The focus on technology and human relationships increases ethical imperatives because what is done, how it is done, and what the intended (and sometimes unintended) outcomes are must be carefully examined.35. The ethical decision is what should be done (the best action), given the competing interests, obligations, and values of others involved in making the decision. 4.7. The Pledge of the American Association of Medical Record Librarians, written in 1934, incorporated values and professional practice standards that carried forward to future codes of ethics. Take action through appropriate formal channels, such as contacting an accreditation or regulatory body and/or the AHIMA Professional Ethics Committee if needed. Since its adoption at the founding meeting of the American Medical Association in 1847, the AMA Code of Medical Ethics has articulated the values to which physicians commit themselves as members of the medical profession.. People have been creating medical records since antiquity, as evidenced by the drawings of medical conditions and surgeries in the cave wall paintings created by early humans. Participate in, condone, or be associated with dishonesty, fraud and abuse, or deception. AHIMA. Moral Intelligence: Enhancing Business Performance and Leadership Success. Base practice decisions on recognized knowledge, including empirically based knowledge relevant to health information management and health information management ethics. Chicago: Physician’s Record Company, 1972, p. 135. A Code of Ethics is important in helping to guide the decision- Clifton Park, NY: Cengage Learning; 2014. AHIMA's Code of Ethics The Code of Ethics restates what we all know about our obligation to Protect Information Promote Confidentiality Preserve and Secure Health Information Identifies core values on which the HIM mission is based Provides Direction The Code of Ethics is based students, staff, peers, or colleagues) where there is a risk of exploitation or potential harm to that other person. Contribute time and professional expertise to activities that promote respect for the value, integrity, and competence of the health information management profession. BOTH SETS OF PRINCIPLES REFLECT EXPECTATIONS OF PROFESSIONAL CONDUCT FOR CODING PROFESSIONALS INVOLVED IN DIAGNOSTIC AND/OR PROCEDURAL CODING OR OTHER HEALTH RECORD … 1934 Pledge of the American Association of Medical Record Librarians, The pledge was adequate for guiding professional behaviors until 1957, at which time the professional association passed the first code of ethics.20 This code of ethics engaged the professional values and ethical principles of service, honor, and the advancement of medical record science, among other values such as placing service before material gain; bringing honor to self, associates, and the medical record profession; preserving and protecting medical records; providing service; honoring the welfare of patients; preserving and protecting privacy and confidential information; following laws and regulations; serving the employer loyally; refusing to participate in or conceal unethical practices; reporting violations to proper authorities; preserving the confidential nature of committees; accepting customary and lawful fees; staying within the scope of responsibilities; advancing medical record science and maintaining continuing education; strengthening professional manpower; honoring association responsibilities; and stating degrees, experience, and credentials accurately. These include policies and procedures created by AHIMA, licensing and regulatory bodies, employers, supervisors, agencies, and other professional organizations. Check back for further updates. Guidelines for ethical and unethical behavior are provided to assist with the interpretation of the American Health Information Management Association (AHIMA) Code of Ethics. 21  Twitty, M. E. “Ethics for Medical Records Library Personnel.” Journal of the American Association of Medical Record Librarians 27, no. Educate stakeholders about the need to maintain data integrity and the potential impacts should data integrity not be maintained. 7th ed. Act with integrity, behave in a trustworthy manner, elevate service to others above self-interest, and promote high standards of practice in every setting. The American Health Information Management Association (AHIMA) House of Delegates approved the newest version of its Standards of Ethical Coding on Dec. 12, 2016. This document provides a solid foundation of guidance in relation to ethical coding practices and … 12.3. 1 (2000). Autonomy must be addressed in bills of patient rights. Evaluate staff's performance in a manner that is fair and respectful when functioning in a supervisory capacity. Information Technology and Moral Philosophy. If you do not accept and abide by this policy, do not use any of the services provided on the website. This policy governs your conduct while using this website. “Ethical Issues and the Electronic Health Record.” Health Care Manager 27, no. Engage in evaluation and research that ensures the confidentiality of participants and of the data obtained from them by following guidelines developed for the participants in consultation with appropriate institutional review boards. These credentials, collectively termed as CCS, are focused on mastery of in- and out-patient coding. 30  American Health Information Management Association. Educational purposes within the department C. Reviewing the history and physical of a coworker when not part of work assignment D. Completion of code assignment. The clinic could be heavily penalized for performing fraudulent billing practices. 