VCOM Block 1 Professionalism and Ethics Exam 2

Mindfulness (Defintion)

Paying attention on purpose, in the present moment nonjudgmentally.

Mindfulness (Origins)

Rooted in ancient Eastern meditation practices it is secular and inspired by Buddhist teachings.

Jon Kabat-Zinn

Founded Mindfulness-Based Stress Reduction (MBSR) as the first mindfulness-based treatment approach.

Mindful Awareness (Acceptance)

Knowing and accepting present experiences without judgement

Mindful Awareness (Perceptions)

Observe feelings, thoughts, and perceptions without attachment to desires or aversions

Mindful Awareness (Awareness)

Developing insight and making deliberate choices and sustain attention.

Mindfulness in Healthcare

Improves empathy, compassion, and quality of care for patients.

Mindfulness in Healthcare (Patients)

Effect in managing Chronic diseases, High blood pressure, Heart disease, and Mental health. Reduce obsessive thinking, and hostility.

Health Professionals (Self-care)

Prevents burnout and maintain quality of patient care, improves stress management, energy levels, and overall well-being.

Health Professionals (Performance)

Enhances self-awareness and relationships, Reducing medical errors and staff turnover rates.

Clinicians (Mindfulness)

Enhances rapport with patients, improve patient compliance, and encourages non-judgmental attitudes and deliberate practice.

Mindfulness-Based Stress Reduction (MBSR)

8-week program Intervention for stress reduction and mindfulness cultivation

Mindfulness-Based Cognitive Therapy (MBCT)

Intervention focus on treating depression and preventing relapse.

Acceptance and Commitment Therapy (ACT)

Intervention that reduces Avoidant Coping Styles individually

Dialectical Behavior Therapy (DBT)

Intervention that improves Emotion Regulation and Distress Tolerance.

Mindful Practice

Involves formal mediation practices and informal application in daily life enhancing skills through systematic practice and real-life generalization.

Meditation Techniques (Sitting Meditation)

By focus on practicing breath-counting, deep breathing, and other sensory techniques to refocus on the moment.

Mediation Techniques (Mantra Meditation)

Repeating a word, syllable, or phase silently or out loud to refocus when one mind wanders.

Meditation (Body Scan)

Develops mind-body connection by focusing bodily sensations and emotions individually then letting them go.

Mindful Practices (Walking Meditation)

Focusing on the act of walking paying attention to every step and sensation in the feet/lower legs.

Mindful Practices (Eating Meditation)

Pay attention to eating experience while fully observing colors, shapes, smells, and intentions.

Health Insurance Portability and Accountability Act (HIPAA)

Aimed to protect patient record's privacy and streamline billing processes.

HIPAA (Bill Passage)

Enacted in August 1996 by Senator's Kennedy and Kassebaum it required Congress to pass regulations by August 1999 and was implemented on 2003.

HIPAA (Title II)

Focuses on Healthcare Fraud prevention, Administrative Simplification, Electronic Transactions, and Medical Liability reform.

HIPAA (Security Rule)

Ensures confidentiality, Integrity, and Availability of Protected Health Information (PHI)

HIPAA (Privacy Rule)

Aims to protect health information while allowing its necessary flow.

Protected Health Information (Definition)

Provides protection of any information that can reasonably identify an individual (Health, Social). Covers demographic data related to their physical and mental condition, care provision, and payments.

Protected Health Information (Examples)

Name, address, age, telephone, diagnosis, treatment plans, and prognosis.

Protected Health Information (Covered Entities)

Includes Healthcare providers (Physicians, dentist, hospitals, pharmacies, and laboratories as well as Business Associates providing services to Healthcare providers.

Disclosure of PHI

PHI can be disclosed as permitted by the Privacy Rule or authorized by the patient or their representative. Covered entities must follow Privacy Rule guidelines for using or disclosing PHI.

Privacy Rules (Permitted Disclosures)

Reveal information to Patients or Authorized representatives, other Healthcare provides for reimbursement, operations ,QA, Training, family members, and agreed facility directories.

