue any loss and the
hospital continues to treat under the purview of Medicaid (Centers for Medicare & Medicaid
Services (CMS), 2012). This is a violation of the vicarious liability and the above mentioned
scenario shows that it is a deliberate act where the principles of liability are applicable. Although
the billing officer was under pressure from the upper authorities of the hospital (Baicker et al.,
2013).

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Question 2
1. The mentioned case study is an ethical issue and it is a kind of situation where a person is
required to choose one option out of the two alternatives, which is evaluated as wrong (unethical)
or right (ethical). The ethics include the dilemmas like the what type of decision is (bad or
good)? The language is wrong or right; the responsibilities and the rights; how to have a good
life (Peters, 2015).
2. The facts presented in the case study include the following:
 Kendra Brown is a technician on the registered health information and is also an
assistant director on the health information services at the memorial hospital.
 Sue Davidson is the facility risk manager and he along with Dr. Philip Russel
went to Kendra’s office to see the requests on all the patients in the past 2 years
that have done gastric bypass surgery by the Dr. Lester Brown.
 Kendra however reminds Sue that there is a departmental policy which states that
the study requests can only be made for 24 hours. It is an important to mention
that the both Sue and Kendra have been close friends and they have worked for 15
years in Memorial hospital.
 The matter of urgency is stated by Sue and Dr. Russel that a patient has died after
the surgery and the family is trying to file a lawsuit against the hospital. Sue also
stated that that there have been previous incidents where the patients of Dr.
Brown died after surgery.
 It is also important to highlight that the Kendra’s mother is also scheduled to have
her gastric bypass surgery by Dr. Brown and this made Kendra to run through the
list.

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 Later on Kendra found that there is a complication in the records and they
indicated that the patients that have done gastric bypass surgery by Dr. Brown
have faced issues related to the re-admitting to hospital, and other medical
complications. Kendra even found that 24 out of the 78 patients have died due to
the complications of the procedures. After finding this data, Kendra felt that the
there is a need to warn her mother regarding the surgery and she also felt that her
mother must consult another surgeon from the same hospital.
 After all these Kendra called her mother and said about what she found after
unearthing the data. Sue however hears the conversation between Kendra and her
mother. Sue confronted Kendra regarding the content of the discussion and with
her mother.
3. The stakeholders in this situation includes Kendra Brown, Kendra Brown’s mother,
Memorial Hospital authorities, Seu Davidson, Dr. Lester Brown.
The values at stake needs to be described at the individual level. Kendra Brown is the
Director of the Health Information Services and thus she will be face the ethical issue
considering the fact that she shared confidential information with her mother. Kendra’s mother
now knows certain confidential information and the fact that she now knows that getting the
surgery done by Dr. Brown might jeopardize her life. The reputation of the memorial hospital
authorities is at stake considering the fact that Kendra’s mother can share the same information
with other people. Seu Davidson also does not have the authority to check the patient records and
it takes 24 hours. Whereas, Kendra said that the departmental policy requires 24 hours.
4. The options that are available to evaluate the stakeholders include ethical principles,
organizational policies. These options can be used as a guiding principle to evaluate the

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performances and the conduct of the various stakeholder associated with the case study. It is
important to note that these options can be considered or taken into account because the
stakeholder by some way or the other violated the ethical principles and the organizational
policies.
5. The alternatives or what else that could have been done include the following. Firstly,
when Kendra came to know about the complications regarding the death of the majority of the
patients that have done gastric bypass surgery from Dr. Brown felt the need to call and share the
same information with her mother. Here, an important aspect is that Kendra knew that her
mother is going to have a gastric bypass surgery done by Dr. Brown made Kendra feel that
complication might arise with her mother as well. It might jeopardize the life of her mother and
this made Kendra think in a biased way. The information Kendra shared with her mother could
have been shared in a different way. Kendra could have shared her concern by informing her
mother that she can have her gastric bypass surgery done by another doctor because Dr. Brown
will be unable to conduct the surgery and will be unavailable for that day, all other surgeries
have already been cancelled (Crossan, Mazutis & Seijts, 2013).
6. The decisions made by Kendra can be justified by fact that when she came to know about
the complications with each and every case that Dr. Brown operated made Kendra believe that
there is an urgency. This urgency is justified considering that 24 out of the 78 patients expired
after the surgery due to complication.
7. The decision made in the step 5 can be implemented ethically by interacting effectively
and sharing the information which will not hamper the image of the Memorial Hospital and Dr.
Brown as well. The implementation will include a general procedure of communication and
molding the information so that the real motive can be conveyed easily.

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8. The evaluation of the outcome of the decision can done ethically. Firstly, it is important
to note that the decisions made in the step 5 is based on the ethical grounds and this will not
jeopardize image of the Memorial Hospital.
9. This issues can be prevented from recurring by take a wide range of measures. Firstly,
one of the biggest measure is to train the employees that handle confidential data and revealing
the same will led to ethical violations. It is important to mention that ethical violations are
rampant if the laws that prohibit such actions are not stringent. Thus, stringent laws also require
the stringent implementation and enforcement of the same. Secondly, the organizational policies
also need to be revamped so that the it can include the provisions of ethical violations and the
legal violations pertaining data sharing and data access (Craft, 2013).

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Reference
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