Patient Confidentiality Statutes in Medicare & Medicaid Fraud Investigations

1987 ◽  
Vol 13 (1) ◽  
pp. 105-137
Author(s):  
Dina Khajezadeh
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Information ◽  
Medical Records ◽  
Court Decisions ◽  
Patient Records ◽  
Care Providers ◽  
Confidential Information ◽  
Right Of Privacy ◽  
Physician Patient

AbstractThe Medicare and Medicaid programs have been burdened with health care providers’ fraudulent and abusive practices since their implementation in 1965. To help states discover and prevent Medicare and Medicaid fraud, Congress has enacted statutes permitting access to patients’ medical records in investigations of fraud. The majority of states have enacted physician-patient and psychotherapist-patient privilege statutes to protect confidential information from disclosure. Thus, the state's need for patient information conflicts with the patient's right of privacy. This Note discusses several court decisions that have wrestled with the tension between these two policies. The courts, after balancing the state interest in eliminating fraud against the patient's privacy interest, have often allowed disclosure of patient medical records. Although some courts have attempted to limit the extent of the information disclosed, few have set forth explicit standards to protect patient records from unwarranted disclosure of confidential information. This Note suggests guidelines for courts, legislatures and health care providers to uniformly limit the extent of this disclosure.

scholarly journals The Use of Medical Records in Research: What Do Patients Want?

2003 ◽  
Vol 31 (3) ◽  
pp. 429-433 ◽  
Author(s):  
Nancy E. Kass ◽  
Marvin R. Natowicz ◽  
Sara Chandros Hull ◽  
Ruth R. Faden ◽  
Laura Plantinga ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Medical Information ◽  
Personal Information ◽  
National Institutes Of Health ◽  
Care Providers ◽  
Electronic Information ◽  
The Past ◽  
Growing Body

In the past ten years, there has been growing interest in and concern about protecting the privacy of personal medical information. Insofar as medical records increasingly are stored electronically, and electronic information can be shared easily and widely, there have been legislative efforts as well as scholarly analyses calling for greater privacy protections to ensure that patients can feel safe disclosing personal information to their health-care providers. At the same time, the volume of biomedical research conducted in this country continues to grow. The budget of the National Institutes of Health, for example, was $20,298 million in 2001, having more than doubled from a budget of $9,218 million 10 years before. This growing body of research includes increased efforts to use stored medical records as a source of data for health services, epidemiologic, and clinical studies.

Patient use of online medical records: an application of technology acceptance framework

2019 ◽  
Vol 28 (1) ◽  
pp. 97-115
Author(s):  
Surma Mukhopadhyay ◽  
Ramsankar Basak ◽  
Darrell Carpenter ◽  
Brian J. Reithel
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Perceived Usefulness ◽  
Security And Privacy ◽  
Care Providers ◽  
Content Type ◽  
The Us ◽  
Continued Use ◽  
Patient Use

Purpose Little is known about factors that affect patient use of online medical records (OMR). Specifically, with rising vulnerability concerns associated with security and privacy breaches, patient use of OMR requires further attention. This paper aims to investigate patient use of OMR. Using the Unified Theory of Acceptance and Use of Technology (UTAUT), factors affecting continued use of OMR were examined. Design/methodology/approach The Health Information National Trends Survey 5 (HINTS 5), Cycle 1 data were used. This is an ongoing nation-wide survey sponsored by the National Cancer Institute (NCI) of the USA. The subjects were 31-74 years old with access to the Internet. Descriptive information was projected to the US population. Findings In total, 765 respondents representing 48.7 million members of the US population were analyzed. Weighted regression results showed significant effects of perceived usefulness, visit frequency and provider encouragement on continued use of OMR while vulnerability perception was not significant. Moderating effects of these variables were also noted. Perceived usefulness and provider encouragement emerged as important predictors. Practical implications Insights may help design interventions by health-care providers and policymakers. Social implications Insights should help patient empowerment and developers with designing systems. Originality/value This is the first study to examine health-care consumers’ continued use of OMR using nationally representative data and real-world patients, many of who have one or more chronic diseases (e.g. diabetes, hypertension, asthma) or are cancer survivors. Results highlight factors helping or hindering continuing OMR use. As such, insights should help identify opportunities to increase the extent of use, project future OMR usage patterns and spread the benefits of OMR, including bringing forth positive health outcomes.

