A local hospital has successfully implemented a fully function EHR system. Upon
ID: 444712 • Letter: A
Question
A local hospital has successfully implemented a fully function EHR system. Upon a recent regulatory inspections, the inspection group asks to be allowed to review the patient’s charts within the hospital’s system. The hospital’s I/S Information System department has a strict policy stating only hospital employees are allowed to have access to any of the hospital’s internal systems. The inspection groups points out their regulatory agreements with the hospital states they’re (the inspection team) allowed to review any patient’s chart in the form the caretakers are utilizing it to care for the patient without observation from the hospital’s staff. Failure to comply could mean a multitude of impacts such as fines, closure, etc.
The immediate issue was resolved and newly created signon and passwords were provided the inspection team immediately to continue the inspection which contained their individual names and user information. Even though resolved, it created a strain on the inspection process in which the regulatory team felt unwelcomed.
Upon reviewing the I/S policy after the inspection, it was suggested to resolve future issues, while satisfying regulatory/legal (HIPPA) demands and revising the internal policy and procedures, to provide 5 generic signons for future inspection teams. The naming convention would be as the following:
Inspector, User1
Inspector, User2
Inspector, User3
Inspector, User4
Inspector, User5
The user names and initial passwords would be provided to the hospital’s quality department for future use. When future inspectors arrived, they would sign the hospital’s “security access” agreement and be assigned one of the 5 signons. A logbook would be kept with the inspector’s name, which id the inspector was given and which regulatory organization the inspector was representing at the time of the inspection. The logbook and security agreements would be kept on file within the hospital’s quality department. Once the inspection was over, the Quality department would change the passwords for each signon to protect from the inspectors accessing outside their inspection requirements. Routine audit trails would be performed to ensure the signon are only being used during inspections by the appropriate individuals.
The hospital’s I/S department denied the request and stated it violated HIPPA regulations, but were unable to provide which requirement it violated.
History:
This is the 1st year the hospital fully implemented an EHR, so they were able to provide paper copies for inspectors in the past.
Hospital users are unable to provide their signon and/or passwords to inspectors due to the security agreement they signed at employment.
QUESTIONS
Think about the case study:
Were there any HIPPA violations in the initial “quick resolution” to provide the inspectors signons?
Are there any HIPPA violations being violated in the suggested future resolution suggestion?
Are there any Ethical issues with either incident (initial or purposed)?
Did the I/S department due their due diligence in investigating the suggested resolution? Why/why not?What should they had done?
What other suggestion would you have to satisfy the dilemma the hospital is facing.
As the CIO of the Hospital, how would you handle the issue?
YOU CAN LOOK : HEALTH INFORMATION MANAGMENT 4TH EDITION TEXTBOOK Editors: Kathleen M
Explanation / Answer
a)
As per the stated case, inspection team were of the view that they had regulatery agreements with the hospital wherein they were permitted to review any patient's chart. However, hospital adminstration considered as a complete violation under Health Insurance Portability and Accountability Act and hence deicded to revise hospital's internal policies and procedures.
b)
When the hospital management revised the hospital's internal policies and procedures and came up with 5 genric signons for future inspection teams, the inspection team were found violating some of the HIPPA regulations. The quality audit team conducted a quality check of the hospital's new policies and procedures and found some of the deviations with the inspection team. The quality check team were not able to detect specific HIPPA vilolation.
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