E-FINALS

Civil Law

Legal relationships between people and the protection of a person’s rights

Health care is mainly affected by civil law: both contractual and torts

Contract

An agreement between two or more parties; can be implied or written.

Offer

Acceptance

Consideration

Parts of Contract

Three

How many parts does the contract have?

Tort

Occurs when a person is harmed or injured because a health care provider does not meet the established standard of care.

Criminal Law

Wrongs against a person, property, or society.

Example practicing without license, use of narcotics, theft, sexual abuse, murder

Legal Responsibilities

• protect healthcare workers, their employer and the patient

•  based on laws created by federal, state and local governments 

•  healthcare workers must know and follow laws pertaining to their license or registration 

KEEPING PATIENT CONFIDENTIALITY

• KEEPING PATIENT CONFIDENTIALITY

• Everyone in the organization is responsible for patient confidentiality

• Board members

• Executive leadership 

• Clinical staff 

• Physicians and nurses 

• Administrative and clerical staff

• Students and interns 

• Volunteers

CONFIDENTIALITY OF MEDICAL RECORDS

• Identity (e.g. name, address, social security #, date of birth, etc.) 

• Physical condition 

• Emotional condition 

• Financial information

• Access patient information only if there is a ‘Need to Know’ 

• Discard confidential information appropriately – (e.g. Locked Trash Bins or Shredders) 

• Forward requests for medical records to the Health Information Management Department. 

• Do not discuss confidential matters where others might overhear. – (e.g. Cafeteria, Elevator, Buses, or Restaurants) 

• Do not leave patients charts or files unattended 

• Report suspicious activities that may compromise patient confidentiality

GUIDING PRINCIPLES

HIPAA

 Health Insurance Portability & Accountability Act of 1996

ARRA

American Recovery and Reinvestment Act of 2009

• Patient Bill of Rights

• 201 CMR 17.00 Standards for the Protection of Personal Information

Massachusetts regulations and statues

• Improve the efficiency and effectiveness of the health care system 

• Encourage the development of an electronic health record 

• Establish national standards for electronic transmission of certain health information 

• Establish national standards to protect health information Ensure patient confidentiality Improve the efficiency and effectiveness of the health care system 

• Encourage the development of an electronic health record 

• Establish national standards for electronic transmission of certain health information 

• Establish national standards to protect health information Ensure patient confidentiality 

• Protect patient privacy 

• Build loyalty and trust 

• Provide exceptional customer service

PURPOSE OF HIPAA

1. Name 10. Social security number 

2. Full face photo

3. Finger or voice print

4. Telephone number

5. Address/zip code

6. E-mail address

7. Fax number

8. Internet Protocol (IP) address

9. Uniform Resource Locator (URL)

10. Social Security number

11. Medical record number 

12. Insurance number 

13. Account number 

14. All elements of dates 

15. Vehicle identifier 

16. Certificate/license 

17. Device ID/serial number 

18. Any unique identifying number, characteristics or code

HIPAA Defines These 18 Elements PHI Identifiers

• Medical records

• Clinic lists 

• Patient information systems

• Test results 

• Billing information (bills, receipts, EOBs, etc.)

• X-rays 

• Patient menus

• Labels on IV bags 

• Patient information on a mobile device

• Conversations

• Telephone notes (in certain situations) 

WHERE IS PHI FOUND?

•Treatment of the patient

•Payment of healthcare bills

•Direct patient care

•Operations related to healthcare

•Referrals to other health care providers •Coordination of care 

•Research

•Consultation

•Required by law (e.g. subpoena, court order, etc.)

Permitted Uses and Disclosures of PHI 

Tort

Blank can either be UNINTENTIONAL one that is negligent, as opposed to INTENTIONAL, which are torts done deliberately.

Assault

Blank Is a deliberate act wherein one person threatens to harm another without consent and the victim feels the attacker has the ability to carry out the threat.

Battery 

Touching the victim without consent.

False imprisonment

Blank is the unlawful confinement of a person within a fixed area.

Defamation

Blank is the making of a false statement to a third party that is harmful to another’s reputation.

Slander

Blank are false charges and malicious oral statements about someone

Libel

Blank are written defamation of a person's character, reputation, business, or property rights

Unintentional torts

Negligence involves a failure on one party to act the way an ordinary, reasonable person would act. Negligence can result in a physical injury, property damage and other type of loss.

Imputed Negligence

The doctrine that makes one person responsible for the negligence of another.

Contributory Negligence

A theory in tort law under which a complaining party's own negligence contributed to or caused his or her injuries.

DUTY 

 The defendant owed a legal duty to the plaintiff under the circumstances;

BREACH 

The defendant breached that legal duty by acting or failing to act in a certain way

CAUSATION

It was the defendant's actions (or inaction) that actually caused the plaintiff's injury

DAMAGES 

The plaintiff was harmed or injured as a result of the defendant's actions.

Malfeasance

An illegal act, especially by a public official

Misfeasance

An act that is legal but performed improperly

Nonfeasance

Failure to act when under an obligation to do so