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HIPAA Privacy Rule


The paper examines a scenario, under which a breach of health information privacy occurs. The paper envisages in depth the scenario analyzing the specific requirements as indicated in the department of health and human services. It also analyzes how these requirements can be used in investigating the given scenario. One of the main goals of the paper will be to identify whether the mentioned incidence was an actual breach of health information privacy. Examining the similarities and differences between the hospital and the HIPAA law will also be done in determining whether the nurse who breached privacy should be fired. The final concern for the paper will be to give an informed judgement on whether to fire the nurse or place her on administrative leave to allow time for investigation.

Specific Requirements Needed to Perform the Investigation

In the given case, a nurse has breached the privacy and confidentiality of information by revealing the name of a patient to her daughter. There are selected requirements as stipulated in the department of health and human services (HHS) that can be tapped in generating an informed judgement about the scenario.

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In finalizing the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the congress identified increasing challenges in keeping health information private because of the advancing rate of health information systems. Ss observed by the congress, this requirement identified that nurses and other medical professionals found it hard to keep information confidential due to the growing number of health systems. It was practical to keep information outside the reach of the public. However, depending on advances in technology, especially in the medical sector, this achievement was gradually being compromised. According to the congress, this view represents the first requirement that can be leveraged to deliver an informed and mature judgement. The health sector faces increasing advances in health systems that unfortunately compromise nurses’ efforts to keep critical information secure (HHS, 2002).

Another requirement pertains to the HIPAA law. One provision implies that no policy will supersede or replace requirements set by the State, which are contrary to the first and provide more stringent measures towards protection of information. This requirement points that no law or sub-law by the HIPAA is above those recognized by the State. This provision is important as it helps policies established by the HHS to remain below the state. More specifically, the department recognizes the state as the superior body and sets every law below it. This requirement can be applied in the given scenario. The rights the state gives to individuals, particularly working professionals, remain intact regardless of any other statutory laws and polices established by minor bodies, such as health centers and hospitals. This requirement can be used in generating the judgement on the nurse.

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Another requirement pertains to violation of information systems. According to the American Immunization Research Association, gross failure or breach in information systems leads to loss of critical information. The AIRA champions this argument noting that health information is not stored in third party sources, such as cloud systems and conventional sources (AIRA, n.d.). This information is vulnerable as far as system failure is concerned. The first group of people to suffer in case of failure or breach is the hospital’s management and staff. Breach or failures mean that medical experts will return to the field and collect the data. The healthcare or organization management might also incur costs contacting private and public healthcare settings to get this information. Patients represent another category of stakeholders who are likely to suffer due to breach or failure of information systems (Koontz, 2013).

In extension to the above requirement, a patient’s medical records as well as previous records for his health are secured inside information systems. Breaching is most likely to interfere with the originality of this information. This nature of interference compromises treatment, diagnosis and overall recovery for patients, especially those in long-term treatment (Herzig, 2010). Particularly, this happens due to the fact that records and past medical histories are referred regularly in efforts to increase the level and quality of treatment. The HIPAA Privacy Rule connects with AIRA stipulating a requirement to enhance the safety, performance and functionality of health care information systems. Information systems represent a critical hub in the maintenance and dissemination of information. Therefore, this requirement views the systems as critical in preserving the privacy of identifiable health information.

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In part B of the HIPAA Law, there is a privacy rule that protects individually identifiable health information. This requirement implies that the privacy of personally identifiable health information should be maintained regardless of conditions and circumstances surrounding the person (HHS, 2002). This means that if a patient suffers from a condition or a disease that might spark public interest, the medical center involved in the administration of care should strive to keep this information private and confidential. This requirement of the HIPAA Privacy Rule recognizes the rights of an individual to live freely in the society. In addition, the requirement observes that if the society learns of an individual health status and conditions, this person might face difficulties interacting with persons in the society. Therefore, the HIPAA Privacy Rule needs to provide patients with privacy in regard to identifiable health information posing that heath information should be kept confidential regardless of circumstances and conditions surrounding the patient. This requirement can be used to judge the nurse in the above scenario.

