Critical issues in health care

HCA 3302, Critical Issues in Health Care 1

Course Learning Outcomes for Unit IV

Upon completion of this unit, students should be able to:

2. Defend an opinion on critical issues facing the U.S. health care system in the 21st century.
2.1 Discuss how health care ethics committees work.
2.2 Explain how ethics are applied to critical health care issues.

6. Summarize the government’s impact on health care regulations and reform.

6.1 Discuss critical issues regarding U.S. health care reform.

Course/Unit
Learning Outcomes

Learning Activity

2.1, 2.2

Unit Lesson
Chapter 6
Chapter 11
Unit IV Essay

6.1

Unit Lesson
Chapter 6
Chapter 11
Unit IV Essay

Required Unit Resources

Chapter 6: Healthcare Ethics Committees: Roles, Memberships, Structure, and Difficulties

Chapter 11: A New Era of Health Care: The Ethics of Healthcare Reform

Unit Lesson

In this unit, we will discuss critical issues for health care organizations. Specifically, we will learn about health
care ethics committees: roles, memberships, structure, and difficulties. We will also discuss the ethics of
health care reform.

Ethics Committees

Health care is in an era of intense change, including the uncertainty of the Affordable Care Act of 2010; the
demand for technology; and changing demographics which all pose service, ethical, and fiscal challenges
(Morrison & Furlong, 2019). The engagement of ethics committees in both clinical and policy roles can help a
health care organization meet these intense demands and changes. Traditionally, a health care organization’s
ethics committee had the roles of case consultation, policy development assistance, and education, but each
of these roles needs to be expanded to meet the challenges that a health care organization may face
(Morrison & Furlong, 2019).

Situations involving health care organizations, clinicians, patients, and families often involve difficult decisions
and raise ethically challenging questions regarding the appropriate course of action (American Medical
Association [AMA], n.d.). Ethics committees can assist with decisions regarding informed consent, organ
procurement, withholding or withdrawing life-sustaining treatments, and advance directives. Ethics
committees also can assist with educating health care providers and patients about various issues in clinical
ethics (Pearlman, 2013). In this type of situation, ethics committees provide assistance in making decisions
that reflect the patients’ interests, concerns, and values (AMA, n.d.).

UNIT IV STUDY GUIDE
Critical Issues for Health
Care Organizations

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Around the 1970s, ethics committees for patient care began to develop. In 1992, the Joint Commission on
Accreditation of Healthcare Organizations (JCAHO) was established because of a need for health care
organizations to have a standard means of addressing ethical issues and conflict (Morrison & Furlong, 2014).

Hospital ethics committees have three main functions:

1. to create procedures and policies;
2. to train and educate staff; and
3. to conduct clinical consultations.

Individuals with a wide range of expertise and backgrounds often make up ethics committees. It is important
for the members of the ethics committee to be diverse because this is effective in decision-making (Morrison
& Furlong, 2014). The members of ethics committees often include administrators, bioethicists, hospital board
members, and clinicians.

Ethics committees began in response to difficult patient issues. Issues in health care relating to ethics happen
all throughout a health care organization. On a daily basis, hospital administrators and clinicians are
challenged with making difficult health care decisions, which increases the demand for ethical oversight. Due
to this, health care organizations must maintain and hire staff who are well-versed in ethical principles and
practices. Health care organizations react to changes in health care policies and patient care guidelines
through ethics committees. The health care administrator has the job of ensuring ethical integrity throughout
the health care organization. At the clinical level, areas of ethical concern include patient autonomy,
confidentiality, informed consent, treatment termination, and advance consent (Morrison & Furlong, 2014).
The clinical level is where the majority of ethical issues in a health care organization occur.

Derived from ethical decision-making principles and legal and clinical practices, guidelines are used for
treatment termination. Through the ethical principle of autonomy, patients have the right to decide their
treatment plans or choose alternative methods of care. Issues do arise when inappropriate treatment is
demanded by patients.

According to the University of Washington School of Medicine’s Robert Pearlman (2013), traditional ethics
committees should have the following goals:

• uphold the rights of patients, fair policies, and procedures,
• support shared decision-making between health care providers and patients; and
• improve the ethical environment for health care organizations.

