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Ethical Health Informatics, 3rd Edition

Book Description

Ethical Informatics is an invaluable resource for HIM, the healthcare team (nursing, physical therapy, occupational therapy et al.), information technology (IT) students (associate, baccalaureate and graduate) and practitioners. Each chapter includes ethical “real life” scenarios, a discussion of the issues, and a decision-making matrix for each scenario that facilitates an understanding of ethical ways to respond to the problem and actions that would not be considered ethical.

Table of Contents

  1. Cover Page
  2. Title Page
  3. Copyright Page
  4. Dedication
  5. Contents
  6. Contributors
  7. Foreword
  8. Preface
  9. Acknowledgments
  10. SECTION I Professional Ethics
    1. Chapter 1 Professional Values and the Code of Ethics
      1. Learning Objectives
      2. Introduction
      3. Ethical Dilemmas for the HIM Professional
        1. Coding and Financial Reimbursement
        2. Accreditation and Regulation
        3. Vendors and Software Applications
        4. Sensitive Information
        5. Research
      4. The Health Information System: Then and Now
        1. The Healthcare System
        2. Healthcare Documentation
        3. Access to Information
        4. Release of Information
        5. Coding and Reimbursement
        6. Technology
      5. Role of the HIM Professional
      6. HIM Profession and Ethical Pledge
      7. Professional Codes of Ethics
        1. AHIMA Code of Ethics
        2. Preamble
        3. Patients and the Healthcare Team
        4. Employer
        5. Public Interest
        6. Professional Associations and Peers
        7. Accountability to the AHIMA Code of Ethics
        8. Policy and Procedure
        9. Ethical Tools
        10. Consequences of Unethical Behavior
        11. American Nurses Association Code of Ethics
        12. Principles of Medical Ethics for Physicians
      8. Shared Professional Values
        1. Interprofessional Collaboration Competencies
        2. Values for Interprofessional Practice
      9. Building an Ethical Health Information System
      10. Conclusion
      11. Key Terms
      12. Chapter Summary
      13. References
      14. Appendix 1-A: 1957 Code of Ethics for the Practice of Medical Record Science
      15. Appendix 1-B: 1998 American Health Information Management Association Code of Ethics
      16. Preamble
      17. Appendix 1-C: 2011 American Health Information Management Association Code of Ethics
      18. Preamble
      19. Purpose of the American Health Information Management Association Code of Ethics
      20. The Code of Ethics and How to Interpret the Code of Ethics
        1. Principles and Guidelines
      21. The Use of the Code
      22. Code of Ethics 2011 Ethical Principles
      23. Resources
      24. Appendix 1-D: Common Values of Health Care Regulators
      25. Values of Health Care Professionals
      26. Appendix 1-E: Ethical Challenges Chapter Abstracts
      27. Professional Ethics
        1. Chapter 1: Professional Values and the Code of Ethics
        2. Chapter 2: Ethical Decision-Making Guidelines and Tools
        3. Chapter 3: Privacy and Confidentiality
      28. Uses of Information
        1. Chapter 4: Data Analytics
        2. Chapter 5: Compliance, Fraud, and Abuse
        3. Chapter 6: Coding
        4. Chapter 7: Quality Management
        5. Chapter 8: Research and Decision Support
        6. Chapter 9: Public Health
        7. Chapter 10: Longitudinal Coordinated Care
        8. Chapter 11: Clinical Care: End of Life
      29. Electronic Health Information
        1. Chapter 12: Electronic Health Records
        2. Chapter 13: Information Security
        3. Chapter 14: Information Technology and Biomedical Instrumentation
        4. Chapter 15: Information Governance and Management
        5. Chapter 16: Integrated Delivery Systems
        6. Chapter 17: Digital Health: Health Information Technology and Information Exchange
      30. Sensitive Health Information
        1. Chapter 18: Genetic Information
        2. Chapter 19: Adoption
        3. Chapter 20: Substance Abuse, Behavioral Health, and Sexual Information
      31. Consumer and Professional Informatics
        1. Chapter 21: Digital Health Technologies for Consumers, Patients, and Caregivers
        2. Chapter 22: Management and Leadership
        3. Chapter 23: Entrepreneurship
        4. Chapter 24: Vendor Management
        5. Chapter 25: Advocacy
        6. Chapter 26: Future Challenges and Opportunities
    2. Chapter 2 Ethical Decision-Making Guidelines and Tools
      1. Learning Objectives
      2. Introduction
        1. Scenario 2-A: Decision Making for an Adolescent
      3. What Is an Ethical Issue?
