Protected Health Information NURS-FPX4040

Additional Requirements

• Written communication: Ensure the staff update is free from errors that detract from the overall message.
• Submission length: Maximum of two double-spaced content pages.
• Font and font size: Use Times New Roman, 12-point.
• Citations and references: Provide a separate reference page that includes 2–3 current, peer-reviewed and 1–2 current, non-peer-reviewed in-text citations and references (total of 3–5 resources) that support the staff update’s content. Current mean no older than 5 years.
• APA format: Be sure your citations and references adhere to APA format. Consult the APA Style and Format page for an APA refresher.

Protected Health Information

Electronic health records (EHRs) provide an e-version of protected health information, including patients’ demographics, progress notes, vital signs, past medical history, immunizations, and lab reports (CMS, 2021). In this sense, EHRs enable healthcare professionals to manage data by automating access to patients’ information.

Despite these benefits, handling data in electronic health records increases the likelihood of cyber security threats, including ransomware, hacking, unauthorized access, and phishing.

Therefore, this assessment elaborates on best practices for safeguarding patient data, laws related to protecting sensitive electronic health information, the importance of interdisciplinary approaches, and the essence of educating nurses about social media usage.

Laws Related to Protecting Sensitive Electronic Health Information

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 remains the most profound policy for institutionalizing strategies for safeguarding data privacy, security, and confidentiality. The law emphasizes providing consent to patients when sharing their identifiable information with other healthcare professionals or between health organizations.

According to the Centers for Disease Control and Prevention (CDC, 2018), HIPAA covers various entities, including healthcare providers, health plans, healthcare clearinghouses, and business associates.

In this sense, these entities must adhere to set provisions, including ensuring confidentiality, integrity, and availability of all electronically protected health information, detecting and safeguarding information against anticipated threats, and protecting data against anticipated, impermissible uses or disclosures. At the minimum, healthcare organizations must ensure that patients know data disclosure and privacy guidelines.

Importance of Interdisciplinary Collaboration in Protecting Sensitive Electronic Health Information

The Health Insurance Portability and Accountability Act (HIPAA) requires healthcare professionals and organizations to comply with data privacy, security, and confidentiality protocols.

However, healthcare professionals face a daunting endeavor to adhere to these guidelines when interdisciplinary collaboration is lacking. Holden et al. (2018) contend that interprofessional team performance is a fundamental approach that allows caregivers to consolidate diverse expertise to solve complex challenges in holistic and comprehensive ways.

In this sense, nurses should collaborate with physicians, organizational management, nurse informaticists, patients, and IT experts to develop collective safeguards for patient information.

Evidence-based Approaches to Mitigate Information Risks

Health organizations can safeguard data privacy, security, and confidentiality by implementing three safeguards: physical, administrative, and technical safeguards. According to Kruse et al. (2017), physical strategies (safeguards) for ensuring data security, privacy, and confidentiality include installing radio frequency identification devices (RFIDs), promoting workstation security, physical access controls, and assigning security responsibilities.

On the other hand, administrative strategies include risk analysis and management, system security evaluation, staff education, and hiring chief information security officers (Kruse et al., 2017, p. 127). Finally, technical security approaches encompass entity authentication, system audits, data/documents encryption, virus checking, and access control to ensure data confidentiality. Undoubtedly, the success of these interventions depends massively upon interdisciplinary collaboration and leadership commitment.

Educating Nurses about Social Media Use

Nurses are susceptible to inadvertently violating or exposing protected health information to threats as they interact on various social media platforms. Often, posting online blogs sharing pictures, audio, and videos may accidentally reveal patients’ vital information. Therefore, it is essential to educate nurses on the tenets of e-professionalism. According to Isik & Jalland (2019), e-professionalism defines social media’s legal and ethical implications.

While e-professionalism is relatively a new paradigm of safeguarding patient data, it guarantees patient satisfaction and enables nurses to provide professional content on social media platforms. Also, educating nurses about proper social media usage enlightens them about the legal and ethical implications of violating data privacy policies. As a result, it emerges as a profound administrative safeguard for ensuring data privacy, security, and confidentiality.

