Impact of regulations on healthcare organization

Health informatics professionals are required to know the laws and regulations that impact health information management. At some point in your career, you may be asked to participate in policy review or development and apply specifications included in new regulations to existing policies. You should understand how new regulations impact the healthcare organization and how best to educate staff on any changes.

This task will provide you with the “Sections of Montana Code” needed for one portion of this assessment. The codes include definitions from Montana law pertaining to the validity of consent of minor for health services (41-1-402), confidentiality of health information (50-16-603), patients’ examination and copying (50-16-541 and 50-16-542), and reasonable fees allowed (50-16-540).

Tasks in Word Document Task 1.
A. Discuss the various issues that should be considered by a healthcare organization when defining the legal health record.
B. Discuss one situation from Montana Code 41-1-402 (2a–d), pertaining to the validity of a minor for health services, which may result in criminal liability to the organization if not followed; use HIPAA’s definition of criminal liability, when you discuss your hypothetical situation.
C. Discuss one situation from Montana Code 50-16-603x (1–7) specific to health record identification that may result in a legal claim against the organization if not followed.
D. Compare three points in the Montana codes with what is stated in HIPAA laws as they refer to release of information; use Montana Codes 50-16-540, 541, 542.

Task 2
LEGAL & ETHICAL CONSIDERATIONS IN HEALTHCARE

Competency 730.3.3: Legal Aspects of Risk Management and Quality – The graduate evaluates the confluence of quality improvement and risk management practices that support favorable legal outcomes for healthcare organizations.
Competency 730.3.5: Compliance Programs – The graduate applies compliance requirements identified by government regulations and by accreditation, licensing, and certification agencies to mitigate legal risk to healthcare organizations.

Introduction:

Risk management, quality improvement, and compliance programs have discrete applications within a healthcare organization, yet they have complementary goals. The motive for these programs is to improve all aspects of the patient experience. There are external regulations and requirements imposed on all organizations, and these regulations are controlled by the internal processes designed by each organization.

There is an expectation of care and trust between patients and their healthcare providers. An organization needs to be vigilant in all circumstances, particularly those involving patient safety.

Requirements:

A. Analyze the “Compliance Management” scenario by doing the following:

1. Describe the mistakes made in this scenario step by step as they occurred.

2. Analyze whether any of the mistakes identified in part A1 were a violation of organizational compliance, a legal concern, or both.

3. Describe specific solutions the compliance officer and Sue, the manager, should implement to prevent reoccurrence of the identified mistakes from part A1.

B. Identify Health Informatics and Information Management (HIIM) areas of expertise in compliance and explain how the HIIM Department staff could assume a leadership role in teaching compliance behaviors to the clinic’s staff members to mitigate legal risk.

1. Explain the importance of staff understanding informed consent in order to ensure patient safety and trust.

2. Describe release of protected health information (PHI) and how it protects patient privacy.

C. When you use sources, include all in-text citations and references in APA format.