      4. Why Do Ethical Issues Need to Be Addressed?
      5. But You Can’t Teach Ethics, Can You?
      6. The Process of Ethical Decision Making
      7. Justification in Ethical Reasoning: How Do You Know What Is Best?
        1. Classic Ethical Theories
          1. Utilitarianism
          2. Deontological Theory
        2. Applying Multiple Theories
        3. Current Ethical Approaches
          1. Analysis of Principles
          2. Analysis of Rights
          3. Ethics of Care
          4. Virtue-Based Ethics
        4. The Bioethicist’s Toolbox
      8. Moral Distress
        1. Scenario 2-B: Access by Adolescents to Patient Portals
      9. Ethics Resources
      10. Conclusion
      11. Key Terms
      12. Chapter Summary
      13. References
      14. Blank Ethical Decision-Making Matrix
      15. Ethical Decision-Making Matrices
        1. Scenario 2-A: Decision Making for an Adolescent
        2. Scenario 2-B: Access by Adolescents to Patient Portals
    3. Chapter 3 Privacy and Confidentiality
      1. Learning Objectives
      2. Introduction
        1. Scenario 3-A: Family and Friends: Should I Tell?
        2. Scenario 3-B: Share Information on Facebook?
      3. Protecting Health Information
      4. Privacy and Confidentiality
      5. Release of Information
      6. The HIPAA Privacy Rule
        1. History of Privacy Laws
        2. HIPAA Privacy Rule Framework
        3. Requirements for Patient Authorization
        4. Use and Disclosure
        5. Patient Authorization Required
        6. Patient Authorization Not Required
      7. Blanket Authorizations
      8. Breaches
      9. Patient Concerns
        1. Medical Identity Theft
        2. Electronic Health Records and Mobile Devices
        3. Social Media
      10. Professional Concerns
      11. Ethical Challenges
      12. Conclusion
      13. Key Terms
      14. Chapter Summary
      15. References
      16. Ethical Decision-Making Matrices
        1. Scenario 3-A: Family and Friends: Should I Tell?
        2. Scenario 3-B: Share Information on Facebook?
  11. SECTION II Uses of Information
    1. Chapter 4 Data Analytics
      1. Learning Objectives
      2. Introduction
      3. The Role of Data Analytics in Health Care
      4. Medical Data and the Data Collection Process
        1. Structured and Unstructured Data
        2. Current State of Medical Data Collection
        3. Paper-Based Medical Records
        4. Hybrid Medical Records
        5. Electronic Medical Records
      5. Ethical Dilemmas Associated with Big Data and Data Analytics
        1. Scenario 4-A: Readmission Predictive Model Project, Part 1: Right Skills?
        2. Scenario 4-B: Readmission Predictive Model Project, Part 2: Impact of Bad Data
        3. Value of Model Assumptions
        4. Data Altruism
      6. Big Data Analysis Techniques Used to Analyze Medical Data
        1. Big Data Analysis
        2. Traditional Data Analysis
        3. Predictive Analytics
        4. Supervised and Unsupervised Analyses
      7. Conclusion
      8. Key Terms
      9. Chapter Summary
      10. References
      11. Ethical Decision-Making Matrices
        1. Scenario 4-A: Readmission Predictive Model Project, Part 1: Right Skills?
        2. Scenario 4-B: Readmission Predictive Model Project, Part 2: Impact of Bad Data
    2. Chapter 5 Compliance, Fraud, and Abuse
      1. Learning Objectives
      2. Introduction
        1. Scenario 5-A: Documentation Does Not Justify Billed Procedure
      3. Regulations that Guide HIM Professionals
        1. False Claims Act
          1. Qui Tam Statutes
        2. Voluntary Disclosure Protocol
        3. Anti-kickback Statute
        4. Anti-referral Statutes: Stark I and II
        5. “Safe Harbors” and Stark Exceptions
        6. Mail and Wire Fraud
        7. HIPAA Regulations
          1. HIPAA Administrative Simplification Standards
          2. Security Standards
          3. Privacy Standards
          4. Enforcement Programs
        8. False Claims Penalties
        9. Roles for HIM Professionals
      4. Compliance Programs to Prevent Fraudulent Behaviors
      5. Dilemmas in Practice
        1. Scenario 5-B: Accepting Money for Information
        2. Fraudulent Documentation Practices
        3. Scenario 5-C: Retrospective Documentation to Avoid Suspension
        4. Retrospective Medical Record Analysis
        5. Scenario 5-D: Coder Assigns Code Without Physician Documentation
        6. Coding Turnaround Time
      6. Conclusion
      7. Key Terms
      8. Chapter Summary
      9. References
      10. Ethical Decision-Making Matrices
        1. Scenario 5-A: Documentation Does Not Justify Billed Procedure
        2. Scenario 5-B: Accepting Money for Information
        3. Scenario 5-C: Retrospective Documentation to Avoid Suspension