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The final requirement that can be used as a basis of judgement on the above scenario accounts whether the hospital is a covered entity. According to the department of health and human services, government-accredited facilitiesmust always recognize their role as covered entities and health care providers. Individually identifiable health information created, received or transferred by a covered entity remains a protected type of information (HHS, 2002). This means that the entity reserves the jurisdiction to use and apply provisions of the HIPAA Law to give judgement to employees. This requirement can be used in the given scenario depending on the status of the hospital. If the hospital where the nurse was practicing is a covered entity, specifically a government-accredited health center, it reserves the power to make decisions based on the HIPAA Law. It can do this while at the same time excluding any concerns that might be raised by the plaintiff. The status of the health center determines the degree of punishment that the nurse will be subjected to.

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Whether the Incidence Was a Breach of Privacy

Indeed, the incidence was a total breach of privacy. As seen above, one requirement of the HIPAA Privacy Rule is that personally identifiable health information should be kept private. The nurse revealed the name of a patient to her daughter. Unfortunately, the daughter was conversant with the patient and spread news about the pregnancy. The name mentioned by the nurse to her daughter was personally identifiable information. The warnings given by the nurse to the daughter were connected with information about the status of the patient. In that vein, the culmination of the nurse’s advice to her daughter constitutes a breach of privacy to personally identified health information. The nurse mentioned the name of a patient who was experiencing a recovery period after delivering a new born with serious health conditions. The reputation of the patient was at risk given how far word had spread about her case. In such a way, the incidence was an actual breach of privacy, particularly to identifiable health information.

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Differences and Similarities between HIPAA and the Hospital’s Stance


The first similarity between the hospital and the HIPAA Privacy Rule is the protection of the patient’s information. In the scenario, the nurse was ready to hand over the badge and keys to the privacy officer. This means the medical professional identified her actions as a violation and immediately resolved to submit these tools of a practicing nurse. The hospital pays close attention to breaching the information about a patient. In addition, the health center views a breach of private health information as a failure to maintain the status of a patient and offers strict punishment to offenders of this policy. Thus, both the hospital and the HIPAA share similar sentiments as far as maintaining the privacy of information is concerned.

Another similarity is that both entities give time for investigation. It is a provision for the HIPAA Privacy Rule that individuals suspected of infringing the policies should be investigated before a judgement is spelled (Klosek, 2011). The Health Insurance Portability and Accountability Act has a provision that states people suspected to be involved in activities that seem to conflict set policies will be analyzed and examined before the judgement. The 1996 HIPAA Act provides room and time to examine activities and actions that violate the set policies (Fox et al. 2007). It appears that the hospital’s stance was more or less similar to the privacy rule. In regard to the privacy officer, the hospital tasked this position with investigating the given scenario and introducing an informed settlement about the actions of the nurse. Although the nurse was strongly anticipating the termination of employment, the hospital was ready to use the 1996 HIPAA Act as a basis of judgement. Consequently, there is a similarity between the hospital’s stance and the law about protecting the privacy of health information and administering punishment to offenders.

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Both the hospital and the Department of Health and Human Services (HHS) are subjected to state laws. According to the congress, any policy, regulation or rule established by the HSS must conform to those of State Laws. The hospital is subjected to both the HHS and State Law. On the other hand, the HHS is subjected to laws of the state. This means that both the hospital and the HIPAA Law share similarities as far as the practice of privacy is concerned. This similarity in the practice and implementation of specifications will significantly determine the degree of punishment in the case scenario.


The hospital and the HIPAA share subtle discrepancies. First and foremost, the two are separate entities, and this nature affects the extent, at which both can implement certain specifications. As seen above, one requirement by the HIPAA is that only covered entities have the power to use the 1996 privacy rule that was revised and finalized. Covered entities refer to bodies recognized by the government in the provision of health services and medical administration (Harman and AHIMA, 2006). If the hospital is a privately developed entity, it might not retain the power to practice certain provisions of the HIPAA Privacy Rule. Therefore, the judgement given to the nurse will be affected. The differences between the hospital’s stance and the HIPAA Law stem from the fact that both bodies are separate entities, the practices of which are entirely independent. While the government expects the HHS to make polices and laws that conform to those of the state, the HSS has no power to control or subvert the functions of a privately owned medical firm. This is the concept that makes both the hospital and the HIPAA contrasting.