Drs. Russo and Gururaj Reply

PEDIATRICS ◽  
1976 ◽  
Vol 57 (4) ◽  
pp. 576-576
Author(s):  
Raymond M. Russo ◽  
Vymutt J. Gururaj
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Health Care Providers ◽  
Practical Importance ◽  
Outpatient Service ◽  
House Staff ◽  
Patient Records ◽  
Care Providers

The involvement of health care providers, whose patient records are to be reviewed, in evolving a set of audit criteria would appear to be an important compliance determinant. And, while its degree of importance remains to be determined, ideally all providers should be involved in creating self-audit criteria. There is, however, an issue of practical importance that arises when large staffs are to be audited, and particularly when a part of this staff is assigned only temporarily to the outpatient service, e.g., house staff officers or medical students.

scholarly journals CAM Curriculum Activities to Enhance Professionalism Training in Medical Schools

2008 ◽  
Vol 13 (2) ◽  
pp. 127-133 ◽  
Author(s):  
W.G. Elder ◽  
Carol Hustedde ◽  
Dave Rakel ◽  
Jennifer Joyce
Keyword(s):  
Health Care ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Health Care Providers ◽  
Care Providers ◽  
Health Care Education ◽  
Sense Of Competence ◽  
Professionalism Training ◽  
Physician Patient ◽  
Complementary And Alternative

Enhancing the professionalism of graduates is a major objective of most health care education institutions today. Educating conventional health care providers about complementary and alternative medicine (CAM) may directly and indirectly improve trainee professionalism by expanding trainees' knowledge and appreciation of diverse health care beliefs and practices, improving physician—patient communication, enhancing self-care, and increasing sense of competence and job satisfaction. A survey based on professional competencies proposed by the Consortium of Academic Health Centers for Integrative Medicine was administered to the grantees of the National Institutes of Health, National Center for Complementary and Alternative Medicine R-25 CAM education project initiative. The survey's aim was to identify project activities that taught professionalism skills. All projects reported curricular features that enhanced trainee professionalism, with substantial percentages of project effort directed toward professionalism-related activities.

Hospital Consent for Disclosure of Medical Records

1998 ◽  
Vol 26 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Jon F. Merz ◽  
Pamela Sankar ◽  
Simon S. Yoo
Keyword(s):  
Health Care ◽  
Child Abuse ◽  
Law Enforcement ◽  
Patient Care ◽  
Health Care Providers ◽  
Medical Records ◽  
General Rule ◽  
Care Providers ◽  
Bodily Harm ◽  
Prior Consent

Physicians and other health care providers owe ethical and legal duties to patients to maintain the secrecy of the information learned during the course of patient care. This obligation is fulfilled by limiting access to such information to only those involved in the patient's care-that is, to those within the “circle of confidentiality.” As a general rule, providers may only disclose to others with the written prior consent of the patient. Exceptions may be “ethically and legally justified because of overriding social considerations,” when permitted or compelled by law. For example, eleven states permit providers to disclose identified records to approved researchers.’ Many states compel disclosure in cases where a patient threatens serious bodily harm to another; require reporting to health or law enforcement authorities of communicable diseases, gunshot or knife wounds, or child abuse; and mandate reporting of cancer or other health care cases to state registries (such as immunization, birth, and abortion).

scholarly journals Longitudinal Health Care for Girls and Women With Turner Syndrome

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A733-A734
Author(s):  
Priyanka Ghosh ◽  
Zorkot Zeinab ◽  
Selma Feldman Witchel ◽  
Meredith Snook ◽  
Svetlana Yatsenko
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Health Outcomes ◽  
Turner Syndrome ◽  
Health Care Providers ◽  
Medical Records ◽  
Delayed Puberty ◽  
Care Providers ◽  
Monosomy X