Conclusion

Although electronic health records automate data and promote clinical practices, they expose patients’ sensitive data to multiple threats, including phishing, hacking, and unauthorized disclosures. As a result, it is essential to emphasize interdisciplinary collaboration to implement physical, technical, and administrative safeguards.

In the same breath, educating nurses regarding e-professionalism prevents the likelihood of inadvertently violating data privacy, security, and confidentiality. Also, staff education enlightens them on the potential legal and ethical ramifications of exposing protected health information to potential cyber security threats.

References

• Centers for Disease Control and Prevention. (2018, September 14). Health Insurance Portability and accountability act of 1996 (HIPAA). Retrieved from https://www.cdc.gov/phlp/publications/topic/hipaa.html
• Centers for Medicare and Medicaid Services. (2021, January 12). Electronic Health Records. Retrieved from https://www.cms.gov/Medicare/E-Health/EHealthRecords
• Holden, R., Binkheder, S., Patel, J., & Viernes, S. (2018). Best practices for health informatician involvement in interprofessional health care teams. Applied Clinical Informatics, 09(01), 141-148. https://doi.org/10.1055/s-0038-1626724
• Isik, B., & Jallad, S. (2019). The potential of social media and nursing education: E-professionalism, nurse educator–learner role, benefits, and risks. New Trends and Issues Proceedings on Advances in Pure and Applied Sciences, (11), 30-38. https://doi.org/10.18844/gjpaas.v0i11.4310
• Kruse, C., Smith, B., Vanderlinden, H., & Nealand, A. (2017). Security techniques for electronic health records. Journal of Medical Systems, 41(8), 1-9. https://doi.org/10.1007/s10916-017-0778-4

Assessment 2 Instructions: Protected Health Information (PHI): Privacy, Security, and Confidentiality Best Practices

Prepare a 2-page interprofessional staff update on HIPAA and appropriate social media use in health care.

Introduction

As you begin to consider the assessment, it would be an excellent choice to complete the Breach of Protected Health Information (PHI) activity. The activity will support your success with the assessment by creating the opportunity for you to test your knowledge of potential privacy, security, and confidentiality violations of protected health information. The activity is not graded and counts towards course engagement.

Health professionals today are increasingly accountable for the use of protected health information (PHI). Various government and regulatory agencies promote and support privacy and security through a variety of activities. Examples include:

• Meaningful use of electronic health records (EHR).
• Provision of EHR incentive programs through Medicare and Medicaid.
• Enforcement of the Health Insurance Portability and Accountability Act (HIPAA) rules.
• Release of educational resources and tools to help providers and hospitals address privacy, security, and confidentiality risks in their practices.

Technological advances, such as the use of social media platforms and applications for patient progress tracking and communication, have provided more access to health information and improved communication between care providers and patients.

At the same time, advances such as these have resulted in more risk for protecting PHI. Nurses typically receive annual training on protecting patient information in their everyday practice. This training usually emphasizes privacy, security, and confidentiality best practices such as:

• Keeping passwords secure.
• Logging out of public computers.
• Sharing patient information only with those directly providing care or who have been granted permission to receive this information.

Today, one of the major risks associated with privacy and confidentiality of patient identity and data relates to social media. Many nurses and other health care providers place themselves at risk when they use social media or other electronic communication systems inappropriately. For example, a Texas nurse was recently terminated for posting patient vaccination information on Facebook. In another case, a New York nurse was terminated for posting an insensitive emergency department photo on her Instagram account.

Health care providers today must develop their skills in mitigating risks to their patients and themselves related to patient information. At the same time, they need to be able distinguish between effective and ineffective uses of social media in health care.

This assessment will require you to develop a staff update for the interprofessional team to encourage team members to protect the privacy, confidentiality, and security of patient information.

