Health information management

Six-year-old Tavion Robinson was taken to Methodist Hospital by his father for treatment of a broken arm and abrasions. When asked about the cause of the injury, Tavion’s father told the triage nurse that he had fallen from the jungle gym at the park. During the time they were in the emergency department, Tavion’s father appeared hesitant to allow Tavion to be left alone with the hospital staff. The emergency department staff suspected that the injuries may not have been acquired in the manner explained by Mr. Robinson. The abrasions were clean, which would not have been the case if Tavion had truly fallen from playground equipment and presented immediately for treatment. When Tavion went for his x-ray, the staff made a point of not allowing his father in the room. They questioned Tavion about his injuries, and he verified his father’s explanation. The staff continued to question Tavion, asking if he was ever afraid of being hurt by anybody at home. He consistently denied abuse or fear of abuse, and it was noted as such in his record.
Prior to leaving the Emergency Department, Mr. Robinson requested that a notice be placed in the record that he was to be notified prior to releasing Tavion’s records to anybody else. He included in the notice that Tavion’s parents are divorced, and his mother, who is the noncustodial parent, may not access Tavion’s records without his consent.
The following weekend, Tavion’s mother presented to the Health Information department requesting copies of records of the Emergency Department visit. She stated that she suspected his father had been physically abusing him, and she wanted to review the documentation.
Discussion Questions
1. Is Tavion’s mother’s statement of concern of abuse sufficient to warrant further investigation by the hospital?
2. Should Tavion’s mother be directed to a different department of the hospital or another organization regarding her concern of abuse?
3. What internal and external forces impact this case?
4. What are the legal issues addressed in this case? How do your state laws address access to health records by noncustodial parents?
5. What are the ethical issues addressed in this case?
6. How would you respond to Tavion’s mother if you were the Release of Information Clerk?
7. Using the case method, evaluate possible actions that should be taken and determine the best option.