        4. Scenario 5-D: Coder Assigns Code Without Physician Documentation
    3. Chapter 6 Coding
      1. Learning Objectives
      2. Introduction
        1. Scenario 6-A: Blood Loss Anemia
        2. Coding Systems
      3. The Function of Coding
      4. Legal Foundation and Framework for Ethical Coding
        1. Aortography
        2. Scenario 6-B: Thoracic Aortogram
        3. Coding and Payment Elements
        4. Fraud and Abuse
      5. Ethical Foundations and Ethical Standards
        1. AHIMA Code of Ethics
        2. AHIMA Standards of Ethical Coding
        3. Coding and Payment Elements
        4. Sources for Coding Direction
          1. Mandated Sources
        5. Coding Sources
          1. Credible Sources
      6. Main Ethical Challenges
        1. Scenario 6-C: Revise the Analysis?
          1. Upcoding
          2. Unbundling
          3. Evading Medical Necessity Requirements
      7. Making a Decision and Making Your Case
      8. Conclusion
      9. Key Terms
      10. Chapter Summary
      11. References
      12. Appendix 6-A: American Health Information Management Association Code of Ethics
      13. Preamble
      14. Purpose of the American Health Information Management Association Code of Ethics
      15. The Code of Ethics and How to Interpret the Code of Ethics
        1. Principles and Guidelines
      16. The Use of the Code
      17. Code of Ethics 2011 Ethical Principles
      18. Resources
      19. Appendix 6-B: American Health Information Management Association Standards of Ethical Coding
      20. Introduction
      21. Standards of Ethical Coding
      22. Resources
      23. How to Interpret the Standards of Ethical Coding
      24. Ethical Decision-Making Matrices
        1. Scenario 6-A: Blood Loss Anemia
        2. Scenario 6-B: Thoracic Aortogram
        3. Scenario 6-C: Revise the Analysis?
    4. Chapter 7 Quality Management
      1. Learning Objectives
      2. Introduction
        1. Scenario 7-A: Inaccurate Publicly Reported Performance Data
      3. Quality Management
        1. Milestones that Created QM Ethical Questions
        2. Transitions Bring Ethical Challenges
        3. Scenario 7-B: Audit Results Indicate Inappropriate Health Care
      4. Ethical Issues Facing QM Professionals
        1. Scenario 7-C: Reporting Hospital-Acquired Conditions
      5. Ethical Standards Affecting QM Activities
        1. Quality and Professional Ethics
        2. Code of Ethics
        3. Organizational Values
        4. Scenario 7-D: Disclosure of an Unanticipated Outcome
        5. Personal Convictions
        6. Moral Courage
        7. Scenario 7-E: Failure to Check Physician’s Licensure Status
      6. Making Ethical Decisions
      7. QM Situations Raising Ethical Questions
      8. Enabling Ethical Conduct
        1. Role of the Profession
        2. Role of the Employer
      9. Conclusion
      10. Key Terms
      11. Chapter Summary
      12. References
      13. Ethical Decision-Making Matrices
        1. Scenario 7-A: Inaccurate Performance Data Reported to the Public
        2. Scenario 7-B: Audit Results Indicate Inappropriate Health Care
        3. Scenario 7-C: Reporting Hospital-Acquired Conditions
        4. Scenario 7-D: Disclosure of an Unanticipated Outcome
        5. Scenario 7-E: Failure to Check Physician’s Licensure Status
    5. Chapter 8 Research and Decision Support
      1. Learning Objectives
      2. Introduction
        1. Scenario 8-A: Designing a Survey to Bias the Results
        2. Scenario 8-B: The Impact of Sample Selection Bias
      3. Roles of the RS and DSS
      4. Ethical Responsibilities of the RS and DSS
        1. Ensuring Data Integrity and Confidentiality
        2. Data Acquisition and Integrity
        3. Privacy and Confidentiality
        4. Data from External Sources
        5. Data Reporting
        6. Data Access
        7. Human Subject Research
        8. Internal Review Board
        9. Research Versus Clinical Record
        10. Medical Record Data in Retrospective Studies
      5. Maintaining and Enhancing Professional Competence
      6. Conclusion
      7. Key Terms
      8. Chapter Summary
      9. References
      10. Ethical Decision-Making Matrices
        1. Scenario 8-A: Designing a Survey to Bias the Results
        2. Scenario 8-B: The Impact of Sample Selection Bias
    6. Chapter 9 Public Health and Informatics
      1. Learning Objectives
      2. Introduction
        1. Scenario 9-A: Gun Control and Reporting Mental Health Status
      3. Public Health Information: An Overview
        1. The Evolution of Public Health and Government Access to Private Medical Information
        2. State Use of Protected Heath Information: Sexually Transmitted Disease Contact Tracing and Partner Notification
      4. Ethical Challenges in Public Health
