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The student discussion
Patient Mark Knox and his family came into see Dr. Angela Smith for a follow up visit. During the visit, she gets an urgent phone call regarding a STAT lab result on a different patient. She asks the patient and family if she can take this call. The lab tech, Kathy, asks to confirm that she is the ordering physician, which she responded ‘Yes’ to, and then proceeded to relay the medical record number. The doctor enters the medical record number and then says out loud, “Oh, this is for John Donnelly, I see the result now.” At the same time Dr. Smith is still in the room, pulling up the information on the computer which sits next to the patient, Mr. Knox. The doctor realizes that this needs immediate action and needs to call the other family right now. The doctor excuses herself and lets the patient and family know that she will be right back. Before the doctor leaves the room, she logs off the EMR and closes the window screen completely.

The correct use of health information in this scenario is when Kathy the lab tech relayed the medical record number to the doctor. This is an example of PHI used correctly between the patients’ healthcare team. The other example that demonstrated the correct use of health information was when the doctor logged off of the EMR before she left the room. This was an example of PHI and HIPPA, it ensured that the patient in the room can’t have access to the patient’s file or anyone else file when the doctor left the room. The incorrect use of health information is when Dr. Smith said the patient’s name out loud and was viewing the other patients chart while in the same room as Mr. Knox and his family, this violated HIPPA and PHI of the patient, John Donnelly. At this point Mr. Knox knew that there was something serious with the patient John Donnelly. If this Mr. Knox ended up knowing John Donnelly, this would bring on even more privacy issues. It also doesn’t give the patient much confidence in the doctor if she is willing to relay other patient information in front of anyone.

According to the American Medical Association (2017), HIPPA privacy and security rules are enforced by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR). If the HIPPA violation was done unknowingly, then there is a $100 fine per violation with annual maximum of $25,000 for repeat violations or it can exceed to a maximum $50,000 per violation. If the HIPPA violation was done with reasonable cause then the minimum penalty is $1,000 per violation or the maximum is $50,000. If its willful neglect but violation is corrected within the required time period then its $10,000 per violation, and maximum penalty of $50,000 per violation. If its willful neglect and is not corrected within required time period then its $50,000 per violation with an annual maximum of $1.5 million (HIPPA Violations & Enforcements, 2017). The criminal penalties can include imprisonment up to 1-10 years. Recommendation is to use the PIA (Privacy Impact Assessments) to avoid further violations in patient privacy.


HIPPA Violations & Enforcement (2017). Retrieved from https://www.ama-assn.org/practice-management/hipaa-violations-enforcement

McGonigle, D., Mastrian, K.G. (2015). Nursing informatics and the foundation of knowledge.

(Third edition). Burlington, Mass: Jones & Bartlett Learning.

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