Health Care Reform

Health care reform has substantial implications for the future of the society in the United States and its
economic life (Sade, 2012). Health care reform is the governmental policies that aim to implement changes
through the methods of delivering health care services. The main objectives for health care reform are to
advance health care outcomes, increase the quality and value of health hcare services offered, and control
the spending by the United States government.

In order to improve health care outcomes for all individuals, ethical principles should be included in health
care reform. This includes vulnerable populations. Ethical principles, as discussed in earlier units, can be
applied to health care reform. Nonmaleficence cannot happen in a health care organization if there are
individuals who are not insured. Beneficence can be observed by populations who are not covered by
insurance (Morrison & Furlong, 2014). Other ethical principles that have impacted health care reform are
autonomy versus paternalism and distributive justice. Disadvantaged individuals tend to be high utilizers of
health care services.

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Patient Protection and Affordable Care Act

Individuals do not have a constitutional right to health care, as it is not written in the U.S. Constitution. The
federal government, however, does have the authority to collect taxes and regulate interstate commerce, and
this is how both Medicaid and Medicare are funded. Federal and state funding both contribute to Medicaid,
while Medicare is based only on federal funding. In 2010, President Barack Obama signed the Patient
Protection and Affordable Care Act (ACA), also known as Obamacare, into law. The primary goals of the ACA
were to grow the number of insured individuals in the United States, improve the quality of health care
offered, and reduce the costs associated with health care services (Manchikanti et al. 2017).

There are several key requirements of ACA:

• Medicaid eligibility for adults who do not have children,
• personal insurance requirements for legal immigrants and U.S. citizens,
• preventative health care services that have no co-pays, and
• private and public health insurance with no preexisting conditions clauses.

The ACA of 2010 created ethical arguments over several controversial topics. The ACA was deemed by
many to be unethical because the act required U.S. citizens to have health insurance and many individuals
believed that ACA was a violation of their right to choose. Some religious traditions include health care as a
right; however, many people argue that health and health care are social goods (Morrison & Furlong, 2019).
Due to the ethical debates surrounding the ACA, health care reform is still a very large topic at the forefront
today.

Since the passing of the ACA in 2010, the ACA has been applauded for increasing the number of insured
individuals in the United States. The majority of the expansion of people insured was because of Medicaid
enrollment. But the ACA has not worked well for the working and middle classes who receive much less
government support (Manchikanti et al., 2017). This has caused the enrollment in the health care marketplace
exchange to be lower than anticipated and has lowered the number of people accepting health benefits from
an employer. Further, the ACA widened the gap between patients who are actually receiving health care and
those having the ability to pay for health care (Manchikanti et al., 2017).

Tax Cut and Jobs Act

In 2017, President Donald Trump signed the Tax Cut and Jobs Act of 2017 (Tax Act). Part of this act took
effect January 1, 2018; however, the portion that affects health care coverage and the ACA were delayed until
2019 (Domenick, 2017). The Tax Act eliminated the individual mandate penalties of the ACA, and the
government will no longer collect individual mandate penalties if a person does not have health care
insurance coverage in 2019 and after. This does not mean that there is not a requirement for individuals to
have health care insurance; however, without penalties, there is no enforcement (Domenick, 2017).

We the Economy

For an example of patient cost in the United States health care system, please review the video: We the
Economy: This Won’t Hurt a Bit!-Why Is Healthcare So Expensive?

The transcript for this video can be found by clicking on “Transcript” in the gray bar to the right of the video in
the Films on Demand database.

Conclusion

Ethics committee members must also be well-versed in ethical principles and complex decision-making
(Morrison & Furlong, 2014). Patients and their families play a vital role in addressing health care matters and
reform and should have ethics committee representation.

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References

American Medical Association. (n.d.). Ethics committees in health care institutions. https://www.ama-

assn.org/delivering-care/ethics/ethics-committees-health-care-institutions.