        1. When the Public’s Right to Know Conflicts with the Individual’s Right to Privacy
        2. An Antecedent Issue: The Duty to Decide
        3. Making a Reasoned Decision
          1. Autonomy
          2. Nonmaleficence
          3. Beneficence
          4. Justice
          5. Utility
        4. Globalization and Attendant Ethical Challenges
        5. Opportunities and Ethical Challenges of Social Media
      5. The HIM Professional’s Role and Responsibility as an Advocate
        1. A Reciprocal Duty Owed to Society
        2. Superior Knowledge
        3. An Unambiguous Duty to Protect Patient Privacy
        4. Resources for Advocacy
        5. Scenario 9-B: Conflicting Personal and Public Duties
        6. Making a Reasoned Decision
          1. Analyzing the Ethical Conflict
      6. Conclusion
      7. Key Terms
      8. Chapter Summary
      9. References
      10. Ethical Decision-Making Matrices
        1. Scenario 9-A: Gun Control and Reporting Mental Health Status
        2. Scenario 9-B: Conflicting Personal and Public Duties
    7. Chapter 10 Longitudinal Coordinated Care
      1. Learning Objectives
      2. Introduction
      3. The Ever-Changing Healthcare Scene
        1. Two Significant Initiatives
          1. Healthy People Initiative
          2. Healthcare Improvement Initiative
        2. Key Stakeholders in Health Care
        3. Population Health
        4. The Focus on Patient-Centered Care
        5. Changes in the Medical Care System
        6. Formation of Accountable Care Organizations
        7. Critical Cultural Changes in ACOs
      4. Health Care in Transition
        1. Patient-Centered Medical Homes
        2. Longitudinal Care
        3. Complex Care Management
      5. Exploring the Ethical Dimensions of PCMH and Longitudinal Care
        1. Ethical Principles
          1. Respect for Autonomy
          2. Application of Respect for Autonomy: Enhancing and Expanding Informed Consent in PCMH and Longitudinal Care
          3. Beneficence (Do Good) and Nonmaleficence (Do No Harm)
          4. Justice
        2. A Decision-Making Methodology in Ethics
        3. Ethical Challenges and Issues
        4. Challenges for Boards and Administrators
        5. Scenario 10-A: Competing Stakeholder Agendas in a Community ACO
        6. Longitudinal Care Coordination
        7. Scenario 10-B: Patient Transfer
      6. Conclusion
      7. Key Terms
      8. Chapter Summary
      9. References
      10. Ethical Decision-Making Matrices
        1. Scenario 10-A: Competing Stakeholder Agendas in a Community ACO
        2. Scenario 10-B: Patient Transfer
    8. Chapter 11 Clinical Care: End-of-Life
      1. Learning Objectives
      2. Introduction
        1. Scenario 11-A: Bad News
      3. Autonomy and Beneficence
      4. Are Physicians Getting the Right Message Out to Patients?
      5. Physician Bias and Equity: A Systems Issue
        1. Scenario 11-B: Treatment Choices
      6. Information Across a Healthcare Continuum
      7. Treatment Goals and Beneficence
        1. Scenario 11-C: Advance Care Planning
      8. Advance Care Planning: An Opportunity
      9. The Meaning of Terminal
        1. Scenario 11-D: Palliative Care
      10. Managing Pain
      11. Palliative Care
      12. Emerging Issues
        1. Physician-Assisted Suicide
        2. Euthanasia
        3. Is Withholding or Withdrawing Life-Sustaining Treatment Euthanasia?
      13. Conclusion
      14. Key Terms
      15. Chapter Summary
      16. References
      17. Ethical Decision-Making Matrices
        1. Scenario 11-A: Bad News
        2. Scenario 11-B: Treatment Choices
        3. Scenario 11-C: Advance Care Planning
        4. Scenario 11-D: Palliative Care
  12. SECTION III Electronic Health Information
    1. Chapter 12 Electronic Health Records
      1. Learning Objectives
      2. Introduction
        1. Scenario 12-A: Patient Record Integrity and Access
      3. EHR Systems: Functions and Expected Features
        1. EHR Definitions
        2. EHR Benefits and Functionality
        3. Health Data Uses
      4. EHR Systems in the Twenty-First Century
      5. EHR Technology and Ethical Issues
        1. Patient Privacy
        2. Data Quality
        3. Patient Interest
        4. Organizational Values
        5. Making Ethical Decisions
        6. Ethical Issues in Implementation
          1. Patient Record Integrity and Access
        7. Additional Ethical Issues in Implementation Planning
        8. Clinical Care Process
        9. Data Correction and Editing Process
        10. System Problems
        11. Health Information Access Capabilities
        12. Scenario 12-B: Parent Access to Child’s Health Information
        13. Expanded Use of Health Information
        14. Infrastructure Strengths and Weaknesses
