Risk Management and Health Care Legislation

Question 1 

Risk management and health care legislation correlate with the latter impacting the former. Risk management involves “identification, evaluation, and prioritization of risks followed by coordinated and economical application of resources to minimize, monitor, and control the probability or impact of unfortunate events or to maximize the realization of opportunities” (Derenyielo & Joseph, 2018). Health care legislation, on the other hand, entails regulations enacted for societal establishments and persons to know acceptable and non-acceptable behaviors related to the health sector (Nowotny et al., 2019). Health care legislation directly affects risk management owing to its primary purpose of protection. The latter seeks to curb any arising risk by taking precautionary steps which health care legislation communicates. Risk management and health care legislation, therefore, correlate with the latter influencing the former. 

Question 2 

A health care organization, when involved in transmitting patient information through avenues like fax, e-mail, or paper, can reduce risk regarding HIPAA compliance by data protection and physical means. HIPAA compliance involves the modernization of healthcare information flow accompanied by their protection (Tovino, 2019). A healthcare organization can reduce risk by enhancing data security by measures such as maintenance of a high level of control of sensitive data throughout the establishment by secure systems and placing policies regarding accessing electronic data or workstations. Others include having a unique system with special encryption and decryption to minimize external or internal hacks. Physical provisions like limiting access and control to authorized person and tracking logs regarding software activity can enhance the other measures therein enhance reduction of risk by healthcare organizations regarding HIPAA compliance. 

Question 3 

As the head of a quality improvement team mandated to reduce the number of inaccurate ICD-10 code entries, I would enact a step-by-step approach for evaluation accompanied by relevant personnel for the project. Rico et al. (2018) submit that the ICD-10 code entries entail “statistical data regarding diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or ailments.” Inaccuracies can therein lead to high risks within healthcare systems which I would minimize by a step-by-step evaluation process. Firstly, I would plan which involves putting in place ideal structures mitigating chances of error. Secondly, I will examine the success of the project by running simulations therein, making corrections. Thirdly, I will assess the immediate outcomes to make sufficient conclusions. Lastly, I will disseminate and report the results by putting them in the database comprehensively and systematically. The entire process requires collaboration with relevant stakeholders such as case management team and the WHO coding team. 

Question 4 

According to current literature, workplace safety and data security are two of the top 10 safety concerns for hospitals which a healthcare facility can adopt ideal strategies to mitigate risk (Guerin et al., 2020). Firstly, hospital work faces dangers with a probability of injury (on a physical and mental level) and the constant risk of infection. The threat is containable by improving the safety standards of healthcare facilities, especially by using technology as assistance to medical work. Medics require sufficient and suitable supply of PPEs to mitigate the risk of infection. Secondly, the risk of data breaches is a safety concern which can hurt the sanctity of keeping a patient’s personal information. Health facilities can reduce risk to such occurrences by enhancing data security systems and sufficient provisions in policies to uphold integrity. 

Question 5 

Two litigious areas for Cleveland Clinic include patient treatment practices and payment of medical bills (Farrell & Allyse, 2018). For the above, legal provisions exist dictating patient-doctor relationship with the patient requirements coming first guided by safety practices under the medical provision. Cleveland Clinic faces lawsuits involving medical malpractices which taint its image (Farrell & Allyse, 2018). The establishment can mitigate such risks by employing well-adverse medical practitioners with a high level of success rate and recognized for suitable approaches when administering to patients. Secondly, the healthcare facility faces concerns on payment of medical bills which the law demands through mandating patients to offer fees for acquired services and products (Farrell & Allyse, 2018). The risk on the litigious area is manageable by enhancing insurance policies to cushion patients against high costs of healthcare. 

Question 6 

The case involving a HIPAA compliance issue whereby 200 incorrect numbers outbound taxes receive outbound taxes is a dire one which would require a sufficient team to manage the problem. The described violation is a significant concern, given it goes against compliance of HIPAA compliance standards by destroying the integrity of patient records. Ad a manager of a healthcare organization under the operational department, I would require relevant professionals to address the issue. Firstly, and most importantly, I would require an IT expert to decrypt the sent data therein eradicate the damage caused. Secondly, I would adopt the services of a communication expert to express the unfortunate turn of events, thereby mitigate further adversity. Lastly, I would take charge of supervision and ensure the risk management process occurs with speed and without a hitch. 

Question 7 

Patients and medics are stakeholders whom healthcare reform impacts. Changes in the healthcare sector affect how medics run operations in healthcare facilities. It equally transforms the nature of receiving services and products by patients. Such reforms on the ideal-side can enhance the patient-doctor relationship by easing access to healthcare services (Gottlieb et al., 2019). They equally can reduce costs for getting the services which will improve patient welfare. Contrastingly, the latter can hurt the welfare of medics by reducing their earnings subject to revenue collection by specific hospitals. It may equally lead to unsafe engagements by patients therein hurting their wellbeing as they feel ensured of receiving treatment at less-to-no costs. 

Question 8 

The availability of doctors, the influx of patients, and persons within the area are three top considerations considerable for healthcare office leadership when considering enrolling as a provider for those covered as under the Affordable Healthcare Act. The first two are organizational concerns which influence expansive measures such as adopting the insurance policy, which “seeks to make healthcare affordable and expand coverage” (Grant, 2017). The third consideration is an external element which directly influences the need for adoption. Many individuals may have the insurance coverage within the area of coverage therein it is proficient at addressing their capabilities. As leaders of the healthcare organization, these three considerations are critical when deciding to adopt the provision. 

References 

Derenyielo, B., & Joseph, E. M. (2018). RISK MANAGEMENT AND ENTERPRISE RISK MANAGEMENT IN NIGERIA: IMPLICATIONS FOR NATIONAL DEVELOPMENT AND GROWTH.  Kuwait Chapter of the Arabian Journal of Business and Management Review, 7 (3), 29-40. 

Farrell, R. M., & Allyse, M. A. (2018). Key Ethical Issues in Prenatal Genetics: An Overview.  Obstetrics and Gynecology Clinics ,  45 (1), 127-141. 

Gottlieb, L., M.D., Fichtenberg, C., PhD., Alderwick, H., & Adler, N., PhD. (2019). Social determinants of health: What's a healthcare system to do?  Journal of Healthcare Management, 64 (4), 243-257. 

Grant, R., M.A. (2017). Public health professionals urgently need to develop more effective communications strategies.  American Journal of Public Health, 107 (5), 658-659. 

Guerin, R. J., PhD., Castillo, D., M.P.H., Hendricks, K. J., M.A., Howard, J.,M.D.J.D., Piacentino, J.,M.D.M.P.H., & Okun, A. H., DrP.H. (2020). Preparing the future workforce for safe and healthy employment.  American Journal of Public Health, 110 (1), 69-71. 

Nowotny, B. M., M.B.B.S., Loh, Erwin, MBBS, LLB, MBA,PhD., F.R.A.C.M.A., Lorenz, Katherine,B.A., L.L.B., & Wallace, Euan M, AM, MBChB, MD, FRCOG,F.R.A.N.Z.C.O.G., F.A.H.M.S. (2019). Sharing the pain: Lessons from missed opportunities for healthcare improvement from patient complaints and litigation in the australian health system.  Australian Health Review, 43 (4), 382-391. 

Rico, R. D., Nambiar, D., Stoové, M., & Dietze, P. (2018). Drug overdose in the ED: A record linkage study examining emergency department ICD-10 coding practices in a cohort of people who inject drugs.  BMC Health Services Research, 18 

Tovino, S. A. (2019). A timely right to privacy.  Iowa Law Review, 104 (3), 1361-1420.