Domenick, L. (2017). 2019 repeal of the Affordable Care Act’s individual mandate penalties. Holland & Hart.

https://www.hollandhart.com/2019-repeal-of-the-affordable-care-acts-individual-mandate-penalties

Manchikanti, L., Helm, S., Benyamin, R. M., & Hirsch, J. A. (2017). A critical analysis of Obamacare:

Affordable care or insurance for many and coverage for few? Pain Physician, 20(3), 111–138.
https://www.painphysicianjournal.com/linkout?issn=1533-3159&vol=20&page=111

Morrison, E. E., & Furlong, B. (Eds.). (2014). Health care ethics: Critical issues for the 21st century (3rd ed.).

Jones & Bartlett Learning.

Morrison, E. E., & Furlong, B. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (4th ed.).

Jones & Bartlett Learning.

Pearlman, R. A. (2013). Ethics committees and consultation. University of Washington.

https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/detail/64

Sade, R. M. (2012). Health care reform: Ethical foundations, policy, and law. Journal of the American College

of Surgeons, 215(2), 286–296.

HCA 3302, Critical Issues in Health Care 1

Course Learning Outcomes for Unit VI

Upon completion of this unit, students should be able to:

4. Summarize the differences between various health care providers.
4.1 Examine guidelines that health care providers need to follow.
4.2 Summarize various epidemics that health care providers have faced.

Course/Unit

Learning Outcomes
Learning Activity

4.1, 4.2

Unit Lesson
Chapter 9
Chapter 13
Unit VI Scholarly Activity

Required Unit Resources

Chapter 9: Ethics and Safe Patient Handling and Mobility

Chapter 13: The Ethics of Epidemics

Unit Lesson

In this unit, we will discuss problems and ethical concerns surrounding safe patient handling and mobility. We
will also discuss health epidemics and various health care provider roles.

Health Care Provider Roles

In the health care field, there are many different roles and responsibilities that make up a care team and help
a health care organization function properly. Physicians play a pivotal role in the delivery of health care
services and products. Physicians are trusted health care partners who are held to high ethical standards.
However, physicians are often faced with making difficult health care decisions that may be outside of ethical
norms.

A primary care provider, also known as a PCP, is a health care provider who manages overall health; patients
see their PCP for checkups and health problems. Within the PCP category are doctors of osteopathic
medicine and medical doctors. Breaking it down further, PCPs include obstetrician/gynecologists, nurse
practitioners, and physician assistants (MedlinePlus, n.d.). Outside of primary care providers, there are also
several specialty care providers such as cardiologists, dermatologists, hematologists, and neurologists.

As part of a health care organization and care team, there are also nursing professionals. There are licensed
practical nurses, advanced practice nurses, registered nurses, certified registered anesthetists, clinical nurse
specialists, and certified nurse midwives (MedlinePlus, n.d.).

UNIT VI STUDY GUIDE
The Clinical Factor

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Safe Patient Handling and Mobility

Safe patient handling and mobility causes professional, legal, safety, and ethical concerns for health care
providers as well as patients and their family members (Morrison & Furlong, 2019). For example, associations
like the National Institute for Occupational Safety and Health (NIOSH), the Nurses Strategic Action Team of
the American Nurses Association, and regulations like the Occupational Safety and Health Act (OSH Act)
have all created guidelines and standards to help diffuse health care provider concerns regarding safe patient
handling (Morrison & Furlong, 2019). Musculoskeletal injuries from overexertion of health care providers are
among the highest in the United States (Centers for Disease Control and Prevention [CDC], n.d.-e). For
instance, NIOSH provides recommendations on a weightlifting limit of 35 pounds when transferring,
repositioning, or lifting patients, and OSHA and NIOSH have both endorsed standards relating to ergonomic
criteria (Morrison & Furlong, 2019). Various health programs and occupational safety organizations conduct
research to identify safety interventions and risk factors to prevent injuries (CDC, n.d.-e). There are also
assistive technologies that can help to ensure that patients be mobilized without harm and to avoid high risk
manual patient handling.