        15. New Opportunities for Vendors and Healthcare Organizations
        16. Scenario 12-C: Differences When Linking EHR Systems
        17. User Access
        18. Security Practices
        19. Data Quality/Integrity
        20. Confidentiality Agreements
        21. Notifying Patients About Information Practices
        22. Audit Trails and Email
      6. Conclusion
      7. Key Terms
      8. Chapter Summary
      9. References
      10. Ethical Decision-Making Matrices
        1. Scenario 12-A: Patient Record Integrity and Access
        2. Scenario 12-B: Parent Access to Child’s Health Information
        3. Scenario 12-C: Differences When Linking EHR Systems
    2. Chapter 13 Information Security
      1. Learning Objectives
      2. Introduction
        1. Scenario 13-A: A Curious Human Resource Employee
      3. The Healthcare Information Revolution
      4. The Role of the CIO
      5. Access and Information Security
        1. Privacy, Confidentiality, Disclosure, and Need to Know
      6. Privacy-Related Security
        1. Confidentiality, Integrity, Availability
        2. Sanctions
      7. Establishing a Security Baseline
        1. Policies and Procedures
        2. Need to Know and Data Sharing
        3. Access Control
        4. Unique User Identification
        5. Scenario 13-B: Failure to Log Out of the System
        6. Audit Trails
        7. Workstation Use and Security
        8. The Internet, Email, and E-Health
        9. Conducting a Risk Analysis
        10. Identifying Vulnerabilities
        11. Scenario 13-C: Storing Data on a Laptop Computer
        12. Interoperability
        13. Patient Notification and Informed Consent
      8. Conclusion
      9. Key Terms
      10. Chapter Summary
      11. References
      12. Ethical Decision-Making Matrices
        1. Scenario 13-A: A Curious Human Resource Employee
        2. Scenario 13-B: Failure to Log Out of the System
        3. Scenario 13-C: Storing Data on a Laptop Computer
    3. Chapter 14 Information Technology and Biomedical Instrumentation
      1. Learning Objectives
      2. Introduction
        1. Biomedical Instrumentation and Interoperability
        2. Scenario 14-A: Lack of Interoperability
        3. Medical Device Interoperability Defined
        4. The Need for Interoperability
        5. Codes of Ethics
        6. Ethical Issues for Interface Development
        7. Interface Development and Biomedical Device Integration
        8. Functional Medical Device Interoperability
        9. Scenario 14-B: Data Interface Decisions
        10. Consultant’s Perspective
        11. Information Gathering
        12. Key Considerations
        13. Benefits of Functional Device Interoperability
        14. Prioritizing Device Integration
        15. A Collaborative Approach to Decision Making
        16. Scenario 14-C: Data Interface Quality
      3. Conclusion
      4. Key Terms
      5. Chapter Summary
      6. References
      7. Ethical Decision-Making Matrices
        1. Scenario 14-A: Lack of Interoperability
        2. Scenario 14-B: Data Interface Decisions
        3. Scenario 14-C: Data Interface Quality
    4. Chapter 15 Information Governance and Management
      1. Learning Objectives
      2. Introduction
        1. Scenario 15-A: Stewardship Literacy for Community Health Improvement
      3. Governance of Health Information
        1. Defining Information Governance
        2. Defining Data and Other Dimensions of Governance
        3. Governance as Ethical Stewardship
        4. Healthcare Organizations and Stewardship
        5. Scenario 15-B: Managing Patient Identification as Master Data
        6. Organizing for Governance
        7. Scenario 15-C: Big Data Analytics and Stewardship
      4. Contemporary Health Information Management
        1. Enterprise Information Management Domains
        2. Organizing for EIM
        3. Scenario 15-D: EHR Integrity Management
      5. Conclusion
      6. Key Terms
      7. Chapter Summary
      8. References
      9. Ethical Decision-Making Matrices
        1. Scenario 15-A: Stewardship Literacy for Community Health Improvement
        2. Scenario 15-B: Managing Patient Identification as Master Data
        3. Scenario 15-C: Big Data Analytics and Stewardship
        4. Scenario 15-D: EHR Integrity Management
    5. Chapter 16 Integrated Delivery Systems
      1. Learning Objectives
      2. Introduction
        1. Scenario 16-A: Scheduling Clerk Has Access to All Clinical Information
      3. Privacy and Security Issues
        1. Models for the Integrated Delivery System
      4. Data Quality Issues
        1. Scenario 16-B: Vulnerabilities in the Electronic Health Record
      5. Management of Patient Identity Management Systems
        1. Scenario 16-C: Inconsistencies in the Patient Identity Management System
