CASE:ROI
Peggy Smith, RHIA is Assistant Director of the Health Information Department at Minnesota Hospital. As part of her assigned responsibilities she supervises the release of information function within the department. Until today, she had very little occasion to be involved in the day-to-day operation of release of information, as she had an excellent ROI supervisor who was the expert in this area. However, she has just learned that the ROI supervisor will be out indefinitely because she was injured in an automobile accident the previous evening. Unfortunately, there is no backup for Patsy's position because they have not filled the vacant ROI clerk position yet. The department director Georgia Lang has informed Peggy that she will have to handle the release of information duties until the supervisor returns or the clerk position is filled. Peggy assigned the file room clerk, Matt, to handle walk
in ROI requests in addition to her file room duties. She shows Matt how to have patients complete an "Authorization for Release of Information" form and gives him explicit instructions to refer all special requests back to her. Peggy will handle telephone and mail requests. It has been a while since Peggy graduated from an HIT program, so she is a little nervous about not being knowledgeable about current ROI standards. She reminds herself that next time there is continuing education money available in the budget; she will request funds for attending a ROI/legal seminar.
Below are listed various release of information situations related to the case above. For each situation there is also the action that Peggy took to handle the situation.
Comment on whether you agree or disagree with the action that Peggy took to handle the situation. In the comment area, give your reasons for agreeing or disagreeing with her actions.
1. Situation: An Emergency Services Department (ESD) physician at another hospital requests the immediate transmission of a patient's latest EKG and echocardiography report. The patient is now in his ESD with chest pain.
Action: Peggy faxed the reports.
2. Situation: Peggy opens a letter from Blue Cross/Blue Shield requesting copies of an individual's discharge summary and pathology report. No patient authorization is attached.
Action: Peggy sends back a letter informing BCBS that the hospital cannot release any patient information without first having a properly executed patient authorization.
3. Situation: The department receptionist informs Peggy that a gentleman from the state Department of Health has arrived and is requesting to review the medical records of three tuberculosis patients.
Action: Peggy contacts the file room and has the records brought to her office for the state representative to review.
4. Situation: Peggy takes a telephone call from an area high school principal who is requesting information about one of the teachers at his school. He specifically wants to know the reason for her hospitalization.
Action: Peggy tells the principal that health information is confidential and cannot be release without the patient's written authorization to do so.
5. Situation: The Medical Examiner's (ME) office calls requesting a copy of an operative report for a patient who recently expired in the operating room at the hospital.
Action: Peggy tells them that an authorization is first needed from the deceased patient's estate before he can release any information.