Solution Manual For Legal and Ethical Aspects of Health Information Management, 5th Edition Dana C. McWay Chapter 1-15(With Appendix A B) Legal & Ethical Aspects of HIM, 5th ed. by Dana C. Mc Way TO THE INSTRUCTOR This Instructor’s Manual complements the textbook Legal Aspects of Health Information Management, fifth edition. The textbook closely follows the 2018 curriculum models established by the American Health Information Management Association (AHIMA) for the baccalaureate degree (HIA) and associate degree (HIT) programs. The domains, competencies, and curricular guidance for both programs have been incorporated into the textbook chapters, and instructors may determine the emphasis level of each chapter when teaching during the semester. A curriculum crosswalk is included for both the programs in each chapter of the Instructor’s Manual.
ORGANIZATION Lesson Plans: Teaching Exercises, Critical Thinking, and Answer Key for Review Questions and Case Studies The manual is organized by chapter to optimize lesson planning. A chapter summary provides a concise recap of materials covered in the textbook. The activities discussed in this manual are designed to deepen the student’s understanding of the material in the text and its application to their lives, both within and beyond the classroom walls. Each teaching exercise is identified at the beginning with a corresponding skill level, using the competency levels established by AHIMA and Bloom’s Taxonomy of Cognitive Skills as reference points. The manual addresses the critical thinking exercises found in each chapter of the textbook, providing thoughts for both the student and instructor to consider when responding to these exercises. The manual also contains the answer key for the review questions located at the end of each textbook chapter along with thoughts to consider for each case study.
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CONTENTS
CHAPTER 1
Workings of the American Legal System .............................................................................. 1
CHAPTER 2
Court Systems and Legal Procedures ...................................................................................... 6
CHAPTER 3
Judicial Process of Health Information ................................................................................. 10
CHAPTER 4
Principles of Liability ............................................................................................................ 14
CHAPTER 5
Ethical Standards ................................................................................................................... 18
CHAPTER 6
Ethical Decisions and Challenges ......................................................................................... 21
CHAPTER 7
Bioethical Issues .................................................................................................................... 26
CHAPTER 8
Patient Record Requirements ................................................................................................ 29
CHAPTER 9
Confidentiality and Informed Consent .................................................................................. 35
CHAPTER 10 Access to Health Information ................................................................................................ 39 CHAPTER 11 Specialized Patient Records .................................................................................................. 44 CHAPTER 12 Risk Management, Quality Management, and Utilization Management .............................. 50 CHAPTER 13 Information Systems .............................................................................................................. 55 CHAPTER 14 Health Care Fraud and Abuse................................................................................................ 60 CHAPTER 15 Law and Ethics in the Workplace .......................................................................................... 64 APPENDIX A Legal Scenarios ..................................................................................................................... 67 APPENDIX B Ethical Scenarios ................................................................................................................... 69
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CHAPTER 2 Court Systems and Legal Procedures
Chapter Summary It is truly an American phenomenon that a primary method of resolving disputes in the United States is through the court system. Although alternative methods of dispute resolution increasingly are being used, filing a lawsuit has become the way many Americans deal with resolving their disputes. Understanding the court systems and the legal procedures employed to process cases through these systems will assist the health information manager in understanding the use of health information in a legal action. Curriculum Crosswalk HIA program Domain:
Health Law & Compliance Competency: Comply with legal processes impacting health information Curricular guidance:
Domain:
Health information laws and regulations HIPAA, The Joint Commission, state laws, federal laws Healthcare legal terminology Legal procedures (e.g., subpoena, depositions, discovery, eDiscovery) Admissibility of health records per Federal Rules of Evidence Business record rule and exception Certification of the legal health record Information Protection: Access, Use, Disclosure, Privacy, & Security Competency: Recommend security strategies for health information E-discovery (e.g., metadata policies) Audit triggers and tools Organizational Management & Leadership Curricular guidance:
Domain:
Competency: Facilitate fundamental leadership skills Curricular guidance:
Negotiating and influencing skills
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Domain:
Health Law & Compliance Competency: Apply legal processes impacting health information Curricular guidance:
Curricular guidance:
Healthcare legal terminology Litigation hold procedures Admissibility of health records per Federal Rules of Evidence United States court systems and legal procedures Competency: Demonstrate compliance with external forces Federal and state legislation Court order, subpoena, subpoena duces tecum, search warrant
Suggested Enrichment Activity Bloom’s Taxonomy level: Comprehension AHIMA-revised Bloom’s Taxonomy level: Understand Suggest to students that they watch the movie The Verdict. This movie focuses on a medical malpractice lawsuit. The movie depicts in a fairly accurate manner the roles of each player in a trial, various legal procedures, the problems of the legal profession, and the anguish faced by a plaintiff and a witness. Ask the students to discuss, in class or through an online discussion board, their impressions of the movie in general and how the movie compares to the information presented in this chapter.
Critical Thinking Discovery can be a wide-ranging process and encompass almost anything pertinent to a lawsuit. Using Table 2.5 as a guide, determine what type of information might be sought as part of the discovery process in the following situations: 1. A car accident 2. A business dispute 3. An employment dispute 4. Injury caused by a dangerous product
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The following are suggested considerations—students may brainstorm more ideas based on the content of Table 2.5. 1. For a car accident, one would try to discover who was involved in the accident; whether there was a police report; were there any witnesses to the accident; what those witnesses saw and where those witnesses were positioned; and whether those involved in the accident said anything to each other or other persons. 2. For a business dispute, one would try to discover any documents relating to the dispute; examine any accounting records; and determine whether there were any business meetings related to the dispute (identifying who attended the meetings and whether minutes were taken). 3. For an employment dispute, one would try to discover how the business makes employment-related decisions; who is involved in those decisions; what standards are used to convey employment-related decisions to employees; and if the business has an employee handbook, which may provide the employee with certain rights. 4. For an injury caused by a dangerous product, one would try to discover how the company made the dangerous product and how the company decided what to disclose about any danger involved in the product it sold.
Critical Thinking Responding to e-discovery requests in the health care context may depend on gathering data from multiple components of a health care institution. Examine what difficulties could be present if all aspects of a patient’s care encounter in a hospital are created and stored by different departments electronically as opposed to held centrally in the patient’s electronic health record. Examples to consider include the following: 1. Radiology imaging systems 2. Fetal monitor data 3. Patient registration systems
Things to Consider Whenever patient data is not stored centrally in the electronic health record (EHR), numerous challenges arise regarding how to coordinate efforts across multiple departments and with persons who have multiple priorities. The three examples in the Critical Thinking exercise sometimes are not integrated fully into an EHR, but other examples may exist and students may be able to brainstorm other examples. The first challenge is to identify what other electronic systems contain patient-related data so that this data can be preserved pursuant to e-discovery requirements. The second challenge involves making certain policies and procedures exist to preserve the data in these other electronic systems so that they are not autodeleted on a scheduled basis. The third challenge is to coordinate with the separate departments when an ediscovery request is received so that the litigation hold is implemented promptly. The last challenge is to produce the data not being held centrally in the EHR that is the subject of the discovery request in a manner that is usable for the requestor. Ideally, the solution to this set of challenges is to have all patient-related data integrated in the EHR so this exercise becomes unnecessary.
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