Epidemics

Plague: The Bubonic plague, also known as the Black Death, was an historic epidemic that affected
mammals and humans. This occurred during the Middle Ages in Europe where millions of people died. The
plague is caused by Yersinia pestis, which is a bacterium that is carried in a rodent flea. Rock squirrels,
ground squirrels, chipmunks, wood rats, prairie dogs, mice, rabbits, and voles are examples of rodents that
can be infected with the plague. If the rodent flea bites a human or mammal, the bacteria can be passed on.
The last recorded urban outbreak of the plague in the United States was in Los Angeles in 1924–1925 (CDC,
n.d.-f). The plague is still present in the western United States but more significantly in parts of Asia and
Africa. The symptoms include fever, chills, headache, and weakness, along with at least one painful and
tender swollen lymph node, called buboes (CDC, n.d.-f). The plague can be treated with modern antibiotics,
but without treatment, the bacteria can cause serious illness and even death as the bacteria spreads
throughout the body.

Cholera: An estimated 95,000 deaths and 2.9 million cases of cholera occur around the world every year.
Cholera is a bacterial infection caused by a toxigenic bacterium called Vibrio cholerae serogroup O1 or O139
(CDC, n.d.-a). Cholera is typically found and spread in regions with poor sanitation and inadequate water
treatment and hygiene. The bacterium is typically found in food or water sources that are contaminated with
feces from another individual that is infected with cholera; however, a person can contract it from eating or
drinking contaminated food and water. Cholera is a diarrheal illness that can be mild, with little to no
symptoms, or severe; about 10% of infected people will have a severe case (CDC, 2018a). Symptoms of
cholera include vomiting, diarrhea, and leg cramps, which can lead to rapid loss of fluids, dehydration, and
shock. If there is no treatment, death can occur rapidly within hours. Treatment for cholera includes the
immediate replacement of the lost fluids and salts through methods of oral rehydration solutions and
prepackaged mixes of salts and sugars with one liter of water that are ingested by the infected individual.
Antibiotics can also diminish the severity of the sickness, but rehydration is the most important step (CDC,
2018a).

Influenza: Influenza, also known as the flu, is caused by viruses: Types A and B. It causes a contagious
respiratory illness. The flu viruses infect the throat, nose, and sometimes the lungs. The symptoms of the flu
include fever, sore throat, stuffy or runny nose, body aches, cough, fatigue, headache, and sometimes
diarrhea and vomiting (CDC, n.d.-c). Compromised health individuals, children, and the elderly are at highest
risk of contracting the flu. The viruses can be spread through tiny droplets made when an infected person
sneezes, talks, or coughs. Vaccination is the best way to prevent getting the flu as individuals may spread the
flu because they may not even know that they are sick. Most cases of the flu can be treated at home, but a
health care provider should be seen if an individual is at risk of complications (Mayo Clinic, 2019). Antivirals
can also be taken within the first 48 hours after the onset of symptoms to try to reduce the length of the illness
and to prevent further complications.

Middle East Respiratory Syndrome: Middle East Respiratory Syndrome (MERS) is a respiratory illness
caused by a coronavirus called Middle East respiratory syndrome coronavirus (MERS-CoV). It was first
reported in 2012 in Saudi Arabia and has spread to several countries including the United States (CDC, n.d.-
d). Individuals infected with MERS typically develop a cough, fever, and shortness of breath, and many

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infected people die from the infection (3 out of 4 infected individuals). The illness is spread from an infected
person through close contact, but because of the new nature of this illness, not much is known about the
exact way the virus spreads. Currently there is no vaccine or specific antiviral treatment recommend for a
MERS-CoV infection (CDC, n.d.-d). Medical care can be given to help relieve symptoms of the infection.

Ebola: In 1976 near the Ebola River, Ebola virus disease (EVD) was discovered. Ebola is a deadly and rare
disease that can infect nonhuman primates and people. Ebola in humans is caused by a group of viruses with
the genus Ebolavira: Ebola virus, Sudan virus, Taï Forest virus, and Bundibugyo virus. These viruses are
mainly located in sub-Saharan Africa; however, scientists do not know the origins of the viruses (CDC, n.d.-b).
Ebola can be spread through direct contact with bodily fluids of a living or deceased infected individual or an
infected animal like a bat or nonhuman primate. Initially, an infected person does not show symptoms or signs
of having the virus. During this time, the virus cannot be spread to others until the signs and symptoms
develop; however, an infected individual will continue to be contagious after signs and symptoms subside.
Currently, there is no treatment or vaccine for Ebola, but blood transfusions from survivors is being explored
(CDC, n.d.-b).

