Access to What?

Over the past decade, Americans are turning more and more to hospitals for care, continuing a trend seen over the last several years. For example, in 2003, hospitals saw more than 34.7 million inpatient admissions and nearly 111 million emergency visits - an increase in emergency visits of 11.6 percent in five years. This occurs in the context of reduced numbers of hospitals receiving emergency patients. Any ideas about why this is?

The Dilemma of Reporting

Last week's class discussed privacy and confidentiality in the emergency department and next week will address topics in sexual health. By coincidence, this month's issue of Virtual Mentor is written about Professional Responsibility in Preventing Violence and Abuse. In particular, the cases and articles about youth and partner violence are very good. If you're interested in keeping up reading about ethics, I'd encourage you to check each month's issue. I'll actually be putting together an issue about ethics in emergency medicine for June of 2010...

HIPAA

Privacy, HIPAA and confidentiality are pretty easy to understand, right? My response would be a resolute, "Yes and No!" If you are inclined to want to know more about this topic, here are some resources.

The Health and Human Services Department's HIPPA Information Page
A specific overview of HIPAA privacy issues (in .pdf)
The UW Bioethics page about confidentiality

Update: I added this late required reading from the Iserson Ethics in the ER text to help us all hit the ground running on Wednesday. It is temporarily viewable on my personal webpage until we can get it on the secure class page.

WA On-Line access to Living will...

Like a hand-full of other states, WA has gone on-line with documents to help verify health care wishes for residents of Washington.

This site includes AA, DPOA, POLST and Mental health directives. Patients and physicians are asked to fax or mail in copies of these forms to the department of health. Then an account is set up for the patient to access their own information on-line.

If a health care provider wants to gain access to the information they must apply for an account through DOH and must have a valid license.

A Few More Resources

These are all from the UW Ethics in Medicine site. Click on the Bioethics Topics button to see the long list. Relevant to this week are:

Advance Directives
Do Not Resuscitate Orders
DNR During Anesthesia and Urgent Procedures
End-of-Life Issues
Physician-Assisted Suicide
Termination of Life-Sustaining Treatment

These pages provide excellent information about both medical and ethical issues related to DNR and end-of-life situations.