      6. Required Skills for HIM Professionals
      7. Conclusion
      8. Key Terms
      9. Chapter Summary
      10. References
      11. Appendix 16-A: Sample Access Policy
      12. Ethical Decision-Making Matrices
        1. Scenario 16-A: Scheduling Clerk Has Access to All Clinical Information
        2. Scenario 16-B: Vulnerabilities in the Electronic Health Record
        3. Scenario 16-C: Inconsistencies in the Patient Identity Management System
    6. Chapter 17 Digital Health: Information Technology and Information Exchange
      1. Learning Objectives
      2. Introduction
      3. Goals and Objectives
      4. Health Information Technology and Health Information Exchange
      5. Health Information Exchange
      6. Data and Information Governance
      7. Evolving Roles, Responsibilities, and Challenges
      8. Background and History of Public- and Private-Sector Activities
        1. Public Sector
        2. Private Sector
        3. Mobile Health
      9. Ethical Challenges
        1. Scenario 17-A: Health Informatics and Information Management (HIIM) Professionals’ Role
      10. Conclusion
      11. Key Terms
      12. Chapter Summary
      13. References and Resources
      14. Ethical Decision-Making Matrices
        1. Scenario 17-A: Health Informatics and Information Management (HIIM) Professionals’ Role
  13. SECTION IV Management of Sensitive Health Information
    1. Chapter 18 Genetic Information
      1. Learning Objectives
      2. Introduction
        1. Scenario 18-A: Genetic Privacy
      3. Genetic and Genomic Information
        1. Genetic Information in the Clinical Context
        2. Translational Science’s Implications for the Management of Genomic Information
        3. Privacy and Confidentiality of Genetic Information
        4. Research Setting
      4. Legislation Regarding Genetic Information
        1. Genetic Information Nondiscrimination Act (GINA)
        2. State Legislative Protections Related to Genetics
      5. Ethical and Social Issues Related to Genetics
        1. Access to Genetic Services and Health Disparities
        2. Whole Genome and Exome Sequencing
        3. Right to Know, Not to Know, and Incidental Findings
      6. Conclusion
      7. Key Terms
      8. Chapter Summary
      9. References
      10. Appendix 18-A: Legislative Acts Relevant to Genetic Testing
      11. Ethical Decision-Making Matrices
        1. Scenario 18-A: Genetic Privacy
    2. Chapter 19 Adoption Information
      1. Learning Objectives
      2. Introduction
        1. Scenario 19-A: Seeking Information Many Years Later
      3. Historical and Emerging Ethical Issues
      4. Adoption and Assisted Reproductive Technology (ART)
      5. Ethical Issues for HIM Professionals
        1. Adoptive Parents Seek Information on Their Adopted Child
        2. Scenario 19-B: An Adoptee Seeks Information on Her Biological Family
        3. Scenario 19-C: A Birth Mother Seeks Information on Her Biological Son
      6. Future Issues
      7. Conclusion
      8. Key Terms
      9. Chapter Summary
      10. References
      11. Ethical Decision-Making Matrices
        1. Scenario 19-A: Seeking Information Many Years Later
        2. Scenario 19-B: An Adoptee Seeks Information on Her Biological Family
        3. Scenario 19-C: A Birth Mother Seeks Information on Her Biological Son
    3. Chapter 20 Substance Abuse, Behavioral Health, and Sexual Information
      1. Learning Objectives
      2. Introduction
        1. Scenario 20-A: The Arrest Warrant: Is This Person in Your Facility?
      3. Substance Abuse Treatment, Health Information, and the Law
      4. Ethical Challenges in Behavioral Health and Substance Abuse Treatment
        1. Law Enforcement Requests Patient-Identifying Information
        2. Scenario 20-B: Safety of a Citizen Versus Privacy of a Patient
        3. Law Enforcement Requests Patient Information for Public Safety Reasons
        4. Scenario 20-C: Patient Confesses to a Psychiatrist
        5. A Behavioral Health Patient Confesses to a Staff Member That He Has Committed a Crime
        6. Scenario 20-D: Patient Confesses to the Nurse’s Aide
        7. Protecting Information About a Patient’s Admission to a Behavioral Health Unit of a General Hospital
        8. Scenario 20-E: Verifying Admission Can Violate Privacy
      5. Requests for Information on Sexually Transmitted Diseases (STDs)
        1. Scenario 20-F: A Prisoner Who May Have AIDS
        2. Requests About Employees and Children
        3. Scenario 20-G: Workers’ Compensation Case
          1. Employees
          2. Children
        4. Scenario 20-H: Children’s Protective Services
      6. Conclusion
      7. Key Terms
      8. Chapter Summary
      9. References
      10. Ethical Decision-Making Matrices