In a health care setting, Ebola can spread very quickly; therefore, health care personal need to practice
caution and use dedicated medical equipment for treatment of Ebola-infected individuals. The proper cleaning
of instruments and the use of a U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant
is important to kill the virus (CDC, n.d.-b).

Zika: In 1947, the Zika virus was first discovered, and in 1952 the first human cases were detected. In 2015,
there was a widespread epidemic of Zika virus in Brazil, which spread to other parts of North America and
South America (CDC, 2014). Zika is a virus that is spread by several means: the bite of an infected Aedes
species mosquito, from a pregnant woman to her fetus, through sexual intercourse, or through a blood
transfusion. Infected individuals may not have symptoms or may experience mild symptoms such as a rash,
headache, fever, joint and muscle pain, or red eyes that may last for several days to a week (CDC, 2014).
Infection of a pregnant woman can cause serious birth defects, including microcephaly, stillbirth, or
miscarriage. Zika is diagnosed via a blood or urine test through a health care provider. Currently, there is no
vaccine or medicine to treat the Zika illness.

In the health care field, there are many different roles and responsibilities that make up a care team and help
a health care organization function properly. It is important for these health care providers to work together,
and follow safe patient handling and mobility practices when caring for a patient. Such guidelines also come
into play when epidemics occur.

References

Centers for Disease Control and Prevention. (n.d.-b). Ebola (Ebola virus disease): Treatment.
https://www.cdc.gov/vhf/ebola/treatment/index.html

Centers for Disease Control and Prevention. (n.d.-a). Cholera – Vibrio cholerae infection: General information.

https://www.cdc.gov/cholera/general/index.html

Centers for Disease Control and Prevention. (n.d.-c). Influenza (flu): Key facts about influenza (flu).

https://www.cdc.gov/flu/about/keyfacts.htm

Centers for Disease Control and Prevention. (n.d.-d). Middle East respiratory syndrome (MERS): Prevention

& treatment. https://www.cdc.gov/coronavirus/mers/about/prevention.html

Centers for Disease Control and Prevention. (n.d.-f). Plague: Ecology and transmission.

https://www.cdc.gov/plague/transmission/index.html

Centers for Disease Control and Prevention. (n.d.-e). The National Institute for Occupational Safety and

Health (NIOSH): Safe patient handling and mobility (SPHM).
https://www.cdc.gov/niosh/topics/safepatient/default.html

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Centers for Disease Control and Prevention. (2014). Zika virus: Overview.
https://www.cdc.gov/zika/about/overview.html

Mayo Clinic. (2019). Influenza (flu): Overview. https://www.mayoclinic.org/diseases-conditions/flu/symptoms-

causes/syc-20351719

MedlinePlus. (n.d.). Types of health care providers. https://medlineplus.gov/ency/article/001933.htm

Morrison, E. E., & Furlong, B. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (3rd ed.).

Jones & Bartlett Learning.

HCA 3302, Critical Issues in Health Care 1

Course Learning Outcomes for Unit V

Upon completion of this unit, students should be able to:

5. Explain the impact of technology on the health care industry.
5.1 Identify a specific health technology, the financial implications, and the ethical concerns of its

meaningful use.

Course/Unit
Learning Outcomes

Learning Activity

5.1

Unit Lesson
Chapter 7
Chapter 8
Unit V PowerPoint Presentation

Required Unit Resources

Chapter 7: Ethics in the Management of Health Information Systems

Chapter 8: Technological Advances in Health Care: Blessing or Ethics Nightmare?

Unit Lesson

In this unit, we will learn about health care technology. Specifically, we will discuss the ethics and laws
surrounding the management and use of health information systems and the adoption of emerging
technologies. Health information technology is intended to enhance patient care and increase the equity,
effectiveness, and efficiency of health care delivery (Morrison & Furlong, 2014). Health care organizations are
struggling to understand if the adoption of such health care technology is beneficial. Will health care
technologies improve quality, or will they result in harm?

