Discuss the differences between a subpoena and a court order.

1. What is health information and why is it important to protect?
2. What federal laws offer protection related to patient information?
3. What is the difference between privacy and confidentiality?
4. How is security related to privacy and confidentiality?
5. Who owns the patient health record and who controls the use of the information
within the record?
6. Describe the role of the custodian of health records.
7. Discuss the differences between a subpoena and a court order.
8. Give examples of two questions that a custodian of a health record can answer
at deposition or trial. Give examples of two questions that should not be
responded to.
Case Discussion
A patient has filed a $3 million medical malpractice lawsuit against St. Patrick Hospital. In
light of the patient’s litigious background and the facts of the case, hospital
administration is adamant that it is not liable. It has instructed its legal counsel to
proceed toward trial, where it may be absolved of liability.
9. Is the hospital’s decision to proceed toward trial a wise one? Why or why not?
10. What other options does the hospital have?
11. Besides the financial resources required to legally defend itself, identify at least
two non-monetary factors that the hospital must take into consideration when
deciding to proceed toward trial?
12. What risks does the hospital assume when it takes a case to trial?
Scenario:
During a school field trip to a local orchard, 13-year-old Johnny Chapman fell out
of a tree while picking apples. That evening, his parents took him to the emergency room
at Woodville Hospital, where he was diagnosed with a fractured ulna. He was admitted
and surgery was necessary. Johnny was discharged after a two-day stay. Johnny’s
parents subsequently sued the school system and two of the three parent chaperones
who had volunteered for failing to safeguard Johnny during the field trip and failing to
seek emergency medical care.
Three months later, the health information department director at Woodville
Hospital, Jay Forshall, was subpoenaed with directions to bring Johnny’s record to a
deposition the following day. The deposition was being held in Columbia City, which was
125 miles away. Jay complied with the subpoena by preparing Johnny’s medical record.
Woodville Hospital’s health record was hybrid, so Jay printed out the electronic
components from the hospital’s electronic health record system and collected the
remaining components that existed on paper.
Jay drove to Columbia City the following morning. During the deposition, legal
counsel for the Chapmans proceeded to ask Jay about Johnny’s medical record. Jay was
asked to verify that the record was Johnny’s and that it was prepared in the usual course
of business. He was then asked about the contents of the record. One question posed to
him was whether Tylenol, which had been administered to Johnny at the hospital, was
given to lessen Johnny’s pain. Jay stated that he presumed legal counsel’s statement
was true, as that is a common reason for Tylenol to be given. Jay was also asked to read
an otherwise illegible note that the physician, Dr. Fogle, had written on the discharge
instruction sheet. Dr. Fogle was a visiting physician, and Jay was not familiar with her
handwriting. Nonetheless, he tried his best to assist legal counsel in deciphering the
note.
Jay was not involved in the case any further following the deposition. Several
months later, he read in the newspaper that the case had gone to trial. One of the parent
chaperones who was initially sued never responded to the complaint and did not
participate in any of the proceedings, including the trial. A jury rendered a verdict against
the school system and the three parent chaperones, with all being required to pay money
damages.
13. Based on the facts, a motion to quash the subpoena (thus nullifying it) could
have been granted based on what two reasons?
14. What questions asked of Jay Forshall during the deposition were inappropriate?