HIPAA (Violations and Privacy Rule Requirements)

Discuss or disclose patient's condition without permission in front of unauthorized individuals as well as inappropriately accessing a patient's electronic medical record without proper authorization.

HIPAA (Mandated Disclosures)

PHI is disclosed by law for Public Health Activities, Abuse Victims, Health Oversight, Judicial Hearings, Law Enforcement, and more.

Patient Rights

Can see, copy, request amendments, update their health records. and receive an accounting of disclosure (Notice of Disclosures). Also request a restriction on certain uses or disclosures.

Patients Rights (Exceptions and Denials)

Withhold copies or amendments if endangering life or physical safety, with requirements for written explanation and compliant procedures.

HIPAA Regulations and Enforcement (Denials)

Denials must be in writing and include reason for denial and directions for filing a complaint.

HIPAA Regulations and Enforcement (Disciplinary Actions)

Violators face oral and written warnings, retraining, termination, or law enforcement.

Government Actions and Penalties (Civil Penalties)

$100 per incident to $25,000 per year for identical violations.

Government Actions and Penalties (Criminal Penalties)

Up to $250,000 and imprisonment for obtaining or disclosing PHI with malicious intent.

HIPAA (Best Practices)

Access records only with legitimate need, follow IT policies, verify sharing permissions, and store PHI safely

HIPAA (Student Violations)

60% reported incidents of posting unprofessional content online. 8% of the posting violated HIPAA.

Confidentiality and Ethical Duties (Importance)

Maintain privacy of patients by controlling access to sensitive information as it encourage patients to seek medical care, complete medical records for better treatment, and prevents discrimination and stigmatization.

Ethical Duties and Responsibilities

Maintain Confidentiality and Autonomy of the patients unless it necessary to protect the welfare of the individual or community.

Waivers of Confidentiality

Only address the use of PHI for specific purposes like care, billing, and operations.

Confidentiality Breach (Required)

Mandate by HIPAA when required by law or public health activities and when necessary to protect third parties from violence or disease spread.

Required Breach (Examples)

Revealing a person has an infectious disease or impairments that affect driving.

Tarasoff v. Regents

University of California (1969) therapist determines patient was suffering from mental illness and only was able to force a short detainment and no warning was given to student or her parents. The patient later killed the student. This made it a legal duty for mental health professionals to warn potential victims of their patients.

Reporting Obligations (Examples)

Suspected child abuse, Elder neglect. Domestic violence and Impairment of Healthcare provider in some states.

Medical Records (Purpose)

Justify payments for services. Enhance patients quality care by including essential information such as diagnosis, treatment plans, and past medical history.

Medical Records (Omitting Information)

Can compromise care and reimbursement. Important clinical data might be unavailable during emergencies.

Medical Records (Information Release)

Requires a written, signed, and dated requests that are specific and time-limited. Individuals have the right to revoke their consent at anytime.

Genetic Information Nondiscrimination Act (GINA)

Protects information from being used in employment decisions including employers acquiring genetic information or family medical history during employment medical exams.

GINA (Exceptions)

Sharing genetic information with written consent, research, court orders, or public health emergencies as well as Family and Medical Leave Act certification or government investigations.

Health Insurance (Importance)

Decreases life' Uncertainty, ensures access to care based on ability to Pay, Availability, and Cultural Competence, and A Key Factor in accessing Care.

Uninsured Demographic

From lower household incomes and education levels between the age of 19-64. Blacks and Hispanic are more vulnerable.

Premium

Annual health insurance payment.

Cost-Sharing

Policyholders share part of the bill.

Deductibles

Amount paid before insurance coverage starts.

Co-insurance

Percentage paid by beneficiary after deductible

Maximum out-of-pocket

Limit on beneficiary's annual payments.

Out-of-network Providers

Result in higher costs for beneficiaries.

Formularies

List of preferred drugs by insurance companies.