Health Information Technology and Management

Health information technology and health information management are a large part of effective and efficient
management of health information systems, and they are essential to the accurate treatment of patients
(Morrison & Furlong, 2019). The ethical principles of fairness and justice are the main ethical concerns
regarding health information technology (Morrison & Furlong, 2014). There are serious ethical concerns that
make health care organization leadership skeptical about the benefits of health information technology
because it is a prominent tool in health care that supports multi-professional and multi-organizational
programs. Health care organizations face many challenges that include interoperability of health information
technology and communication between health care providers in addition to ethical issues that occur.
Complying with regulations, providing confidentiality while also supporting data sharing for coding and
research are a couple of examples of ethical challenges. Advances in health information technology are on
the rise, and in parallel, there are also social and ethical concerns:

• patient privacy abuses,
• inappropriate use of patient data,
• unauthorized patient consent, and
• computer peripherals assistance during procedures (Morrison & Furlong, 2014).

UNIT V STUDY GUIDE
Health Care Technology

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Health care reform has increased the need for health information technology; however, health information
technology comes at a large monetary cost. In order for health care organizations to meet quality standards
and to provide effective quality of care, the adoption of health information technology is imperative. Due to the
high expense of health information technology, health care organizations need to truly understand the
benefits of adopting these new technologies. Some health information technology benefits include increased
productivity, lowed administrative costs, and improved health outcomes.

The American Recovery and Reinvestment Act and the Health Information Technology for Economic

and Clinical Health Act

The American Recovery and Reinvestment Act (ARRA) was signed into law in February 2009 (Office of
Inspector General, n.d.). The primary objective of ARRA was to save and create jobs, but it also aimed to
provide relief and invest in infrastructure, renewable energy, health, and education (Federal Communications
Commission, 2011).

The Health Information Technology for Economic and Clinical Health Act (HITECH), which is a piece of
ARRA, supported the use of electronic health records (EHR) and meaningful use, focused on increasing the
use of a certified EHR by hospitals and providers, as well as addressed privacy and security concerns
regarding electronic health data (Office for Civil Rights [OCR], 2009a). The HITECH Act also provided funding
for the EHR incentive program, known as meaningful use. The Centers for Medicare & Medicaid Services
(CMS) and the Office of the National Coordinator for Health Information Technology manage meaningful use,
which is a set of standards that guides the use of EHRs and allows eligible health care providers and
hospitals to earn incentives if certain measures are met (Reider & Tagalicod, 2013).

Meaningful Use

Meaningful use is built on the five pillars of health outcomes policy priorities:

• increase quality, safety, efficiency, and reduce health disparities;
• engage patients and families in their health care;
• improve care coordination;
• improve population and public health; and
• safeguard privacy and security protection for personal health information (Reider & Tagalicod, 2013).

Participation in meaningful use is completely voluntary, but CMS gives an incentive payment to any eligible
provider or hospital that can demonstrate that they have engaged in adopting, implementing, or upgrading a
certified EHR. To encourage adoption of an EHR, promote innovation, and avoid the excess burden on health
care organizations, meaningful use was rolled out in three stages.

Stage 1 of meaningful use was announced in 2010 and promotes basic EHR adoption and the gathering and
sharing of health data (OCR, 2009b). Health care organizations focused on storing health information
electronically in a standardized format that is easily accessible and authorized by providers and patients. In
2014, Stage 2 of meaningful use began, and it focused on care coordination and the exchange of patient
data. Stage 3 of meaningful use began in 2015 and focused on the advance use of EHRs, health information
exchanges, and improvement to health outcomes (Agency for Healthcare Research and Quality, 2013). As
meaningful use unfolded, Stages 2 and 3 were modified.

If an eligible provider or hospital met the meaningful use criteria, it received incentive payments ranging from
$44,000 over 5 years for the Medicare providers to $63,750 over 6 years for Medicaid providers (Agency for
Health Care Research and Quality, 2013). Meaningful use has served a valuable purpose by ensuring that
money allocated from ARRA was used meaningfully and for creating a nationwide EHR infrastructure. In
2016, more than 95% of eligible hospitals accomplished meaningful use (Office of the National Coordinator
for Health Information Technology, 2016).

