Introduction
Healthcare administration in America is in the process of change. The changes affecting how healthcare institutions handle patient data are not new. Traditionally, healthcare providers were expected to handle patient data confidentially. In the recent years, the challenge of maintaining confidentiality has become greater. The main contributor towards this situation is the use of information technology in the treatment process. This paper reviews a case in which a healthcare provider was forced to pay a fine of 275,000 dollars to settle claims made against it because of a confidentiality breach. The main claim against the hospital is that one of its administrators sent confidential information about a patient to almost 800 of its employees on email.
Overview of the Article
Prime Healthcare Service Inc. is one of the largest healthcare facilities in America. It runs a chain of 23 healthcare facilities in different part of America. An article written by Lance Williams, who is a senior reporter for the Center for Investigative Reporting, indicated that the healthcare chain had chosen to pay 275,000 dollars to settle breach of privacy allegations made against it (Williams, 2013). The specific case in the article related to an incident in which one of the senior managers of the hospital sent an email that contained confidential information about a patient to about 800 employees of the hospital (Williams, 2013). The hospital was using the email to undercut an investigative reporting project that was seeking to find out whether the hospital was using aggressive Medicare billing practices (Williams, 2013).
The report further stated the hospital was under investigation by federal authorities in relation to its billing practices. In this regard, the hospital decided to pay the money to federal authorities in order to halt the investigations. However, the hospital accepted no wrongdoing in the entire issue. The patient in question had raised the flag regarding the hospital’s aggressive billing practices after she was billed for Kwashiorkor treatment. Kwashiorkor is very rare in America. The Centre for Investigative Reporting decided to investigate the hospital because it had an inordinate number of Kwashiorkor cases. This issue also raised the interest of federal regulators. Apart from the Kwashiorkor cases, the hospital has been claiming large reimbursements for treating several rare ailments (Williams, 2013). This trend is what led to investigations by the Center for Investigative Journalism to find out whether the hospital was claiming money for services it had not rendered, or whether there were outbreaks of rare diseases in the hospital.
Confidentiality in Medical Care
Confidentiality is a central feature of medical care. This practice is not new. However, confidentiality is also a central tenet in the practice of other professions such as law. The motivation for maintaining confidentiality in these professions is that it improves the quality of services that clients receive. For instance, a client is likely to tell his lawyer the truth if the lawyer will not divulge potentially damaging information to other people. Understanding the reality helps a lawyer to frame his defense on behalf of the client. In healthcare, confidentiality is even more crucial because of the ramifications a leaked medical report can have on a patient. Patients deliberately choose to be open with their healthcare providers in order to get the best medical care (Ulmer, 2010). If a patient knew that personal information such as their HIV status would be divulged to other people, then very few people would be ready to go for HIV tests. The public health impacts of such a situation would be devastating.
Confidentiality is becoming difficult to maintain today because of the adoption of information technology in information storage and retrieval (Ulmer, 2010). In the case under review, the information sent to the employees reached them via email. Email is almost instantaneous and can be resent very easily. This means that a mishap in the process of data collection and transmission can result in the sending of information to unwanted parties. The consequences can be very expensive as the case under review illustrates.
Ethical and Legal Issues Reported in the Article
The ethical issues raised in the article are as follows. The first issue is the sharing of patient information with unauthorized persons. Even though the email was sent to employees of the hospital, there was no way of controlling what each of these employees would do with the message. Secondly, the hospital was accused of aggressive billing. This raises the question of whether the hospital’s primary concern is the provision of healthcare, or otherwise. Aggressive billing usually suggests a strong profit motive. The third ethical issue that arises from the case is whether there was financial impropriety in the hospital because of its efforts to get reimbursements for treating ailments that patients did not have.
The legal issues that arose in the case were related to the ethical ones already raised. Federal healthcare standards demand privacy and confidentiality in the provision of healthcare, and the in the management of health records. Therefore, the breach of privacy laws is both an ethical and legal issue. Secondly, while there is no law that forbids private healthcare facilities from making a profit, very huge profits are not ethically acceptable. The legal issue that arises from an evaluation of the books of the hospital is whether the hospital was seeking reimbursements in a fraudulent manner. A good example here is the high number of patients treated for Kwashiorkor without the knowledge that they had the ailment.
Proposed Solution to Patient Confidentiality
Managerial responsibilities in regards to ethical issues are varied. In this case, the problematic email originated from one of the senior managers. One of the people with the responsibility of enforcing ethical standards was the one who violated the ethical obligations of the hospital. Normally, the administrators of a healthcare institution are responsible for the enforcement of ethical standards in the provision of healthcare (Niles, 2010). In the case reviewed, this role was in conflict with the need to ensure that the hospitals image was not tainted by the claims against the hospital. The result is the denial of wrongdoing, but coupled with the willingness to pay a fine to halt investigations.
While the hospital can pay a fine as a means of accepting responsibility for its ethical shortcomings, it is not proper for it to escape legal liability if it is on the wrong. The fine imposed robs the public of the opportunity to know whether the hospital is actually responsible for the claims made against it. A full inquiry in public interest would have been the best way of settling the liability issues raised against the hospital. As it stands, the facility did not accept any wrongdoing in its part. An inquiry would have helped stakeholders to know whether the hospital was guilty of any wrongdoing.
Reference
Niles, N. J. (2010). Basics of the U.S. Healthcare System. Sadbury, MA: Jones & Bartlett Learning.
Ulmer, C. (2010). Future Directions for the National Healthcare Quality and Disparities Reports. Washington DC: National Academies Press.
Williams, L. (2013). Hospital Chain to Pay $275,000 to Settle Federal Patient-privacy Case. Web.