Explanation of Benefits (EOB)

Details services, costs, and payments.

Impact of Payment Methodologies

Cost-sharing disproportionately affects low-income individuals, contributes to healthcare disparities, influence service utilization, and out-of-pocket expenses can deter appropriate an d inappropriate health service usage.

Value-Based Insurance Design (VBID)

Incentivizes services provided based on value, improve quality and control cost in healthcare delivery, and encourage efficient and effective healthcare utilization.

VBID (Implementation)

Minimize or eliminate out-of-pocket expenses for high-value care (Ex. No cost-sharing for insulin or Ambulatory Surgery Center). Do cost-sharing for low-value cost (Ex Hospital Operating Room).

Managed Care Organization

Diverse groups that manage car and reduce cost usually by payment models (Accountable Care Organizations) and bundled models.

Pay-for-Performance Impact

Rewards physicians and hospitals based on quality, efficiency, and patient outcomes to encourage healthcare providers to deliver high-quality care

Health Insurance (Barriers)

Pre-approvals, paperwork, and denials in health insurance procedures.

Fee-for-Service

Payment per service provided, often discounted

Capitation

Fixed fee per member for a specific period

Episode-based Payments

Single payment for a defined care period

Global Payments

One payment covering a group for a set time

Risk Allocation

Payors aim to shift risk to providers. Providers may resist accepting increased financial risk.

Fee-for-Service Payments (Concern)

Encourages unnecessary care delivery, lack incentives for provider collaboration, and contributes to rising healthcare expenditures.

Cultural Competency

Behaviors, knowledge, attitudes, and policies enabling effective work in cross-cultural situations.

Healthcare Cultural Competency

Addresses cultural, social, and linguistic needs of patients.

Cultural Competence (Benefits)

Improved patient care, reduced disparities, and operational efficiency while also decreasing malpractice risk.

Culture (Definition)

Encompasses learned beliefs, values, communication styles, and traditions.

Diversity (Defintion)

Distinct qualities, backgrounds, and beliefs that differentiate individuals or groups

Race

Denotes identifiable biological traits in the same species within a group.

Ethnicity

Individuals with a shared cultural, linguistic, or national heritage.

Gender

The state of being socially male of female

Minority

An identified group of individuals which has little power or representation in a given society.

Socioeconomic Status (SES)

Economic and Social position based on income, education, and occupation.

Health Care (Disparites)

Stem from social, economic, and environmental disadvantages in Healthcare.

Black (Covid Outcome Disparity)

Blacks COVID-19 deaths compared to white in South Carolina.

Disability Status

18.7% of the US with higher rates of obesity, physical inactivity, smoking, and cardiovascular disease.

Race-based Medicine

Providers' stereotypes and time constraints result in poor patient communication and outcomes instilling mistrust, reduced adherence, and limited service in communities.

Cultural Incompetence

Result in lower expectations for disadvantage patients and influence outcomes.

Cultural Competence (Skill Development)

Recognize personal biases through introspection and strive for better care while utilizing epidemiological data to practice cultural sensitivity medicine.

Fluidity of Terminology

Gender and sexual identity terms are dynamic and culturally influenced, emphasizing individual and self definitions.

Intersex and Cisgender

Highlight variations in reproductive anatomy and alignment of gender identity with assigned sex.

Hostile Sexism

Reflects biased attitudes and behaviors, often viewing gender identity equality as a threat to traditional values.

Benevolent Sexism

Positive views of individuals conforming to traditional gender roles

Impact Sexism

Disparaging girls in masculine domains and vice versa. Reinforces gender stereotypes through teasing

Inclusive Environments

Implementing gender-affirming practices; Preferred name usage, single occupancy restrooms, inclusive patient intake forms. Trained staff on unique needs to LBGTQ+.

Life Course Framework

Addresses varying health needs at different stages of life.

Social Ecology

Considers how social environments impact well-being.

Minority Stress

Chronic stress from social stigmatization