Question

The following case study (Rinehart?Thompson) at hypothetical St. John Hospital illustrates numerous
issues that the HIPAA privacy rule presents and which HIPAA?covered entities must address on a daily
basis. As you conclude Chapter 9 and the HIPAA privacy rule requirements, use this case study to
identify the issue(s) presented on each date, determining how each situation should be handled in order
to comply with the HIPAA privacy rule.
From May 26?30, Mary Jones was hospitalized in St. John Hospital, located in Johnson County, with
depression and a drug overdose (documented by the physician as possible suicide attempt). She also
had Type I diabetes and a previous above?knee amputation of the right leg, with prosthesis. During her
hospital stay, she had several sessions with her psychiatrist, Dr. Bridges.
On July 18, Ms. Jones contacted the HIM Department at St. John Hospital to request a copy of her
medical records from her May hospital admission. The chart was copied for her by ReadyChart, the
record?copying service utilized by St. John Hospital.
On August 7, Ms. Jones returned to the HIM Department at St. John Hospital, extremely upset that her
May records indicated a possible suicide attempt. She wanted Dr. Bridges to change the incorrect
records to reflect that the overdose was accidental. Dr. Bridges refused, stating that Ms. Jones didn’t
know what she was talking about.
On September 14, Ms. Jones was readmitted to St. John Hospital with an infection of the prosthetic site.
She was treated with an antibiotic regimen.
On October 5, St. John Hospital received a call from Mercy Hospital. Ms. Jones was in the emergency
department there, with a severe infection of her prosthetic site. The nurse in the Mercy Hospital
emergency department asked for faxed copies of medical records from Ms. Jones’ September admission
at St. John, as she was being prepared for immediate surgery.
On October 15, Ms. Jones decided to go to another psychiatrist. She called St. John Hospital HIM
Department and asked that her medical records from her May hospital admission be mailed to Dr. Lyon,
as she has an appointment scheduled with him this coming January. Ms. Jones stated that she had also
changed jobs in September, and her new health insurer was Liberty Life and Health.
On October 30, Ms. Jones requested a copy of her medical records from her September admission. The
new HIM manager in charge of correspondence, Don Day, stated that he was aware of a state statute
that prohibited the release of medical records to patients without prior written approval of their
attending physician. This has not been the practice at St. John Hospital. Mr. Day was concerned about
the hospital’s longstanding violation of state law. He suggested that correspondence requests (in which
records would be released directly to patients) be suspended until the state law could be researched
further.
On November 10, Ms. Jones received a brochure and samples from Comfort Healthcare, a
pharmaceutical company that manufactures ointment for patients with prostheses. Ms. Jones called the
St. John Hospital registration desk to complain. Jessica Carter, a candystriper, took Ms. Jones’ call.
On November 12, Liberty Life and Health submitted a request to Dr. Lyon’s office for copies of Ms.
Jones’ medical records from her May St. John Hospital admission and from Dr. Lyon’s office.
On November 17, A case worker from the Johnson County Children’s Services called the HIM
Department at St. John and requested Ms. Jones’ medical records from her May hospitalization.
Children’s Services had received a complaint that Ms. Jones had an “episode” on May 26 and there was
concern that her children were being subjected to ongoing abuse. As a result, it was initiating an
investigation.
On November 20, the physical therapy department at St. John Hospital is performing a correlational
study to determine the effects of two different types of treatment that the physical therapy department
has used with its above?knee amputation patients during the past two years. Ms. Jones received
treatment from the St. John physical therapy department during her September admission.
On November 21, Dr. King, an orthopedic surgeon, presented a seminar to the state association of
orthopedic surgeons on above?knee amputation techniques. He had performed Ms. Jones’ procedure
one year ago, and he showed slides that compared her condition before the procedure, immediately
after, six months later, and one year later.

Based on the HIPAA privacy rule issues discussed in Chapter 9, identify the issue or issues presented on
each date in the above case study.

Answer 1

The Health Insurance Portability and Accountability Act describes how personal health information may be used and how the client can obtain acesss to the information.The personal health information includes identifiable information that relates to the clients past,present,or future health,treatment and payment for health care services.

a.May 26-30 -no vioation of HIPAA rules.

b July 18 -The hospital copied her records for her but the at requies health care agencies to keep personal health information private,provides information to the client about the legal resonsibilities regarding privacy and explains the clients rights with respect to PHI.

c August 7-It is the clients right to ask the health care agency to amend the PHI that is contained in a record if the PHI is inaccurate.

dO.ctober 30 -According to the disclosures of personal health information ,the patient hasthe right to use the information to avert a serious threat to the clients health safety or the health or safety of others..As a consumer of health care under HIPAA and any client requests may need to be placed in writing ,a fee may be attached to certain client requests.

e November 21- The clients privacy ights have been violated .She may file acomplaint if the client believes that privacy rights have been vioated.