The HIPPA privacy regulations were formulated to safeguard patients’ personal health information in the possession of entities covered by the act and provide patients with an assortment of rights about their medical information. Simultaneously, the privacy regulations have been balanced so that it accommodates the disclosure of critical, personal health information required for optimum patient care and other essential functions. To enhance the efficiency and usefulness of the medical care system, HIPPA 1996, incorporated administrative simplification stipulations that necessitate the department of health and human services to espouse national standards for digital medical care transactions and canon sets, exclusive health identifiers, and safety (HIPAA, 2011).
HIPPA seeks to develop standardized mechanisms for digital data exchange, safety, and confidentiality of all medical care-related data. The Act dictates; regulated formats for all patient medical, administrative, and monetary data; distinguished identifiers for each medical care entity, including persons, employers, health schemes, and health caregivers. They also include security measures to ensure privacy and data integrity for and data that identify a person. HIPPA categorically addresses matters concerning the privacy of the patients, safeguarding all identifying information such as an individual’s name, date of birth, persona phone number, and social security registration number. Under this new regulation, patients will be required to give or provide written consent before any of their private information can be shared with a third party. The Act dictates that patients have a right to access and make changes to their health records. The exception is considered to be about psychiatric records. Patients will also be required to fill out official forms indicating the changes they want to make and the reasons that led them to make the changes (HIPAA, 2011).
The Health Information Technology for Economic and Clinical Health Act (HITECH) was part of the section of the American Recovery and Reinvestment Act (ARRA) enacted in 2009. HITECH widens the scope of confidentiality and security regulations already encompassed in the HIPPA act. This legislation also increases the legal liability for not complying with the legal provisions and provides stringent enforcement. HITECH necessitates data breach notification for unsanctioned uses and disclosures of personal medical information that is not secured. These breach notification stipulations are similar to many state breach regulations related to individually identifiable information. For medical care providers with digital health records systems in place, it mandates that patients have a right to view their health records or data. The patients can permit the sharing of medical information with a third party at a fee that is equivalent to the labor cost of production. Additionally, HITECH has transformed it such that business associates like billing firms, law agencies, and accounting firms of institutions subject to HIPPA, for example, pharmacies and health caregivers will also be subjected to similar regulations. The Act provides that, by the year 2011, health caregivers will be provided with financial subsidies for illustrating the meaningful application of electronic health records. Incentives will be available until 2015, after which fines might be charged for failing to show such application. The Act also creates grants for educational centers for the staff required to support a medical information technology infrastructure (Brokel, 2010).
Traditionally, institutional and legal regulations have concentrated upon disclosure of information from the medical caregiver to the patient, apart from the two-way interaction that has been described by some scholars as shared decision making. Constricted interpretations of consent that comprise of the one-way channel of information from the doctor to the patient result in an unsatisfactory, naive model of information communication, which takes the form of health providers talking ‘at’ and not ‘with’ patients. This has resulted in considerable misinterpretation of consent in the medical practice context. Consent is commonly referred to as a deed such as a patient consenting. Viewed from this perspective, the purpose of consent is to avoid litigation and follow institutional guidelines instead of improving communication with clients. Such an understanding usually results in a perfunctory methodology to consent (Purtilo & Doherty, 2011).
Consent is better perceived as two-way traffic of shared and informed decision-making processes. This framework maintains as its core focus the independence and the interests of the patient but evades a naive health professional-patient separation of labor and the division between facts and information while, on the other hand, beliefs, choices, and likes. This framework acknowledges that health professionals are not just value-neutral givers of evidence related to diagnosis, treatment, and prognosis options but are autonomous moral agents with well-structured professional roles. Decision-making is unequivocally shared because each person brings their convictions and knowledge to the therapeutic association. Clinical, ethical practice requires much more of the medical professional as compared to superficial identification of the patient’s self- fortitude. Whereas consents may be superficially perceived as acting, authentication of an intervention, in a broader sense it is a core and continuing part of the phases of shared decision making. From this point of view, the development of legal regulations of disclosure, and better organizational guidelines for consent might be less significant than making sure that professional training includes the learning of efficient communication skills and associated values to all medical care professionals (Purtilo & Doherty, 2011; Curtis, 2002).
Appropriate administration of ethical issues in medical care is critically dependent on competent communication amongst health professionals, members of the medical team, the patient, and the patient’s family. Communication is a dynamic process, and various factors, including the immediate environment, constraints of time, training in communication skills, and disparities between the medical professionals and patients in the level of education, social status, cultural backgrounds, age, sex, social morals or convictions have a lot of influence on the quality of interaction. Not only does the failure of communication erode the quality of and gratification with medical care but it also increases the probability of litigation as a result of adverse occurrences. Disappointingly, hospitals and health care institutions rarely provide an ideal environment in which interaction can easily occur.
Health professionals must know how to attend to patients, acknowledge their autonomy, offer time for reactions and respect and acknowledge cultural diversity where they are manifested. Conflict usually arises between the patients and health care providers when health workers insist that, in the interest of the patient, a blood transfusion should be carried out. The patient and family will strongly object to this and will not be willing to submit written consent to this effect. The law allows patients to reject any medical procedures or treatment, even though many health practitioners find it hard to accept it. Three strategies, coercion, deception, and mutual trust, are applied to solve the conflict. Coercion is evident when the courts grant the parent autonomy and fail to give the same treatment to children. Deception is used where doctors make transfusions and never inform the patients. The shared decision-making structure argues that, in most cases, coercion and deception cannot be justified because they undermine the patient-doctor relationship (Curtis, 2002; Kerridge, Lowe & McPhee, 2005).
Brokel, J. (2010). Moving Forward With NANDA-I Nursing Diagnoses With Health Information Technology for Economic and Clinical Health (HITECH) Act Legislation: News Updates NANDA International News. International Journal Of Nursing Terminologies & Classifications, 21 (4), 182-185.
Curtis, K. A. (2002). Physical therapy professional foundations: Keys to success in school and career. Thorofare, N.J: Slack.
HIPAA The Health Insurance Portability and Accountability Act. (2011). National Nurse, 107 (7), 18-26.
Kerridge, I., Lowe, M., & McPhee, J. (2005). Ethics and law for the health professions. Annandale, N.S.W: Federation Press.
Purtilo, R. B., & Doherty, R. F. (2011). Ethical dimensions in the health professions. St. Louis, Mo: Elsevier/Saunders.