Prior to the passing of the HITECH Act and the start of meaningful use, adoption rates for certified EHRs were
low and slow to rise. This is believed to be because of the cost of implementation and the lack of knowledge
concerning the return on investment. According to the Journal of Health Affairs, after the HITECH Act was
passed, the EHR adoption rate increased from 3.2% to 14.2% (Alder-Milstein & Jha, 2017). However, despite

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federal government mandates, some health care organizations have opted out of the Medicare electronic
health record incentive program and have chosen reimbursement reductions instead.

The U.S. government aims to mandate health care organizations to adopt health information technologies,
like EHRs. This is in hopes to improve health care quality, doctor-patient communication, access to health
data, and the availability of provider performance data that will reduce health disparities and increase care
coordination.

Health Insurance Portability and Accountability Act

As referenced earlier, a very important act is the Health Insurance Portability and Accountability Act, also
known as HIPAA; it supports medical history and personal medical information by protecting it from any entity
not allowed to access the information. Passed by the U.S. Congress in 1996 and enforced by the Office for
Civil Rights, HIPAA aimed to ensure that workers in the United States who had previous health insurance
coverage from an employer would not have to requalify their preexisting chronic conditions when changing
employment or between jobs (OCR, 2008). This means that there is no waiting period for insurance coverage
to begin for chronic conditions. For example, when an employee with cancer changed to a new job, he or she
would not have to wait to receive care or medication, but rather, the insurance coverage would be
immediately available. HIPAA has two main rules: the Security Rule and the Privacy Rule.

First, the HIPAA Security Rule states the minimum requirements to protect electronic personal health
information. It established national standards to protect patients’ electronic health information that was
created, received, used, or maintained by a covered entity (OCR, 2009b). The Security Rule aims to secure
and protect personal health information from destruction or unlawful disclosure or intent and also outlines the
technical, physical, and administrative safeguards that a covered entity under HIPAA must implement. The
physical safeguards protect a health care organization’s structures from natural or environmental hazards
(OCR, 2009b). Safeguards protect software, hardware, and backup data that contain electronic personal
health information. Technical safeguards include protecting access to sensitive and personal health
information by having unique user identification, auto log-off, encryption, security, etc. The administrative
safeguards manage the security of electronic personal health information and the conduct of the health care
organization’s staff. The administrative safeguards require a risk analysis and an overseer of a security
program (OCR, 2009b).

The second HIPAA rule is the Standards for Privacy of Individually Identifiable Health Information, also known
as the Privacy Rule. It established a set of national standards aiming to protect personal health information
(OCR, 2008). The HIPAA Privacy Rule aims to ensure privacy of patient information in both paper and
electronic formats. It further discusses that personal health information can only be released when allowed by
the law or an authorized individual.

Conclusion

The federal government plays a large role in the use, adoption, and regulation of health information
technologies. Specifically, the government plays an active role in the security and privacy of patient medical
information through acts like HIPAA and HITECH. The security of a health care organization’s data and
information technology systems is necessary to protect the privacy of patients. Security of a health care
organization’s data and health information technology systems is necessary to protect patient privacy and
their most sensitive data. Health information technology is working prove it is beneficial to patient care and
improves quality and efficiency of services delivered to patients.

References

Adler-Milstein, J., & Jha, A. K. (2017). HITECH Act drove large gains in hospital electronic health record

adoption. Health Affairs, 36(8). https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.1651

Agency for Healthcare Research and Quality. (2013). Practice facilitation handbook: Module 17. Electronic

health records and meaningful use. https://www.ahrq.gov/professionals/prevention-chronic-
care/improve/system/pfhandbook/mod17.html

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Federal Communications Commission. (2011). American Recovery and Reinvestment Act of 2009.
https://www.fcc.gov/general/american-recovery-and-reinvestment-act-2009

Morrison, E. E., & Furlong, B. (Eds.). (2014). Health care ethics: Critical issues for the 21st century (3rd ed.).

Jones & Bartlett Learning.

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