There are time when security and privacy breaches occur in organizations, despite organizational efforts and having best practices in place to prevent them. The ability to respond efficiently and effectively to a data breach incident is crucial for success as a health informatics professional.
Read the case study below and simulate your response to the data breach incident by developing and communicating a comprehensive incident response plan to be presented to organizational leadership in the form of an email communication.
Case Study: HIPAA
Health Care Inc., a health care consulting company, was engaged to perform an MS-DRG validation audit of 100 Medicare inpatient claims for ABC Hospital. The inpatient cases to be reviewed were selected by ABC Hospitals coding manager. The Health Care Inc. auditors were provided VPN access to the hospitals EHR to review the documentation of the selected inpatient cases to validate the MS-DRG assignment.
The consulting manager with Health Care Inc., who is responsible for performing the quality review of the work of the team, decided to download the inpatient cases included in the review to a company-issued laptop to perform the quality review while traveling to another client site. In the course of travel, the laptop was left in the back seat of a rental car while the consulting team stopped to have dinner. When the team returned from dinner, it was discovered that the rental car had been burglarized and the laptop stolen.
This is the first time that patient data from ABC Hospital have been compromised. However, this is the third time in 11 months that a laptop containing patient data from Health Care Inc. has been stolen.
Part 1: Preparing to Respond
Consider the facts of the case and identify the following:
- Assess who is liable for the loss of inpatient cases and identify specific activities that demonstrate ineffective management of the inpatient cases.
- Identify the responsibilities of each key person in the organization (e.g., hospital administrator, IT security officer, legal counsel, public relations manager) in addressing the loss of inpatient cases and determining whether a HIPAA breach has occurred.
- Review relevant HIPAA regulations, focusing on breach notification rules and the use of Business Associate Agreements (BAAs).
- Consider how each key role will manage the data breach legally and ethically.
Part 2: Incident Response Plan Email Communication
Develop a formal incident response plan outlining the steps to be taken immediately following a data breach in a 500-750 word email to the leadership team. The email should address the following:
- Summary of the incident, including the inefficiency and gaps that occurred in securing the inpatient data and the resulting liability issues for ABC Hospital and Health Care, Inc.
- Determination of whether a HIPAA breach occurred, and legal obligations associated with a breach, is applicable.
- Explanation of the role and importance of a BAA in the context of vendor management.
- Describe the internal response procedures for key individuals within the organization, including measures that will be taken to prevent similar future incidents. Summarize the HIPAA-compliant methods for securing inpatient data.
- Identify changes that will be made to existing policies or new policies to be enacted to better manage and secure inpatient data.
- Describe the external communication strategies that will be implemented including a list of affected stakeholders and information that will be shared with them.
Solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines.
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