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Records/Court Cases
Vocab
Vocab
Matching Terms
Terms
100
Who owns a patients medical record
Patients medical records are property of the owners of the facility where they were created
100
Collection of data recorded when a person seeks medical treatment
medical record
100
A law in all 50 states to protect individuals who stop and give first aid in the event of an emergency
Good Samaritan Act
100
Addresses the electronic storage and transmission of health information
What is HIPPA
100
HIT includes the following
telemedicine, use of the internet, digital versions of the patients medical records
200
The time medical records are kept on file in case of litigation
2-7 years
200
A principle under which a physician can exercise judgment as to whether to how patients who are being treated for mental or emotional condition
doctrine of professional discretion
200
Electronic form of an medical record
EHR (electronic health record)
200
Protects patients from being coerced into tratment
What is doctrine of informed consent
200
A federal statue that protects the confidentiality of medical records of patients with history of substance abuse
What is Confidentiality of Alcoholl and drug abuse, patient records
300
If a patients medical record is requested by a third party what is needed
written permission from the patient
300
A federal statue that protect patients with histories of substance abuse regarding the release of information
confidentiality of alcohol and drug abuse, patient records
300
A legal document that can be subpoenaed as evidence in court
medical record
300
Protects health care providers from lawsuits when providing care in an emergency situation
what is the Good Samaritan Act
300
Three reasons a medical office might be rquested to release patient records
Insurance claims, transfer to another physician, court
400
What is Fiduciary duty
a physician's duty to his/her patient, based on trust and confidence
400
When a patient gives permission
consent
400
Five C's of charting
Concise complete clear correct chronologically ordered and NO Judgments or opinions
400
provides for a continuum of medical care for patients
what is the medical record
400
Consequences that can happen when a person is treated without consent
lawsuit
500
Who cannot give informed consent
Minors, persons under the age of majority, mentally incompetent people, persons who speak little or no English without an interpreter
500
Is the legal basis for informed consent and is outlined in the states medical practice act
doctrine of informed consent
500
A physicians obligation to his or her patient based on trust and confidence
Fiduciary duty
500
allows physicians to decide whether or not to show medical records to a patient being treated for a mental or emotional disorder
What is Doctrine of professional discretion
500
when is consent unnecessary
In an emergency situation when the patient is in immediate danger