Abstract Background Turner Syndrome (TS) is the most common chromosomal abnormality seen in females and is often diagnosed in childhood. The transition of patients with TS from pediatric to adult providers is characterized by inconsistency. As such, limited data are available to assess long term health outcomes of women with TS. Objectives: 1) To evaluate the long term health outcomes in women with TS followed at a single academic institution and 2) to establish clinical recommendations for evaluation, counseling, and planned transition of this population. Methods: A retrospective pilot study was performed by examining medical records of women with TS who presented with short stature or delayed puberty and were diagnosed with TS on the basis of cytogenetic analysis. Patients with monosomy X, mosaic monosomy X, or X chromosome structural abnormalities consistent with TS or mosaic TS diagnosis were included. Medical records from an academic children’s hospital and an affiliated women’s hospital were reviewed. Results: To date, 15 females aged 26-32 years were identified. Electronic records were available for 12/15 with age at diagnosis ranging from in utero to 15 years of age. Those with pediatric information available had documentation addressing use of growth hormone and pubertal hormone replacement therapies. Of the 12 patients, 11 had cardiac imaging performed; only one had an MRI. Consistent planned transition to adult health care providers was not evident. Of the 12 patients, 3 had consultation with a Reproductive Endocrinology and Infertility specialist; 3 had a diagnosis of anxiety or depression; 3 had a DEXA scan done (1 had osteopenia); 5 had dyslipidemia; and 2 developed insulin resistance. Conclusions: This pilot study confirms heterogeneity in practice patterns and variable interactions of women with TS with the healthcare system, especially as patients enter adulthood. Although some women were referred to subspecialists, our initial data uncover patient uncertainty about healthcare and transition recommendations. Our preliminary data indicate the need for early patient education in a collaborative, multi-disciplinary fashion. We plan to validate and extend our initial findings by reviewing additional medical records. Ultimately, we plan for expanded education, consistent surveillance recommendations, and planned transition of patients with TS from pediatrics to adult caregivers.

scholarly journals Usage Pattern Differences and Similarities of Mobile Electronic Medical Records Among Health Care Providers

2017 ◽  
Vol 5 (12) ◽  
pp. e178 ◽  
Author(s):  
Yura Lee ◽  
Yu Rang Park ◽  
Junetae Kim ◽  
Jeong Hoon Kim ◽  
Woo Sung Kim ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Medical Records ◽  
Health Care Providers ◽  
Medical Records ◽  
Usage Pattern ◽  
Care Providers

scholarly journals Supporting Heart Transplantation Aftercare through Mobile Access to Medical Records: Feasibility and Usability of the App “Phellow”

2021 ◽  
Author(s):  
Julia Müller ◽  
Lina Weinert ◽  
Laura Svensson ◽  
Rasmus Rivinius ◽  
Michael M. Kreusser ◽  
...  
Keyword(s):  
Health Care ◽  
Heart Transplantation ◽  
Health Care Providers ◽  
Outpatient Clinic ◽  
Medical Records ◽  
Routine Care ◽  
Care Providers ◽  
Mobile Access ◽  
Usability Problems ◽  
System Usability Scale

