NUR 450 3rd Lecture - Legal and Ethical Issues in Nursing - Princess Nourah bint Abdulrahman University

College of Nursing Nursing Management and Education Department NUR 450 Legal Aspects and Ethical Issues in Profession 1st semester 1446H Lecture 3 By: Dr. Rawaih Falatah  Outline Common Health Insurance...

College of Nursing Nursing Management and Education Department NUR 450 Legal Aspects and Ethical Issues in Profession 1st semester 1446H Lecture 3 By: Dr. Rawaih Falatah  Outline Common Health Insurance Portability and Accountability Act (HIPAA) Violations and ways to avoid them Social Media guidelines Ethical Economic Issues Distributive Justice Entitlement -Fair Distribution Distribution of Resources -Theories of Justice  Introdactory video https://www.youtube.com/watch?v=DeACY_nYI8s  Common Health Insurance Portability and Accountability Act (HIPAA) Mandates the development of a centralized electronic database containing all health records for every patient in the United States as a means of administrative simplification. Before the enforcement date of this act, federal law did not fully protect patient confidentiality in medical records. Fines and penalties are included in the act to enable the Secretary to enforce the act against those who violate its provisions.  HIPAA It is important to know that: HIPAA rule applies to “covered entities.” Covered entities include health plans such as Medicare, Medicaid, and commercial health plans. Protected health information (PHI ). These are individually identifiable health information indicators, and the list includes 18 such indicators. PHI is collected from the individual by the covered entity and relate to past, present, or future physical or mental health or condition of the individual, or the past, present, or future payment for the provision of health care to an individual. Shifts the control of health information from providers to the patient by giving patients significant rights.  PHI includes the following: Name of the individual or initials; Addresses (street address, e-mail, or Internet addresses); Dates (including birth date and dates of services received); Telephone and fax numbers; Social Security or other personal identification numbers; Medical record numbers; Health plan account numbers; License or certificate numbers; Medical device identifiers; Biometric identifiers such as fingerprints or photographic images; Any other unique identifying characteristic or code.  Information Disclosure Information may be disclosed to assist in healthcare Health care facilities must provide patients with a document entitled Notice of Privacy Practices A covered entity may disclose to: Family member, other relative, or close friend of the patient, or any other person identified by the individual Law enforcement officers “in response to law enforcement requests” HIPAA standards allow information to be shared or used for Treatment, Payment, and Healthcare Operations (TPO) purposes.  In summary What is HIPAA? Health Insurance Portability and Accountability Act Purpose: Protect patient information and ensure privacy Key Components Privacy Rule Security Rule Breach Notification Rule  Violations and ways to avoid them https://www.youtube.com/watch?v=sN-zLAqYoTo  Violations and ways to avoid them Unauthorized Access to Patient Information Example: Employees accessing records without a need-to-know basis Improper Disposal of PHI (Protected Health Information) Example: Disposal of paper records without shredding Inadequate Data Encryption Example: Unencrypted email containing PHI Failure to Conduct Risk Assessments Example: Not assessing potential threats to PHI  Ways to Avoid HIPAA Violations Implement Access Controls Use role-based access controls to restrict information Regular Training and Education Conduct ongoing HIPAA training for employees Secure Disposal Methods Shred physical documents and use encryption for digital data Conduct Regular Risk Assessments Identify and address potential security risks  Social Media guidelines -‫رﺿﯾﻊ‬-‫ﺑوﺟﮫ‬-‫ﯾﻌﺑﺛن‬-‫ﻣﻣرﺿﺎت‬-‫ﺑﺎﻟﻔﯾدﯾو‬https://www.alarabiya.net/saudi-today/2018/01/02/ ‫ﺗﺗﺣرك‬-‫واﻟﺻﺣﺔ‬ https://sabq.org/saudia/c9vmgz  Social Media guidelines Guidelines to minimize negative social media impact: Craft policies and train your team Follow de-identification best practices Monitor for HIPAA violations Build a process for patient approvals Stay up to date on legislative changes Confidentiality and privacy of patient information in KSA Agancies: Ministry of Health National Health Information Center National Data Mangment Office National Cybersecurity Authority Saudi Data & AI Authoruty  Confidentiality and privacy of patient information in KSA Low, Policies, and Guidelines: MOH Bill of Right Saudi Health Information Exchange Policies Essential Cybersecurity Controls Anti-Cyber Crime Law Personal Data Protection Law  MOH Bill of Right Rights of Patients and Their Families The fourth item under this component is Privacy and Confidentiality: Providing privacy and confidentiality when discussing the patient’s treatment program, whether in person or the legal guardian. Ensuring that the patient’s private parts are covered except for what is required for treatment. Preventing disclosure, misuse, circulation or access to patient information, whether in (the medical file and medical information related to the diagnosis, analysis and treatment of any party or person without the consent of the patient or their legal guardian (except as required by the judicial authorities).  