2004. You are advised to visit this page periodically to review the policy because it is binding on you. Be a mentor for students, peers, and new health information management professionals to develop and strengthen skills. 20  American Medical Record Association, Code of Ethics for the Practice of Medical Record Science. The 1934 pledge and the six codes of ethics for the HIM professional association have provided guidance for ethical leadership across a continuum of time, roles, and responsibilities. Don't use plagiarized sources. New York: Wharton School, 2008. Hopefully every organization has a process in place to enable … The ethical pledge was written and presented by Grace Whiting Myers at the first annual professional convention.11 This pledge was expanded in 1935 and used by members of the professional association until 1957, at which time the first code of ethics was approved.12 Five codes of ethics were subsequently adopted by the association, with the most recent code of ethics approved in 2011.13-17 The health information professional has had a stable and consistent connection with the importance of values and ethical decision-making throughout this timeframe. The code is relevant to all AHIMA members and credentialed HIM professionals and students, regardless of their professional functions, the settings in which they work, or the populations they serve. It strengthened guidelines to support operations within the professional association and continuing education efforts. Although electronic health records (EHRs) will be beneficial, their universal adoption will not come without conflict. New York: Oxford University Press, 2001. Code of Ethics. Allowing patterns of optimizing or minimizing documentation and/or coding to impact payment, Assigning codes without provider documentation, Coding when documentation does not justify the diagnoses or procedures that have been billed, Hiding or ignoring review outcomes, such as performance data, Failing to report licensure status for a provider through the appropriate channels, Recording inaccurate data for accreditation purposes, Allowing inappropriate access to genetic, adoption, health, or behavioral health information, Misusing sensitive information about a competitor, Developing a “record set” that excludes meaningful consumer information to be shared with consumers to protect the health system or specific providers. Decision-making criteria for work decisions can include technological feasibility, reasonable cost, legality, available personnel expertise, standards of care, and organizational goals. Indexing in process. The American Health Information Management Association, AHIMA code of ethics is formulated for controlling the ethical behaviors of members and non-members who are obliged to undertake health information management. Ethical Challenges in the Management of Health Information. 13.4. Ethical principles such as beneficence, autonomy, justice, and fidelity will be challenged as electronic health information systems evolve. Sweden became the first nation to ban aerosol sprays that were thought to damage earth's protective ozone layer. Permit one’s private conduct to interfere with the ability to fulfill one’s professional responsibilities. 24  Twitty, M. E. “Ethics for Medical Records Library Personnel,” p. 186. American Health Information Management Association Standards of Ethical Coding [2016 version], Ethical Standards for Clinical Documentation Improvement (CDI) Professionals (2016), HIM & Ethical Decision Making: Complex Challenges. 4th ed. 36 Harman, L. B., and V. L. Mullen. 1988. Evaluate students' performance in a manner that is fair and respectful when functioning as educators or clinical internship supervisors. “Celebrating 75 Years of Excellence: An AHIMA Timeline.” (accessed March 11, 2012). Copyright © 2018 by The American Health Information Management Association. Available in the AHIMA Body of Knowledge. She was appointed as the first president of the Association of Record Librarians of North America (ARLNA).4,5 This conference elevated the standards for medical records by addressing the content, availability, and preservation of the medical record.6. In terms of accuracy, AHIMA’s ethical standards require honest reporting of medical records to accurately reflect the work performed by a provider. 22  American Medical Record Association  Code of Ethics for the Practice of Medical Record Science. The 1998 code of ethics included language that supported “striving” to provide professional excellence and accurate and timely information and had eliminated the principle related to refusing to participate in or conceal unethical practices and procedures. A professional HIM code of ethics is shaped by the context of the times, changes in the healthcare system, and the issues faced by the profession and the public at large. 2nd ed. Professional values for HIM include the importance of education and technical competency, patient safety, data validity and accuracy, truthfulness, compassion, and dedication to providing quality services in professional roles. Design or conduct evaluation or research that is in conformance with applicable federal or state laws. The core ethical principles of beneficence (do good), nonmaleficence (do not harm), autonomy (control by the individual), and justice (fairness) stated by Beauchamp and Childress7 are important to a code of ethics. Together, the Principles of Medical Ethics and the Opinions of the AMA's Council on Ethical and Judicial Affairs make up the Code. It is therefore conceivable that the 2028 code of ethics could be written in collaboration with medical science librarians. A health information management professional shall not: 2.6. Crack (a derivative of cocaine) was available to the public. 