Preparation

To successfully prepare to complete this assessment, complete the following:

• Review the infographics on protecting PHI provided in the resources for this assessment, or find other infographics to review. These infographics serve as examples of how to succinctly summarize evidence-based information.
  • Analyze these infographics and distill them into five or six principles of what makes them effective. As you design your interprofessional staff update, apply these principles. Note: In a staff update, you will not have all the images and graphics that an infographic might contain. Instead, focus your analysis on what makes the messaging effective.
• Select from any of the following options, or a combination of options, the focus of your interprofessional staff update:
  • Social media best practices.
  • What not to do: social media.
  • Social media risks to patient information.
  • Steps to take if a breach occurs.
• Conduct independent research on the topic you have selected in addition to reviewing the suggested resources for this assessment. This information will serve as the source(s) of the information contained in your interprofessional staff update. Consult the BSN Program Library Research Guide for help in identifying scholarly and/or authoritative sources.

Instructions

In this assessment, assume you are a nurse in an acute care, community, school, nursing home, or other health care setting. Before your shift begins, you scroll through Facebook and notice that a coworker has posted a photo of herself and a patient on Facebook. The post states, “I am so happy Jane is feeling better. She is just the best patient I’ve ever had, and I am excited that she is on the road to recovery.”

You have recently completed your annual continuing education requirements at work and realize this is a breach of your organization’s social media policy. Your organization requires employees to immediately report such breaches to the privacy officer to ensure the post is removed immediately and that the nurse responsible receives appropriate corrective action.

You follow appropriate organizational protocols and report the breach to the privacy officer. The privacy officer takes swift action to remove the post. Due to the severity of the breach, the organization terminates the nurse.

Based on this incident’s severity, your organization has established a task force with two main goals:

• Educate staff on HIPAA and appropriate social media use in health care.
• Prevent confidentiality, security, and privacy breaches.

The task force has been charged with creating a series of interprofessional staff updates on the following topics:

• Social media best practices.
• What not to do: Social media.
• Social media risks to patient information.
• Steps to take if a breach occurs.

You are asked to select one or more of the topics and create the content for a staff update containing a maximum of two content pages. This assessment is not a traditional essay. It is a staff educational update about PHI. Consider creating a flyer, pamphlet, or one PowerPoint slide (not an entire presentation). Remember it should not be more than two pages (excluding a title and a reference page).

The task force has asked team members assigned to the topics to include the following content in their updates in addition to content on their selected topics:

• What is protected health information (PHI)?
  • Be sure to include essential HIPAA information.
• What are privacy, security, and confidentiality?
  • Define and provide examples of privacy, security, and confidentiality concerns related to the use of technology in health care.
  • Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
• What evidence relating to social media usage and PHI do interprofessional team members need to be aware of? For example:
  • How many nurses have been terminated for inappropriate social media use in the United States?
  • What types of sanctions have health care organizations imposed on interdisciplinary team members who have violated social media policies?
  • What have been the financial penalties assessed against health care organizations for inappropriate social media use?
  • What evidence-based strategies have health care organizations employed to prevent or reduce confidentiality, privacy, and security breaches, particularly related to social media usage?

Notes

• Your staff update is limited to two double-spaced content pages. Be selective about the content you choose to include in your update so you can meet the page length requirement. Include need-to-know information. Omit nice-to-know information.
• Many times people do not read staff updates, do not read them carefully, or do not read them to the end. Ensure your staff update piques staff members’ interest, highlights key points, and is easy to read. Avoid overcrowding the update with too much content.
• Also, supply a separate reference page that includes two or three peer-reviewed and one or two non-peer-reviewed resources (for a total of 3–5 resources) to support the staff update content.

Additional Requirements

• Written communication: Ensure the staff update is free from errors that detract from the overall message.
• Submission length: Maximum of two double-spaced content pages.
• Font and font size: Use Times New Roman, 12-point.
• Citations and references: Provide a separate reference page that includes 2–3 current, peer-reviewed and 1–2 current, non-peer-reviewed in-text citations and references (total of 3–5 resources) that support the staff update’s content. Current means no older than 5 years.
• APA format: Be sure your citations and references adhere to APA format. Consult the Evidence and APA page for an APA refresher.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
  • Describe the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team.
  • Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
• Competency 2: Implement evidence-based strategies to effectively manage protected health information.
  • Identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information.
  • Develop a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage.
• Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
  • Follow APA style and formatting guidelines for citations and references.
  • Create a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling.