        1. Scenario 20-A: The Arrest Warrant: Is This Person in Your Facility?
        2. Scenario 20-B: Safety of a Citizen Versus Privacy of a Patient
        3. Scenario 20-C: Patient Confesses to a Psychiatrist
        4. Scenario 20-D: Patient Confesses to the Nurse’s Aide
        5. Scenario 20-E: Verifying Admission Can Violate Privacy
        6. Scenario 20-F: A Prisoner Who May Have AIDS
        7. Scenario 20-G: Workers’ Compensation Case
        8. Scenario 20-H: Children’s Protective Services
  14. SECTION V Consumer and Professional Informatics
    1. Chapter 21 Digital Health Technologies for Consumers, Patients, and Caregivers
      1. Learning Objectives
      2. Introduction
        1. Scenario 21-A: Plain Language and Health Information Privacy Policies
      3. The HIM Professional and Consumer, Patient, and Caregiver Digital Health Technologies
      4. Consumer, Patient, and Caregiver Digital Health Technologies
      5. Benefits and Risks of Digital Health Technologies
      6. Special Considerations for Privacy and Security Management in Digital Health Technologies
      7. Patient Portals and Their Special Significance for HIM Professionals
        1. Data Access
        2. Receiving Patient-Generated Information
        3. Secure Messaging
        4. Interactive Tools
        5. Links to Authoritative Information
      8. National Policy Related to Digital Health Technology for Consumers, Patients, and Caregivers
      9. Information Access and the HIM Professional
      10. Ethical Issues Related to Consumer, Patient, and Caregiver Digital Technology Access
        1. Scenario 21-B: Ensuring Privacy Protections for Digital Health Technologies
      11. Emerging Issues
      12. Conclusion
      13. Key Terms
      14. Chapter Summary
      15. References
      16. Ethical Decision-Making Matrices
        1. Scenario 21-A: Plain Language and Health Information Privacy Policies
        2. Scenario 21-B: Ensuring Privacy Protections for Digital Health Technologies
    2. Chapter 22 Management and Leadership
      1. Learning Objectives
      2. Introduction
        1. Scenario 22-A: Lateness and Absenteeism
      3. Moral Development and Moral Awareness
        1. Stages of Moral Development
        2. Ethic of Caring
      4. Moral Awareness
        1. Scenario 22-B: Concerns in Telecommuting
        2. Scenario 22-C: Failure to Document Poor Work Performance for a Friendly Employee
      5. Moral Muteness
      6. Orientation of New Employees
        1. Scenario 22-D: Avoiding the Employee Who Will Be Fired
      7. Ethical Organizational Leadership: Beyond a Mission Statement and Code of Ethics
      8. Ethical Frameworks for Diversity Management
      9. The Ethical Leader: Doing the Right Thing
      10. Conclusion
      11. Key Terms
      12. Chapter Summary
      13. References
      14. Ethical Decision-Making Matrices
        1. Scenario 22-A.1: Lateness and Absenteeism—Fire the Employee
        2. Scenario 22-A.2: Lateness and Absenteeism—Don’t Fire the Employee
        3. Scenario 22-B: Concerns in Telecommuting
        4. Scenario 22-C: Failure to Document Poor Work Performance for a Friendly Employee
        5. Scenario 22-D: Avoiding the Employee Who Will Be Fired
    3. Chapter 23 Entrepreneurship
      1. Learning Objectives
      2. Introduction
        1. Scenario 23-A: Competing Constituencies
      3. Entrepreneurship in Health Information Management
        1. Defining the Entrepreneur
      4. Entrepreneur versus Intrapreneur
        1. Function-Based Issues for the Consultant
        2. Rights of the Independent Contractor
        3. The Expert Role
        4. Delivering a Difficult Message
        5. Advice Not Taken
        6. Conflicts of Interest
        7. The Collaborative Role
        8. Scapegoating
        9. Special Opportunities for the Consultant to Act as Moral Voice
        10. Relationship-Based Issues for the Independent Contractor
        11. Social Isolation
      5. Business Ethics: Concepts and Principles
        1. Contracts
        2. Advertising
        3. The Profit Motive
        4. Corporate Responsibility
        5. The Case for Ethics in Business
      6. The Intersection of Ethics and HIM Entrepreneurship
        1. Scenario 23-B: Negotiating Contracts
        2. Negotiating Contracts
        3. Scenario 23-C: Unrealistic Client Expectations
        4. Scenario 23-D: Discovering Sensitive Information About a Client, Competitor, or Colleague
        5. Learning Sensitive Information About a Client, Competitor, or Colleague
        6. Managing Client Relationships
      7. Conclusion
      8. Key Terms
      9. Chapter Summary
      10. References
      11. Ethical Decision-Making Matrices
        1. Scenario 23-A: Competing Constituencies
        2. Scenario 23-B: Negotiating Contracts