6.1. The Code of Ethics created by the “American Health Information Management Association” carries out or implements the aforementioned values and ethical principles to direct or motivate the proper behavior (American.., 2004). 10.3. Anticipate, clarify, and avoid any conflict of interest, to all parties concerned, when dealing with consumers, consulting with competitors, in providing services requiring potentially conflicting roles (for example, finding out information about one facility that would help a competitor), or serving the Association in a volunteer capacity. Harman L., Cornelius F. Ethical Health Informatics: Challenges and Opportunities (formerly titled Ethical Challenges in the Management of Health Information). Code of Ethics. Adapted with permission from the 1999 Code of Ethics of the National Association of Social Workers. 26  American Medical Record Association. This code of ethics reinforced the integrity and trustworthiness of the HIM professional.26. The 2004 code eliminated the verb “strive” and reintroduced the principle related to the refusal to participate in or conceal unethical practices. Cooperate with lawful authorities as appropriate. Consult with a colleague when feasible and assist the colleague in taking remedial action when there is direct knowledge of a health information management colleague's incompetence or impairment. The Social Security Act of 1935 was passed without a health insurance component. The “American Health Information Management Association or AHIMA” for short has several reasons for developing a Code of Ethics (American.., 2004). Patients must have the right to review and make corrections in their electronic record, and this right must be honored especially as states and organizations develop health information exchanges (HIEs). The code does not provide a set of rules that prescribe how to act in all situations. 1957. “As the founders of AHIMA recognized, the profession requires information management expertise, courage, and ethics—today more than ever. The pledge identified the responsibility of the medical record professional to protect privacy and to release information only if authorized. The use of this word signified the tremendous tensions experienced by the HIM professional when performing work responsibilities, such as the tension between quality documentation, accurate coding/billing, and quality care. Honestly acknowledge the work of and the contributions made by others verbally or written, such as in publication. The first test-tube baby was born in England. The original Code of Ethics has been revised several times since 1957—in 1978, 1988, 1998, and 2004. 2.5. 10 Harman, L. B. 13  American Medical Record Association. Avoid endorsing products or services of a third party, for-profit entity that competes with AHIMA products and services. Uphold the decisions made by the association. 1977. 2 (February 2012): 40. 3.3. In 2003, the government implemented the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). A code of ethics is developed within the context of the healthcare environment and, at times, world events. Available online on the NASW web site. The American Information Management Association (AHIMA) in Chicago has recently revised its ethics policy for coding practices, as well. Everyday Ethics: AHIMA Code of Ethics Guides Daily Work, Complex Situations. 2.2. 2004. Adherence to AHIMA Code of Ethics ... Adherence to AHIMA Code of Ethics/Professionalism The new HIM director recently relocated from another state. Core health information issues include what information should be collected, how the information should be managed, who should have access to the information, under what conditions the information should be disclosed, how the information is retained, when it is no longer needed, and how is it disposed of in a confidential manner. Inform recipients of the limitations and risks associated with providing services via electronic or social media (e.g., computer, telephone, fax, radio, and television). 12  American Medical Record Association, Code of Ethics for the Practice of Medical Record Science. By entering and using the website, you acknowledge that you have read and understood the terms and conditions and that you agree to abide by them. Establishes a framework for professional behavior and responsibilities when professional obligations conflict or ethical uncertainties arise. 4.1. 1957. The AHIMA was founded in 1928, and has since then provided for CCA, CCS, RHIA, and RHIT credentials. Take reasonable steps to provide or arrange for continuing education and staff development, addressing current knowledge and emerging developments related to health information management practice and ethics. Promote the value of self-determination for each individual. The language and sequence included the following items: In 2000, the certification titles changed from registered record administrator (RRA) to registered health information administrator (RHIA) and from accredited record technician (ART) to registered health information technician (RHIT). Summarizes broad ethical principles that reflect the profession's core values. 