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How the Similarities and Differences Pertain to Firing

The nurse is a voting citizen meaning she has the freedom to enjoy certain rights as captured in the State laws. However, in contrast to a contemporary citizen, the nurse is subjected to another set of laws – those captured by the employer. The hospital has the right to punish for the activities and actions displayed by her that clearly do not preserve the privacy of identifiable health information. The hospital is capable of firing the nurse if it is a privately owned organization. A private firm is not a covered entity and, therefore, is partially subjected to HIPAA Privacy Rule. However, if the hospital was completely recognized by the government, or was a federally owned health center, it has the right to punish the nurse by terminating her employment. Nevertheless, this settlement can be compromised by the rights enjoyed by the nurse under the state laws.

As a citizen of the United States, the nurse enjoys the freedom of employment and should not be denied the right of making a living through employment or business. Therefore, the degree of punishment will be affected by two points. First is the nurse’s citizenship and her freedom to enjoy free employment without unnecessary termination. Second is the hospital’s urge to adhere to rules and policies as stipulated in the HIPAA Act of 1996. In such a way, if the hospital is recognized by the government, the nurse is likely to reserve her employment although she will still face punishment. However, if the health center is a privately developed entity, the nurse might face termination of employment because her employer is not fully subjected to the HHS.











To Fire or Not – Final Decision

The nurse breached the policy of maintaining the privacy of individually identifiable health information. This violation comes with punishment as stipulated by the department of health and human services under Health Insurance Portability and Accountability Act of 1996. The nurse will NOT BE FIRED because the infringement of policy was used as a basis of information and advice. Within the given scenario, the nurse observed the condition of the 15-year old patient. As a parent, the nurse talked to her daughter to caution her from actions that can to put her in a similar situation. Therefore, the breach of the privacy rule by the nurse occurs not as the result of ignorance or bad mouthing but as a basis of advice and good counsel. It would not be mature to fire the nurse given this requirement. However, the degree of this settlement is affected by the reputation of the 15-year old patient. The patient is a mother at a young age, and her reputation in school has starkly been compromised. She might not enjoy free interactions in the society given her new status – a parent at 15 and a mother to a child with health conditions. Taking this into consideration, it would not be fair to fire the nurse. Therefore, the judgement is to suspend the nurse for a given period. The nurse will be expected to go on an impromptu leave and think about the implications of her actions. However, after the given period, she will keep the job and continue working as a registered nurse.

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Maintaining the privacy of health information is of critical concern not only to private and non-private bodies but also to the government (Robichau, 2014). The state recognizes the need to ensure equality in the society. The government is also concerned in ensuring that citizens live in peace and harmony and without discrimination. However, these requirements cannot be achieved without determining the scope of health information. Identifiable health information points at the status of a person in terms of diseases, conditions and circumstances. If this information is disposed to the public, the person may not be able to enjoy free coexistence with others, particularly those in the same age. These are perhaps the concerns that surround the need to make health information private and confidential.


The paper examines a case scenario involving the breach of health information. The paper develops a critical and comprehensive list of requirements that are needed in investigating the given scenario. A part of this work was to feature information systems and show how they can be used to achieve the privacy of identifiable health information. The analysis identifies whether the scenario was an actual breach of privacy according to the Health Insurance Portability and Accountability Act. The paper has also examined the similarities and differences of the hospital and the HIPAA Privacy Rule determining whether the nurse should be fired or not. The final component of the paper was to give an informed judgement using the requirements as stipulated by the department of health and human services. The above analysis surmises the paper adding knowledge about the HIPPA Privacy Rule.

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