MOH Bill of Right (cont.) Preventing access to the patient’s medical file for non-members of the medical team supervising the treatment or those authorized by the management of the facility, by the patient or their guardian, or by the judicial authorities. Preventing the patient from meeting anyone who is not related to the provision of health care, including visitors.  MOH Bill of Right (cont.) Preparing places for admission, examination and medical procedures. All possible measures shall be taken to maintain privacy and covering the private parts except for what is required by the necessity of treatment. The patient shall be moved to a special room for examination if the patient’s room is not suitable, ensuring that the patient do not stay in the examination room for more than the necessary period, and making sure that a person of the same gender is present during the clinical examination or the required interventions. Providing appropriate clothing and necessary personal toiletries for the patient. Providing suitable separate waiting areas for both men and women.  National Health Information Center (cont.) 1. Saudi Health Information Exchange Authentication Policy The purpose of this policy is to ensure that systems and individuals interacting with the Saudi Health Information Exchange systems are known through the process of reliable security identification of subjects by incorporating an identifier and its authenticator. 2. Saudi Health Information Exchange Consent and Access Control Policy The purpose of this policy is to define who and how individuals and systems can access the Saudi Health Information Exchange managed data. This policy specifies means of ensuring that the resources of a data processing system can be accessed only by authorized entities (individuals or machines interacting with the Saudi Health Information Exchange system) in authorized ways. This policy also defines the circumstances in which a Subject of Care can permit or withhold the use and disclosure of the Saudi Health Information Exchange accessible health information.  National Health Information Center (cont.) 3. Saudi Health Information Exchange Information Security Policy The purpose of this policy is to ensure that the information security is conducted in a manner that protects personal health information and supports the availability, confidentiality, integrity, and accountability of the Saudi Health Information Exchange shared clinical information. 4. Saudi Health Information Exchange Identity Management Policy The purpose of this policy is to ensure that the identities of the individuals and entities interacting with the Saudi Health Information Exchange are assured to enable a data processing system to recognize entities.  National Health Information Center (cont.) 5. Saudi Health Information Exchange Audit Policy The purpose of this policy is to ensure that the security and confidentiality of Subject of Care data transmitted through the Saudi Health Information Exchange are monitored/tracked through privacy/security audits. 6. Saudi Health Information Exchange Purpose of Use Policy The purpose of this policy is to define permissible uses of the uses of the Saudi Health Information Exchange such as Patient Care, Public Health, and Quality. 7. Saudi Health Information Exchange Breach Notification Policy The purpose of this policy is to define policy surrounding identification, investigation, notification, and mitigation of a breach within the Saudi Health Information Exchange system.  National Health Information Center (cont.) 8. Saudi Health Information Exchange Subject of Care Rights Policy The purpose of this policy is to define Subjects of Care and healthcare consumer expectations that will govern the design and implementation of the Saudi Health Information Exchange Systems. 9. Saudi Health Information Exchange Secondary Use Policy The purpose of this policy is to establish the conditions, if any, under which personal health information on the Saudi Health Information Exchange may be used for purposes other than direct patient care (as defined in the Purpose of Use Policy). Essential Cybersecurity Controls  Anti-Cyber Crime Law This Law aims at combating cybercrimes by identifying such crimes and determining their punishments to ensure the following: 1. Enhancing information security. 2. Protecting rights pertaining to the legitimate use of computers and information networks. 3. Protecting public interest, morals, and common values. 4. Protecting the national economy.  References Anti-Cyber Crime Law Royal Decree No. M/17 March 27, 2007 https://sproutsocial.com/insights/hipaa-and-social-media/ Saudi Health Information Exchange Policies https://nhic.gov.sa/standards/Policies/IS0303-Saudi-Health- Information-Exchange-Policies-v1.0.pdf Saudi Data & AI Authoruty Personal Data Protection Law https://sdaia.gov.sa/en/SDAIA/about/Documents/Personal%20Data%2 0English%20V2-23April2023-%20Reviewed-.pdf