9.7. The Institute of Medicine report. Promote the obligation to respect privacy by respecting confidential information shared among colleagues, while responding to requests from the legal profession, the media, or other non-healthcare related individuals, during presentations or teaching and in situations that could cause harm to persons. Healthcare consumers are increasingly concerned about security and the potential loss of privacy and the inability to control how their personal health information is used and disclosed. Ethics is on the mind of more than just Internet privacy experts these days. Such determination can only be made in the context of legal and judicial proceedings. The code used language referring to quality several times in the guiding principles. Justice can also be demonstrated by allowing access to health information for all individuals and reducing disparities. Relinquish association information upon ending appointed or elected responsibilities. 6.2. Serve an active role in developing HIM faculty or actively recruiting HIM professionals. “The College thus realized that some method would have to be devised in their standardization program to provide better medical records for use not only by candidates for fellowship, but also for something much more important—for efficient care of the patient in present and future illnesses, for the medicolegal needs of the hospital, physician and the patient and for use in medical research.”2, The ACOS sought to properly evaluate the work of the surgical candidates for fellowship; hence the need for standardization in record content was identified.3 The ACOS contacted Grace Whiting Myers, librarian emeritus of Massachusetts General Hospital, and she organized the activities for the conference, which was attended by medical librarians from the United States and Canada. Forty-two guiding statements were associated with the principles. Report only those continuing education units actually earned for the recertification cycle and correct any inaccuracies occurring regarding CEUs. The AHIMA Code of Ethics is to be used by AHIMA members, non-members with the Commission on Certification for Health Informatics and Information Management (CCHIIM) certifications, students enrolled in a formal certificate or degree granting program directly relevant to AHIMA’s Purposes, and consumers, agencies, organizations, and bodies (such as licensing and regulatory boards, insurance providers, courts of law, government agencies, and other professional groups) that choose to adopt it or use it as a frame of reference. 11.3. These changes, which were consistent with the 1991 association name change, were a sign of the times. Her position is critical for accurate reimbursement from payors and must clearly reflect the care given. 12.2. 2nd ed. The code of ethics also recognized the importance of the HIM professional’s responsibility to support medical research by “assisting the doctor in the immediate care of the patient and assisting him in the future care of the patient through medical research.”21. The 1980s offered a time of regulation and deregulation as the federal government increased regulation on health reimbursement. An introduction that described the role of the HIM practitioner and the professional association was added. These codes are an invaluable resource to assist the professional faced with complex challenges at work. The Nuremberg Code, often considered the … A code of ethics can provide immediate guidance on what should be done. 29  American Health Information Management Association. The AHIMA Code of Ethics serves seven purposes: Promotes high standards of HIM practice. In addition to AHIMA’s ethical code of conduct, coders should be aware that confidentiality in all patient recordkeeping is legally required by HIPPA. See Table 2for some of the changes in the healthcare system at the time that the various codes of ethics were passed. A profession develops in the context of the world, not in an isolated silo. A code of ethics cannot guarantee ethical behavior. For example, for Principle II (“Put service and the health and welfare of persons before self-interest and conduct themselves in the practice of the profession so as to bring honor to themselves, their peers, and to the health information management profession”), the code included that HIM professionals shall “act with integrity, behave in a trustworthy manner, elevate service to others above self-interest, and promote high standards of practice in every setting” and shall not “take unfair advantage of any professional relationship or exploit others to further their personal, religious, political, or business interests.”30 The preamble, values, and statements related to ethical behaviors attested to the power of the individual to make a difference. Develop and enhance continually professional expertise, knowledge, and skills (including appropriate education, research, training, consultation, and supervision). All Rights Reserved. This review is not intended to be a complete study of history, and the facts related to the year of passage of a code of ethics are cited only as a point of reference. The code of ethics dealt with association responsibilities (the larger community within which HIM professionals functioned) and moved beyond the focus on the patient to others in the world of work and the professional communities. 2 (2008): 165–76. Historical Environment of the Codes of Ethics. The association changed its name several times over the years: the Association of Record Librarians of North America (ARLNA) 1928; American Associ… Professional values form the basis for the principles that are included in a code of ethics. Ethical obligations are central to the professional's responsibility, regardless of the employment site or the method of collection, storage, and security of health information. This pledge was written and read by Grace Whiting Myers at the first annual professional association meeting in Boston as follows: I pledge myself to give out no information from any clinical record placed in my charge, or from any other source to any person whatsoever, except upon order from the chief executive officer of the institution which I may be serving.18. The 2004 code of ethicsincluded a preamble that highlighted the ethical obligations of the HIM professional, the importance of professional values, the purposes of the code of ethics, and how the code should be used by HIM professionals and others who use health information on behalf of patients. The 1930s was marked by the Depression, unemployment, and a lack of healthcare coverage. AHIMA issues standards of ethical coding . Investigate the history and current organizational structure of AHIMA by visiting the web site and specifically reviewing AHIMA’s history, mission, and Code of Ethics. 