Case #4: Dentist Revises Process to Safeguard Medical Alert PHI
Covered Entity: Health Care Provider
Issue: Safeguards, Minimum Necessary
Plaintiff: Several patients
Defendant: AU Bright Smiles Dental
An OCR investigation confirmed allegations that a dental practice, AU Bright Smiles Dental, flagged some of its medical records with a red sticker with the word “AIDS” on the outside cover and that records were handled so that other patients and staff without the need to know, could read the sticker.
Legal Violations:
- Privacy Act of 1974 (One shall not disclose patient information to any other person or company without written consent from the individual) – these standards were violated by public markers with the word “AIDS” written on red dots. In doing so, this information was easily disclosed to the waiting room patients who could identify the patients that have been diagnosed with AIDS.
- HIPAA breach (The subtitle that affects health information privacy within HIPAA is known as Administrative Simplification- regulations based on this subtitle are divided into the privacy rule, restricts the use of personal health information without the patient’s consent)
- My Personal Health Information was not secured and was openly visible to other patients who could see my results and circulate my medical history within the community
- This in turn can affect my livelihood such as job opportunities and relationships with others, even though discrimination (be it medical or otherwise) should never have a place in society
- Other factors that could negatively impact the plaintiff due to these careless practices would include a stigma whereby individuals could choose not to associate with me based on my prognosis. This in turn could then lead to depression/isolation of the patient.
- A corrective action plan should include monitoring by the Office for Civil Rights (OCR) for compliance with HIPAA regulations
- Employees need to be given proper training on how to organize files with patient information while running risk assessments monthly to ensure the practice is adhering to Minimum Necessary Standard
- Based on these practices, trust has been broken, therefore word of mouth is compromised for this company
- In conclusion, the relationship with AU Bright Smiles Dental will be terminated due to not feeling secure or valued by the medical professional team
From the Ethical Standpoint regarding this court case:
- Using a sticker on the outside of a patient file goes against the Code of Ethics which establishes behavior expectations that an organization has for its employees and third parties
- Another system such as files becoming paperless would be a better alternative
- The company should consider moving to electronic health records (EHR) with a tablet-based system. For example: when the medical professional calls a patient back to the exam room, the tablet would be faced towards them and out of sight for the patients in the waiting room to view.
- The Mission and vision statement of AU Bright Smiles Dental states that family and their rights come first). This was ultimately compromised through failure to keep patient records confidential
- Regardless of changes made, AU Bright Smiles Dental should be held accountable for their actions
- They need to work on keeping the relationships they do have or else they run the risk of being shut down and put out of business
Solution
Case #4: Dentist Revises Process to Safeguard Medical Alert PHI
Juror 1- Here, I am the juror to case #4 Dentist Revises Process to Safeguard Medical Alert PHI. Being a juror, I have to take a stand in order to understand the case from both ends in order to give a clear justification for the violation complained by the plaintiff and how the defendant is actually trying to remove the complaint. Thus, this case moves with the allegation made prior to the OCR investigation that confirms the allegations made on the dental practices, to the AU Bright Smiles Dental, which is flagged with some medical records, based on the red stickers with the word “AIDS”, on its outside cover, and this record is handled with because the patients and the staffs shall learn and read from the sticker attached. Being the juror I would like to mention that the information on the note of the red sticker used at a dentist’s chamber can never be abnormal, as this is like spreading awareness among the people about the destructiveness caused due to AIDS. Hence, lastly, on the last note, I would like to mention that as the sticker is placed outside the dental clinic, none of the patients can overlook it, hence, can identify the various patients dealing with Autoimmune diseases. Therefore, a law that is created is based on protecting the patient’s sensitive as well as personal information. Therefore, here, I shall stand for the defendant because, the defendant has given a proper idea, in order to make improvements in placing the red stickers in order to proceed with the awareness that contains the name of the patients, from the front record, which does not violate the HIPAA or the Privacy Act 1974.
I agree that this sticker allows the dental assistant, the staff, the dentist as well as the patients to learn about internal hygiene, to make awareness of possible exposure and the risk which is associated with the patients. Apart from this, this sticker is very important, it requires to be placed everywhere, be it a veterinary place or outside the dentist, because, this sticker, does not make the patient feel discriminated, but this helps them to take pre-precautions in order to cure themselves of this disease and shall get better treatment and care. Thus, witnesses have given the idea that identifiers that mostly include allergies, diseases, and certain conditions based on a widespread practice due to the harm caused by AIDS, are required to spread awareness within the hospital, and among the medical staff, so that they can spread awareness among the common mass. Hereafter, the staff is required to continue with their potential risk for patient safety. Thus, as stated by the AU Bright Smiles Dental, was mainly introduced to give significance to patient privacy and provide training in order to avoid potential exposure. Thus, I really liked that AU Bright Smiles Dental has taken up the initiatives so that they can develop their staff skills, and can educate them with their best practices so that the patients can get good safety on a dental basis. Apart from this, on my part, I would like to mention this clinic ensures moving towards electronic health records along with something that has yet not been done based on the transition to learning about the potential technological risk. Therefore, as the defendant mentioned that in case of the electronic health records based on the transition can be costly enough, with the implementation of new equipment as well as training the latest software.
On the other hand, the defendant even mentioned Nicholas Terry’s article, which was titled “Legal perspectives in bioethics”, often quotes that there shall be no doubt on the electronic health records while maintaining digitization on a personal note, with medical information which is often beneficial for the technology which is introduced in order to make improvements in the quality in order to give more care while reducing the cost in medical errors. However, the potential cost is associated with the transition that is formed by the organization, to take up a proactive measure in order to ensure the privacy of the patients, with their plan in case of new records, as they provide an informative fact, that assures about their quality treatment given to the patients along with improvements that they made based on the red sticker of AIDS made outside the dental clinic, which is very significant for patients.
References
Bustillos, D., & Vellek, S. (2019). Health care ethics and medical law. Bridgepoint Education.
The Health Insurance Portability and Accountability Act Download The Health Insurance Portability and Accountability Act (HIPAA). Washington, D.C.: U.S. Dept. of Labor, Employee Benefits Security Administration.
U.S. Centers for Medicare and Medicaid Services. (2021). Electronic health records. CMS. Retrieved from https://www.cms.gov/Medicare/E-Health/EHealthRecords [Retrieved on 9th January 2022]