Protected Health Information Scoring Guide

Criteria	Non-performance	Basic	Proficient	Distinguished
Define nursing informatics and the role of the nurse informaticist.	Does not define nursing informatics and the role of the nurse informaticist.	Defines nursing informatics and the role of the nurse informaticist, but the description lacks detail or is missing important information.	Defines nursing informatics and the role of the nurse informaticist.	Defines nursing informatics and the role of the nurse informaticist. References current data, evidence, or standards to support and refine definition.
Explain how the nurse informaticist collaborates with the interdisciplinary team, including technologists, to improve the quality of patient care.	Does not explain how the nurse informaticist collaborates with the interdisciplinary team, including technologists, to improve the quality of patient care.	Identifies but does not explain how the nurse informaticist collaborates with the interdisciplinary team, including technologists, to improve the quality of patient care.	Explains how the nurse informaticist collaborates with the interdisciplinary team, including technologists, to improve the quality of patient care.	Explains how the nurse informaticist collaborates with the interdisciplinary team, including technologists, to improve the quality of patient care. Makes explicit reference to scholarly or professional resources to support explanation.
Justify the need for a nurse informaticist in a health care organization.	Does not justify the need for a nurse informaticist in a health care organization.	Proposes but does not justify the need for a nurse informaticist in a health care organization.	Justifies the need for a nurse informaticist in a health care organization.	Justifies the need for a nurse informaticist in a health care organization and references relevant and timely scholarly or professional resources to support the justification.
Explain evidence-based strategies that the nurse informaticist and interdisciplinary team can use to effectively manage patients’ protected health information (privacy, security, and confidentiality).	Does not explain evidence-based strategies that the nurse informaticist and interdisciplinary team can use to effectively manage patients’ protected health information (privacy, security, and confidentiality).	Describes but does not explain evidence-based strategies that the nurse informaticist and interdisciplinary team can use to effectively manage patients’ protected health information (privacy, security, and confidentiality).	Explains evidence-based strategies that the nurse informaticist and interdisciplinary team can use to effectively manage patients’ protected health information (privacy, security, and confidentiality).	Explains evidence-based strategies that the nurse informaticist and interdisciplinary team can use to effectively manage patients’ protected health information (privacy, security, and confidentiality), with reference to specific data, evidence, or standards to support the explanation.
Follow APA style and formatting guidelines for citations and references.	Does not follow APA style and formatting guidelines for citations and references.	Partially follows APA style and formatting guidelines for citations and references.	Follows APA style and formatting guidelines for citations and references.	Follows APA style and formatting guidelines for citations and references with flawless precision and accuracy.
Create a clear, well-organized, and professional proposal that is generally free from errors in grammar, punctuation, and spelling.	Does not create a clear, well-organized, and professional proposal that is generally free from errors in grammar, punctuation, and spelling.	Creates a proposal that lacks clarity and/or has errors in grammar, punctuation, and spelling.	Creates a clear, well-organized, and professional proposal that is generally free from errors in grammar, punctuation, and spelling.	Creates a clear, comprehensive, well-organized, and professional proposal that is error-free in grammar, punctuation, and spelling.

Protected Health Information (PHI): Privacy, Security, and Confidentiality Best Practices Example

Protected health information PHI is the personal information collected by healthcare professionals for the aim of patient identification. Protected health information includes demographic information, the medical history of a patient, their tests and laboratory results, the patient’s health conditions, and the patient’s insurance information.

The HIPAA requires healthcare institutions to maintain safeguards that ensure confidentiality, privacy, integrity, and unavailability of protected health information to unauthorized persons. The act also lays out guidelines for running health apps that potentially use, store, or transmit protected health information. HIPAA does not necessarily cover data collected by these apps. However, the healthcare institution applying the app is required to have a HIPAA compliance officer evaluating the app before implementation to ensure that it safeguards patients’ privacy, security, and confidentiality (HIPAA journal, 2022).    

Privacy, security, and confidentiality

Protection of the patient’s privacy and treating their information with confidentiality protects them from security issues that would develop when unauthorized persons access their information. Patient privacy is the protection of the information that the institution collects about the individual. It is the right one to determine for themselves when and how personal information can be accessed or shared.

