***GRADING RUBRIC AND INSTRUCTIONS MUST BE FOLLOWED***
Prepare a workplace brief (4-6 single-spaced pages) to address a privacy breach that occurred in a health care organization. Include the consequences of failure to act and evidence-based recommendations for addressing the breach.
Instructions
In this assessment, you are assuming the role of an early careerist in risk management and quality improvement at one of Vila Health’s community-based hospitals. Vila Health is a medium-sized system of health operating facilities in Minnesota and Wisconsin. You are working on a team-based initiative under the supervision of the Vila Health Chief Compliance Officer. Your role is to assist in addressing a specific compliance risk regarding a breach of privacy and potential HIPAA violation. A Vila Health employee has disclosed—without prior written authorization—a patient’s protected personal health information.
Here is the information the team has collected about the privacy breach and potential HIPAA violation to date. A Vila Health supervisor instructed an employee to obtain pre-authorization for an upcoming surgical procedure for a patient. The Vila Health employee submitted confidential, protected health care information about the patient to the insurance company. The Member Services Representative at the insurance company contacted the Vila Health supervisor. The insurance company representative indicated that further discussion of the matter without prior written consent from the patient is prohibited.
As part of the team exploring the privacy breach, you will prepare a workplace brief with authoritative, evidence-based references to support your work.
Instructions
This is a workplace brief rather than an academic paper. Use the attached template and Be sure to address all of the following in your brief:
Background
Include a short paragraph of no more than five or six sentences describing the known details about the privacy breach and HIPAA violation.
Privacy Breach—HIPAA Violation
Summarize the relevant health care compliance concepts that apply to this privacy breach and HIPAA violation. Be sure to consider the following:
- Federal, state, and local laws and associated regulations.
- Disclosure.
- Human resource concepts and law(s).
- Industry and accrediting body standards.
Seven Essential Elements of an Effective Compliance Program
Apply to this HIPAA breach the seven essential components of an effective health care compliance program, as determined within the Federal Register.
Privacy Breach Consequences
Provide a synopsis of the consequences for an individual leader and for other internal health care organization stakeholders for not taking immediate actions to address a privacy breach. At a minimum, be sure to consider all of the following in your synopsis:
- Patient safety.
- Financial losses.
- Individual and organizational violations of the law.
Evidence-Based Recommendations
Construct evidence-based recommendations to resolve the HIPAA-related privacy breach. You may also want to include relevant information related to:
- Human resource laws.
- Professional codes of ethical conduct and standards.
- Previous case precedents.
- Current alleged health care legal violations.
For help in identifying appropriate evidence-based recommendations, you may want to visit some of the authoritative sources, such as the DOJ/OIG, CMS/HHS, et cetera, listed under the suggested resources for this assessment.
Ethical Decision-Making Framework for Health Care Leaders
Describe an ethical decision making framework as one of your concluding recommendations. Tip: You may want to use the ACHE’s ethical decision-making framework:
- Nelson, W. (2015). Making ethical decisions. Healthcare Executive, 46–48. Retrieved from https://ache.org/abt_ache/EthicsToolkit/JA15_ethic…
Conclusion
Write a paragraph that summarizes the following:
- Key concepts.
- Importance of compliance.
- Best practices to monitor for future quality improvements.
- Short list of resources.
- Note: Be sure to include all appropriate citations.
Expert Solution Preview
Introduction: As a medical professor responsible for designing and evaluating assignments for medical college students, I understand the significance of maintaining patient privacy and complying with HIPAA guidelines. This workplace brief aims to address a privacy breach and potential HIPAA violation that occurred in a healthcare organization and provide evidence-based recommendations for addressing the same.
Background: A Vila Health employee disclosed a patient’s protected personal health information without prior written authorization. The employee submitted confidential, protected healthcare information about the patient to the insurance company, and the Member Services Representative at the insurance company contacted the Vila Health supervisor. The insurance company representative indicated that further discussion of the matter without prior written consent from the patient is prohibited.
Privacy Breach-HIPAA Violation: The relevant healthcare compliance concepts that apply to this privacy breach and HIPAA violation include federal, state, and local laws and regulations, disclosure, human resource laws, industry, and accrediting body standards. These concepts are of utmost importance to ensure patient privacy is maintained, and patient’s rights are protected.
Seven Essential Elements of an Effective Compliance Program: The seven essential components of an effective healthcare compliance program, as determined within the Federal Register, which apply to this HIPAA breach are leadership and oversight, a written set of standards and procedures, education and training, communication, monitoring and auditing, enforcement, and response and prevention. Implementing these components can help healthcare organizations maintain compliance with HIPAA guidelines.
Privacy Breach Consequences: Failure to act on a privacy breach can have grave consequences for individual leaders and other internal healthcare organization stakeholders, such as patient safety, financial losses, and individual and organizational violations of the law. Therefore, immediate action must be taken to address a privacy breach to mitigate its consequences.
Evidence-Based Recommendations: To address the HIPAA-related privacy breach, evidence-based recommendations may include human resource laws and professional codes of ethical conduct and standards. Previous case precedents and current alleged healthcare legal violations can also help identify appropriate evidence-based recommendations to resolve the privacy breach.
Ethical Decision-Making Framework: Using an ethical decision-making framework can guide healthcare leaders in making the right decisions. The American College of Healthcare Executives (ACHE) ethical decision-making framework is recommended as an effective ethical framework for healthcare leaders.
Conclusion: Maintaining patient privacy and compliance with HIPAA guidelines should be of utmost importance for healthcare organizations. Regular monitoring and auditing, education and training, and effective communication can reduce privacy breaches and potential violations. Healthcare organizations should always be vigilant and responsive to prevent such breaches in the future. Suggested resources for this assessment include the DOJ/OIG, CMS/HHS, among others, which can provide evidence-based recommendations and guidelines on maintaining healthcare compliance.