Abstract Background: Giving patients access to their medical records can improve health literacy, adherence to therapy, patients’ health-related self-care, doctor-patient communication, and quality of care. The application (app) phellow was developed to provide patients with mobile access to selected content of their medical records (i.e. physician letters, drug trough levels). It was tested at the heart transplantation (HTx) outpatient clinic at Heidelberg University Hospital among volunteer patients after heart transplantation as well as healthcare providers.Objective: The aims of this study were (1) to assess whether the phellow app can be effectively used by all users (usability) and (2) to determine if the app is feasible to be further implemented in routine care (feasibility). Methods: Usability was quantitatively measured through the System Usability Scale (SUS) among patients who actively used phellow. In addition, usability and feasibility were qualitatively measured through semi-structured guide-based interviews with patients (users, non-users) and health care providers from the HTx outpatient clinic. Quantitative data were analyzed descriptively and through correlation analyses. Qualitative data were pseudonymized, audiotaped, and transcribed verbatim. Themes were identified through thematic analysis.Results: The usability rating measured with the SUS questionnaire (N=31) was 79.9 (SD 14.1) which indicates a high usability. No statistically significant correlation was found between SUS scores and patients’ sociodemographic or phellow use characteristics. A more in-depth view on usability and feasibility was obtained from interviews with 16 patients and 7 health care providers (N=23). App appreciation, interest, and willingness-to-use were high. Tasks fit with clinic workflow and were perceived as clear. An improved technical support infrastructure, clearly defined responsibilities, and app-specific trainings were suggested for further implementation. Usability problems such as incompleteness of record, incomprehensible presentation of content, technical issues, and complex registration procedures were reported. Participants recommended usability improvements and suggested new functionalities.Conclusion: Despite some issues, usability of the phellow app was considered high. To be feasible for an implementation in routine care, usability problems should be solved. Accompanying research is crucial to monitor usability improvements and to assess effects of app use on patients and clinic workflow.

Supporting Heart Transplantation Aftercare through Mobile Access to Medical Records: Feasibility and Usability of the App “phellow” (Preprint)

2021 ◽  
Author(s):  
Julia Müller ◽  
Lina Weinert ◽  
Laura Svensson ◽  
Rasmus Rivinius ◽  
Michael M Kreusser ◽  
...  
Keyword(s):  
Health Care ◽  
Heart Transplantation ◽  
Health Care Providers ◽  
Outpatient Clinic ◽  
Medical Records ◽  
Medical Staff ◽  
Routine Care ◽  
Care Providers ◽  
Mobile Access ◽  
Usability Problems

BACKGROUND Giving patients access to their medical records can improve health literacy, adherence to therapy, patients’ health-related self-care, doctor-patient communication, and quality of care. The application (app) phellow (“personal health fellow”) was developed to provide patients with mobile access to selected content of their medical records (i.e. physician letters, drug trough levels). It was tested at the heart transplantation (HTx) outpatient clinic at Heidelberg University Hospital among volunteer patients after heart transplantation from late 2018 onward. OBJECTIVE The aims of this study were (1) to assess whether the phellow app can be effectively used by all participating parties (usability) and (2) to determine if the app is feasible to be further implemented in routine care (feasibility). METHODS Usability was quantitatively measured through the System Usability Scale (SUS) among patients who actively used phellow. In addition, usability and feasibility were qualitatively measured through semi-structured guide-based interviews with patients (users, non-users) and health care providers (medical staff, physicians) from the HTx outpatient clinic. Quantitative data were analyzed descriptively and through correlation analyses. Qualitative data were pseudonymized, audiotaped, and transcribed verbatim. Themes were identified through thematic analysis. RESULTS The usability rating measured with the SUS questionnaire (n=31) was 79,9 (SD 14,1) which indicates a high usability. No statistically significant correlation was found between SUS scores and patients’ age, gender, or frequency or duration of phellow use. A more in-depth view on usability and feasibility was obtained from interviews with 16 patients (5 non-users, 11 users) and 7 health care providers (HCPs; 4 medical staff members, 3 physicians) (n=23). App appreciation, interest, and willingness-to-use were high. Tasks fit with clinic workflow and were perceived as clear. An improved technical support infrastructure, clearly defined responsibilities, and app-specific trainings were requested for further implementation. Usability problems such as incompleteness of record, incomprehensible presentation of content, technical issues (e.g. sudden app crashes), and complex registration procedures were reported. Participants recommended usability improvements (e.g. chronically plausible presentation of record content, simplified registration and log-in) and suggested new functionalities (e.g. access to full record, communication module, appointments, medication refill requests). CONCLUSIONS Despite some usability issues, usability of the phellow app was considered high. To be feasible for an implementation in routine care, usability problems should be solved. Accompanying research is crucial to monitor usability improvements and to assess effects of app use on patients and clinic workflow.

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