healthcare casestudy
You can pick anyone of the below case studies.
1. Building a Better MIS-Trap—Case for Chapter 8
Sharon B. Buchbinder
You are the CEO of a large health services organization (HSO) in Florida. Your HSO has inpatient and outpatient facilities, home healthcare services, and every other service your patient population needs. You also have a world-renowned AIDS treatment center that has been considered by many to be a model for the rest of the United States. Your HSO has always enjoyed an excellent reputation, and your quality of care is known to be excellent. You have been very happy in your work, knowing that your HSO provides good care to people who truly need it in a caring and cost-effective manner.
Your HSO has recently been featured in every media vehicle known to every man, woman, and child in the United States and beyond. The reason: someone downloaded the names of 4,000 HIV+ patients who had been seen in your world-renowned HIV clinic and sent the list to newspapers, magazines, and the Internet.
You and your board of trustees are completely blown away. The board is furious and wants to fire you. You have been able to convince them that they need to keep you on to fix the HSO’s management information system (MIS). Their last words to you were “You had better come back with plans for building a better MIS, or you’re fired!”
You hire a computer security consultant, and she comes into your organization under disguise as a nurse manager to help you determine where the security leak might be. She returns to you in three days with the following report.
“While I was undercover in your organization for a mere three days, I observed the following breaches in computer security. These are the highlights (or lowlights):
■ Nurses log in with their passwords, walk away, and leave the system open and up and running;
■ Dr. Jones leaves his password taped to the PC on a piece of paper;
■ Fax machines and printers are often in areas of high traffic and in rooms without locks;
■ With my one password, I had remote access to every database in the hospital, including Human Resources, from my home;
■ There are no programs reminding people to change their passwords on a regular basis;
■ When I pretended to forget my password, other nurses gave me theirs; and
■ When I requested sensitive patient files on flash drive, even after this incident, people rarely questioned me.
In short, you have a major problem with your MIS—and your staff!” What should you do?
DISCUSSION QUESTIONS
1. What law is being violated by the employees at this health services organization?
2. Why was this law enacted?
3. What are the penalties for violating this law?
4. If an employee shares confidential medical information about a celebrity and is caught, what should the penalty be?
5. Do you think you should be updating your resume and looking for a new job?
2. Oops Is Not an Option—Case for Chapter 16
Maron J. Boohaker
Bill Salamander is a consultant working in the medical records department of a medical center. As would any vendor doing business with this hospital, Bill’s company has signed a Business Associate Agreement. This agreement confirms that the vendor will abide by the hospital’s compliance and Health Insurance Portability and Accountability Act (HIPAA) policies.
Bill has friends all through town, and they know how much access he has to patient information. One such friend is a personal injury attorney, Anna Anywaican. This attorney is full of ideas. One of her schemes includes a network of associates at hospitals around the state. She hadn’t yet made inroads into this one facility, but now she had Bill.
It was a simple plan—Bill would provide Anna access to trauma patients, and for every case he recruited, she would award him 10% of any monies she recovered.
In his first assignment, Bill was paid $25,000 after Anna’s client accepted a settlement. However, Bill still had one problem. His access to the medical records was limited to postdischarge. Sometimes, a trauma patient’s record would not arrive to the medical records department for months. Bill had to find help.
Bill decided to go to the Emergency Room and scout the third-shift employees. Eventually, he comes to you, Micah Makaliving. On your break, he asks you to provide him access to the patients who register in the ER as trauma patients. He offers you two choices: either pass out Anna Anywaican’s cards or hand him a list of patient names and addresses. Bill will pay you 50% of what he makes. Micah, what will you do?
DISCUSSION QUESTIONS
1. What law is Bill violating?
2. Why was this law enacted?
3. What are the penalties for violating these laws?
4. If you agree to help out and Bill and Anna get caught, what do you think is the probability that they will roll over and give you up to the authorities?
5. Do you think you should be updating your resume and looking for a new job? Or should you find out where the whistle-blower number is?
6. Do you think Bill and Anna should be thinking about how they’ll make new friends in jail?
3. The Brawler—Case for Chapters 11 and 12
Sharon B. Buchbinder and Dale Buchbinder
Dr. O’Connor was known for his hot temper and drinking. Although he claimed never to come to work under the influence, nurses, physicians, and other coworkers had their doubts, and several expressed their alarm to their supervisors. The emergency room needed coverage, and it was hard to find physicians who would work the graveyard shift, so little was done to address these concerns. One night, Dr. O’Connor walked across a clearly marked wet floor that the custodian had just mopped. When the angry janitor protested loudly and pointed to the bright yellow sign and the offending footprints, Dr. O’Connor took a swing at the other man and a fistfight ensued.
DISCUSSION QUESTIONS
1. What should the hospital do to deal with the good doctor? Who should handle this?
2. What role, if any, did the janitor play in this incident? What could he have done differently?
3. Where should Dr. O’Connor be referred—anger management, Alcoholics Anonymous, psychiatric evaluation? Provide a rationale for your response.
4. How can this incident be turned into a “teachable moment” for the staff, physicians, and others?
5. How could this have been prevented?