Confidentiality is the protection of sharing information with unauthorized persons. Security is the level at which personal information is restricted and allowed for those authorized only. According to Keshta and Odeh (2021), patient privacy, security, and confidentiality concerns include failure to safeguard various information directly affecting patients’ families. Also, accessing personal patient information would expose the patients to security risks such as being conned.    

Importance of the interdisciplinary collaboration in safeguarding sensitive electronic health information

The interdisciplinary team has the role of safeguarding electronic health information, whether they come into contact with the information directly or indirectly. Since the consequences of breaching the protection of electronic health information may affect the entire healthcare institution, each interdisciplinary team member needs to maintain privacy, security, and confidentiality safeguards. It is the role of the interdisciplinary team to promote patient safety. One way to promote patient safety is by safeguarding patient privacy and confidentiality and ensuring patient security. Effective safeguarding of sensitive electronic patient information requires the collaboration of the interdisciplinary team (Keshta & Odeh, 2021).     

Evidence relating to social media usage and PHI

The issue of electronic health information and the protection of protected health information should be taken seriously by all interprofessional team members. It is worth noting that the US government takes inappropriate social media use by the healthcare team very seriously.

It has legal complications ranging from license termination, individual fines, and even fines to the healthcare organization. Healthcare institutions also set consequences for the interdisciplinary team when caught with social media misconduct. A healthcare professional may be suspended from working in the institution or initiate legal action. The misconduct may also make the institution to attract financial penalties or even affect its licensure.

Our institution’s evidence-based strategies to prevent and reduce confidentiality, privacy, and security breaches, especially related to social media use, include staff training, disciplinary action taken against the staff found breaching and taking legal action (Zhou et al., 2018). The institution has annual social media and information technology training for all staff members, whereby the staff is reminded of the safety issues of social media use. There are also set steps to report social media misconduct and breaches, and all the staff members are aware of the consequences.         

Professional Staff Update

Every member of staff should be careful when using social media so that we can maintain patient safety. We need to safeguard the patient’s privacy, confidentiality, and security to achieve desired patient outcomes and make our work safe.   

Social Media Best Practices

• Healthcare professionals should have a clear distinction between social media and work.
• Care providers should not post content that may bring privacy and security concerns to the patient.
• Care providers should not post patients’ personal information on social media platforms, especially personal identification information.
• The doctors and nurses should not post any diagnostic or patient medical history on social media without the patient’s consent.
• Avoid sharing any sensitive patient information on social media platforms.
• Social media misconduct should be reported to the disciplinary of the institution or the relevant authority.

Social Media Risks to Patient Information

 The profound use of social media in healthcare poses a significant risk to sensitive patient information (Terrase et al., 2019). Patient information that hackers access may have detrimental effects on the patient’s safety and security. Personal information can be used to con the patient and patient families in the name of the healthcare institution.

Some hackers can also use patient information to illegally access insurance reimbursements that cater to the patient’s treatment expenses. Also, healthcare professionals’ accounts can be hacked, and patient information shared by malicious hackers, thus attracting legal implications to the owner of the hacked accounts. Therefore, it is integral for all healthcare staff in the interdisciplinary team to maintain good social media use and avoid as much as sharing patient information on their accounts. 

References

Keshta, I., & Odeh, A. (2021). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal, 22(2), 177-183. https://doi.org/10.1016/j.eij.2020.07.003

Terrasse, M., Gorin, M., & Sisti, D. (2019). Social media, e‐health, and medical ethics. Hastings Center Report, 49(1), 24-33. https://doi.org/10.1002/hast.975

What is Protected Health Information? January 2, 2022. HIPAA Journal. Accessed on July 11, 2022. https://www.hipaajournal.com/what-is-protected-health-information/

Zhou, L., Zhang, D., Yang, C. C., & Wang, Y. (2018). Harnessing social media for health information management. Electronic Commerce Research and Applications, 27, 139–151.  https://doi.org/10.1016/j.elerap.2017.12.003