Health Insurance Portability and Accountability Act
health
[helth]Current views of health and illness recognize health as more than the absence of disease. Realizing that humans are dynamic beings whose state of health can change from day to day or even from hour to hour, leaders in the health field suggest that it is better to think of each person as being located on a graduated scale or continuous spectrum (continuum) ranging from obvious dire illness through the absence of discernible disease to a state of optimal functioning in every aspect of one's life. High-level wellness is described as a dynamic process in which the individual is actively engaged in moving toward fulfillment of his or her potential.
Person and environment are defined as co-extensive, open energy fields. The two evolve together and move toward increasing complexity and diversity, manifested in patterns of interaction that occur along continua of time and space. Person is also defined as a specific pattern of consciousness.
Health is a process of expanding consciousness that synthesizes disease and non-disease and is recognized by patterns of person-environment interaction. An understanding of pattern is basic to an understanding of health, and involves the movement from looking at parts to looking at the whole. Pattern is defined as information that depicts the whole, and gives an understanding of the meaning of relationships.
Nursing is an integrative force within the new paradigm of health seen as the undivided wholeness of the person in interaction and as a process of evolving consciousness. The nursing process is modified by Newman and encompasses nursing diagnosis/intervention based on the unique configuration of each person-environment interaction. Intervention is broadly intepreted as the recognition and augmentation of person-environment patterns, where the nurse and the client evolve together toward expanding consciousness.
In the United States, the spectrum of health care has been defined by the Department of Health and Human Services as encompassing six levels of health care. The first level of care is preventive care, which is primarily provided by school health education courses and community and public health services.
Primary care is the usual point at which an individual enters the health care system. Its major task is the early detection and prevention of disease and the maintenance of health. This level of care also encompasses the routine care of individuals with common health problems and chronic illnesses that can be managed in the home or through periodic visits to an outpatient facility. Providers of care at the primary level include family members as well as the professionals and paraprofessionals who staff community and neighborhood health centers, hospital outpatient departments, physicians' offices, industrial health units, and school and college health units.
Secondary or acute care is concerned with emergency treatment and critical care involving intense and elaborate measures for the diagnosis and treatment of a specified range of illness or pathology. Entry into the system at this level is either by direct admission to a health care facility or by referral. Provider groups for secondary care include both acute- and long-term care hospitals and their staffs.
Tertiary care includes highly technical services for the treatment of individuals and families with complex or complicated health needs. Providers of tertiary care are health professionals who are specialists in a particular clinical area and are competent to work in such specialty agencies as psychiatric hospitals and clinics, chronic disease centers, and the highly specialized units of general hospitals; for example, a coronary care unit. Entry into the health care system at this level is gained by referral from either the primary or secondary level.
Respite care is that provided by an agency or institution for long-term care patients on a short-term basis to give the primary caretaker(s) at home a period of relief.
Restorative care comprises routine follow-up care and rehabilitation in such facilities as nursing homes, halfway houses, inpatient facilities for alcohol and drug abusers, and in the homes of patients served by home health care units of hospitals or community-based agencies.
Continuing care is provided on an ongoing basis to support those persons who are physically or mentally handicapped, elderly and suffering from a chronic and incapacitating illness, mentally retarded, or otherwise unable to cope unassisted with daily living. Such care is available in personal care homes, domiciliary homes, inpatient health facilities, nursing homes, geriatric day care centers, and various other types of facilities. See also home health care.
Health Insurance Portability and Accountability Act (HIPAA),
The nature of the relationship between the patient and the health care provider demands that all information obtained from the patient in the course of diagnostic evaluation and treatment be held in strictest confidence. Preserving the confidentiality of medical information has traditionally been a part of medical, nursing, and hospital ethics, and policies and procedures have been established to safeguard the privacy of medical information and medical records. HIPAA established a national standard for the protection of all individually identifiable health information. Although its primary intent is to protect medical information that is electronically transmitted, the law as enacted applies to individually identifiable health information in all forms-electronic, written, oral, and any other. The HIPAA Privacy Rule requires each provider of health care to adopt specific policies and procedures, including physical safeguards such as locked file cabinets and computer passwords, to protect the confidentiality of all medical information in its keeping, to ensure that staff members understand these policies and procedures, and to provide information to patients about their privacy rights and how their medical information can be used and transmitted. No personally identifiable information about a patient, and no part of any patient's medical record, may be revealed or transmitted to, or discussed with, any person without the patient's written authorization, except under clearly specified circumstances. Under the Privacy Rule, health care workers may exchange or discuss medical information about patients among themselves as needed to provide medical, nursing and other services. They may impart information from a patient's record to other health care providers (including ambulance attendants; emergency department staff; pharmacy, laboratory, and x-ray personnel; and specialists or consultants) who are involved in the care of that patient. However, this rule requires health care providers to make reasonable efforts to limit the disclosure and use of personal health information to the minimum extent necessary to accomplish the intended purpose. Disclosure and use of information may be permitted without prior consent in an emergency or when substantial communication barriers exist. This rule also gives patients the right to examine their own health records, obtain copies, and request corrections, and prescribes civil and criminal penalties for health care workers who violate patients' privacy rights.