Security and Privacy of Health Information
Dramatic advance in technology has made it faster and cheaper to practice telemedicine and Telehealth. These technological advances offer the ability to capture, store, and transfer health information to one person or a billion with just the touch of a fingertip on a keyboard. This raises many troubling privacy, confidentiality and security concerns.
The health care industry’s concerns about the privacy, security and confidentiality of patient information are not unique. The financial services industry, including banks and credit cards companies, have been at the forefront of developing protections for personally identifiable financial information. Yet many consumers consider their health information to be more “private” than a bank account statement, which is routinely accessed by mortgage lenders, landlords and other third parties. Patients with chronic health problems or more serious conditions, such as cancer or HIV/AIDS, may be vulnerable to involuntary disclosure that could affect their job status or health insurance coverage.
Nurses must become conversant with these issues to not only protect their patients but themselves from inadvertently revealing patient information, and from potential criminal prosecution

Protecting a patient’s privacy and confidentiality
• Case Scenario # 1
o Consider the example of a male patient in the waiting room. He’s the only male in the room. His physician is discussing his condition- testicular cancer- with a nurse, and everyone in the waiting room can hear the conversation. What could have been done differently to protect this patient’s privacy?
• Case Scenario # 2
o Mr. Olsen, a patient in a facility, has had an adverse reaction to his medication. The nurse tries several times to reach the patient’s physician for instructions, with no success. Finally, she reaches the club where the physician is attending a social event. She asks the receptionist to tell the physician that Mr. Olsen has had an adverse reaction to his medication, and she urgently needs a call back. What should the nurse have done differently?
• Case Scenario # 3
o Susan is a nurse in the ER of a city hospital, and she has just heard through the grapevine that a fellow nurse is pregnant. The other staff members would like to give this nurse a baby shower, but nobody knows when the baby is due or whether it is a boy or girl. Susan has access to the records and could easily find the answers to both questions. Should Susan try to get the information?
Security Regulation and Electronic Information
• Case Scenario # 4
o It has been regular practice to leave the records system open and logged on at the nurses’ station computer at the end of a shift. This saves time during shift changes for the staff who need to retrieve records. Is this an allowable practice under HIPAA?
• Case Scenario # 5
o A man tells you that he is here to work on the computers. He wants your password to log on to the electronic medical record system. What do you do?
• Case Scenario # 6
o You are just coming off from work at the hospital, and a physician asked you to fax her patient’s OT (Occupational Therapy) evaluation findings to her office fax. The findings are ready, but it is after hours, and none of the physician’s staff are available to receive the fax. What do you do?

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