        3. Scenario 23-C: Unrealistic Client Expectations
        4. Scenario 23-D: Discovering Sensitive Information About a Client, Competitor, or Colleague
    4. Chapter 24 Vendor Management
      1. Learning Objectives
      2. Introduction
        1. Scenario 24-A: Vendor Request
      3. Vendor Relations
        1. Sales Ethics
        2. Scenario 24-B: Vendors as Friends
        3. Scenario 24-C: Gifts
        4. Prevention of Ethical Problems
        5. Scenario 24-D: Preferred Vendors
      4. Requests for Proposals
        1. Introduction
        2. Directions
        3. Standard Text
        4. Statement of Work
        5. Social Responsibility
        6. Ethical Considerations for the RFP Process
        7. Scenario 24-E: Negotiating
      5. Negotiation
      6. Enhancement of Vendor Relationships
      7. Ethical Behavior
        1. Scenario 24-F: Unethical Behavior
      8. Conclusion
      9. Key Terms
      10. Chapter Summary
      11. References
      12. Appendix 24-A: Sample Gifts Policy
      13. Appendix 24-B: Sample Conflict of Interest Policy
      14. Ethical Decision-Making Matrices
        1. Scenario 24-A: Vendor Request
        2. Scenario 24-B: Vendors as Friends
        3. Scenario 24-C: Gifts
        4. Scenario 24-D: Preferred Vendors
        5. Scenario 24-E: Negotiating
        6. Scenario 24-F: Unethical Behavior
    5. Chapter 25 Advocacy
      1. Introduction
        1. Scenario 25-A: Violating the Privacy of a Prominent Citizen
      2. Advocacy: The Choice of Ethics in Action
      3. Advocating for Patients
      4. Patient Rights
        1. Supporting Patients Who Advocate
      5. Health Information: Individual Patient and Collective Patient Stories
      6. Advocating for Peers
        1. Scenario 25-B: Compassion in Action for an Alcoholic Peer
      7. Advocating for Staff
        1. Scenario 25-C: Cockroaches in the HIM Department
        2. Scenario 25-D: Unfair Treatment of Part-Time Workers
      8. Advocating for the Healthcare Organization
        1. Scenario 25-E: Small Print on a Consent Form
        2. Scenario 25-F: The Data Warehouse Wants to Sell Patient Information
      9. Advocating for the Larger Community and Society
      10. Advocating for One’s Self
      11. Conclusion
      12. Key Terms
      13. Chapter Summary
      14. References
      15. Appendix 25-A: Example of Organizational Engagement in Societal Advocacy
      16. Appendix 25-B: Precepts of Effective HIM Advocacy
      17. Ethical Decision-Making Matrices
        1. Scenario 25-A: Violating the Privacy of a Prominent Citizen
        2. Scenario 25-B: Compassion in Action for an Alcoholic Peer
        3. Scenario 25-C: Cockroaches in the HIM Department
        4. Scenario 25-D: Unfair Treatment of Part-Time Workers
        5. Scenario 25-E: Small Print on a Consent Form
        6. Scenario 25-F: The Data Warehouse Wants to Sell Patient Information
  15. SECTION VI Looking to the Future
    1. Chapter 26 Future Challenges and Opportunities
      1. Learning Objectives
      2. Introduction
      3. Uses of Information
        1. Clinical Care
          1. Substance Abuse, Behavioral Health, and Sexual Information
          2. Longitudinal Coordinated Care
          3. End of Life
        2. Family Decisions
          1. Adoption
          2. Genetics
        3. Data Analysis
          1. Quality Management
          2. Research and Decision Support
          3. Data Analytics
          4. Information Governance and Management
          5. Public Health
      4. Professional Roles
        1. Management and Leadership
        2. Entrepreneurship and Intrapreneurship
        3. Vendor Management
        4. Advocacy
      5. Emerging Trends
        1. Technology Explosion
        2. Digital Health: Health Information Technology and Information Exchange
        3. Digital Health Technologies for Consumers, Patients, and Caregivers
        4. Electronic Health Records
        5. Integrated Delivery Systems
        6. Biomedical Instrumentation and Interoperability
        7. Growth for Healthcare Expenditures
        8. Growth for HIT
      6. Challenges
        1. Clinical and Legal
          1. Privacy and Confidentiality
          2. Coding, Fraud, and Abuse
          3. Legal System Changes
        2. Technology
          1. Information Security
          2. Cyberintelligence and Cybersecurity
          3. Security Breaches
          4. Interoperability, Terminology, and Standards
          5. Big Data/Data Analytics
          6. Surveillance
          7. Cloud Computing
      7. Opportunities
        1. Interdisciplinary Education
        2. Interdisciplinary Collaboration
        3. Ethics as Standard of Practice
      8. Conclusion
      9. Key Terms
      10. Chapter Summary
      11. References
  16. Glossary
  17. Index