Professional and Ethical issues in Epidemiology

ByBertha Gonzalez- Saturday, September 19, 2015, 12:32 PM

I work in three different departments and wear many hats in the hospital: Community Outreach, Program Coordinator, Life Style Coach and Diabetes educator. Even when we provide different services in each department one part of my daily job is to explain the HIPPA privacy rule to the patients, I do this every day. “The HIPPA Privacy rule creates national standards to protect individual’s medical records and other personal information.”

Yakima Valley Memorial Hospital is committed to protecting the patient medical information and is required by law to do so. As an employee of Memorial Hospital I follow this policy. The hospital has zero tolerance to any violation to this rule and is constantly reminding us of the guidelines of HIPPA. This education and policy help me to keep my professional ethics in place.

When the patient signs the HIPPA form he/she is also giving the permission to share some of his/her information with insurance for billing and with other providers.

Federal states or local laws sometimes require us to disclose patient’s medical information, for instance, we are required to report the abuse or neglect of children or vulnerable adults. We are also required to give information to the State Worker’s compensation program for work related injuries, and to report certain communicable diseases to the state and may need to report patient problems with medications or medical products to the FDA or may notify patients of recalls of products they are using.

I am glad that these types of policies exist, especially when we need to report the abuse or neglect or children or vulnerable adults. We have done this reports before, for instance there was the case of a 12 year old diabetic child, we received the reference of the providers for a medical nutrition therapy, after we scheduled and called them, the parents kept re-scheduling, in one occasion they don’t even show up to the appointment. We contacted them back and explained that the appointment was critical to help the child to control his diabetes, his glucose levels were high. Finally when they came to the appointment we found out that both parents were drug users and when we asked questions about the meals, insulin shots and glucose monitoring they were totally out of the loop, the child was on his own responding to the questions. After they were gone I had to make use of my professional ethics and sent out a report to the provider. Then the provider sent the report to the Child Protective Services. This was a difficult situation and I was very glad of the existence of the Child Protective Services (CPS).

The data that raised a discussion in the diabetes and wellness program and in the hospital are the social determinant of health of some Latinos.

One in three Latinos have lack of medical coverage, many of them have no access to medical care, no primary health provider and they arrive to the diabetes classes with high levels of A1C(TheA1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to measure how well the patient is managing diabetes.), they also have several barriers to attend the diabetes classes and appointments and tend to develop more complications for uncontrolled diabetes.

Not all the providers, diabetes educators and other health workers understand the social determinants of health of our Latino families and not all of them see a need to support or develop sensitive programs available for Latinos. This is when my personal ethics and faith come across. Here is when I need to keep them in balance in order to be more strategic and in order to find support from decision makers from the hospital that can help us to develop culturally and linguistically sensitive programs for these Latino families.

http://www.yakimamemorial.org/patients-and-visitors-hipaa.asp

Lily (Bertha) Gonzalez