11 Huffman, E. K. Manual for Medical Record Librarians. Summarizes broad ethical principles that reflect the profession's core values. Check back for further updates. Alleged violations of the code are subject to a peer review process. Take responsibility and credit, including authorship credit, only for work one actually performs, or to which one contributed. 2nd ed. 2017. The reader is encouraged to contemplate these events and consider what bearing the events may have had on each code of ethics. Resign from an association position if unable to perform the assigned responsibilities with competence. 4 (1956): 185–87, quote at 187. The HIM professional has an obligation to demonstrate actions that reflect values. Ensure all voices are listened to and respected. In addition to the resequencing of the principle statements to put service to the association first, two additional principles related to the association were added. Disclose any real or perceived conflicts of interest. 2.4. Beginning in 1994, a series of Physicians at Teaching Hospitals (PATH) Audits were conducted by the federal government to investigate improper billing by teaching hospitals and physicians. Violation of principles in the Code of Ethics does not automatically imply legal liability or violation of the law. 10.7. Bylaws Amended, October 1994; Code of Ethics Amended, 1991  Unknown author ( American Health Information Management Association , 1996-01 ) 27  American Health Information Management Association. HIM professionals face many ethical problems, including issues related to privacy and confidentiality; compliance, fraud, and abuse; clinical code selection and use; quality review; research and decision support; public health; managed care; clinical care; electronic health information systems, including information security, software development and implementation, data resource management, integrated delivery systems, e-health, information technology, and information exchange; management of sensitive information (genetic, adoption, and behavioral health); management; entrepreneurship; vendor management; and advocacy.10 The problems that emerge can be solved using technical or administrative standards or criteria as described above; however, the decisions can be strengthened for the professional if a code of ethics is used. The Health Maintenance Organization (HMO) Act of 1973 was a federal law passed to encourage employers to develop and seek HMO initiatives. Engage in any relationships with a consumer where there is a risk of exploitation or potential harm to the consumer. It would be feasible for the association to review and approve a new code of ethics in 2028, the 100th anniversary of the founding of the association. The 2011 code of ethics followed the format of the 2004 code and incorporated language to reflect changes in technology, the healthcare system, and association management, and it “provides enhanced steps for reporting individual, unprofessional actions.”31 The full code of ethics is available at www.ahima.org/about/ethicscode.aspx. Participate in and contribute to decisions that affect the well-being of consumers by drawing on the perspectives, values, and experiences of those involved in decisions related to consumers. Key words: values, ethics, code of ethics, health information management, health information management professional, health information management professional association, ethical decision-making, healthcare system. Establishes a set of ethical principles to be used to guide decision-making and actions. The principle of justice can be violated in use of public data—data from the EHR must be presented and used in ways that promote justice. Bioethical decisions always require action. The terms "shall” and “shall not" are used as a basis for setting high standards for behavior. Ethical behaviors result from a personal commitment to engage in ethical practice. 9.4. The American Health Information Management Association (AHIMA) is the premier association of health information management (HIM) professionals worldwide. The American Health Information Management Association (AHIMA) is the leading voice and authority in health information, wherever it is found.Our people work at the intersection of healthcare, technology, and business. For example, genetic discrimination and medical identity theft had to be dealt with far in advance of legislation or policies and procedures to guide actions. Sudbury, MA: Jones and Bartlett, 2006. The HIM professional should put others first and make a difference in the quality of the services that are provided. Chicago: Physician’s Record Company, 1972, p. 135. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of American Recovery and Reinvestment Act of 2009 (ARRA), included provisions to advance the use of health information technology by including privacy, security, and electronic health record incentives. 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