Ethical Implications of Electronic Health Records
Brian Davis
Dr. Kemp defines an electronic medical record (EMR) as “the digital version of a paper chart that contains all of a patients ' medical history from one practice” (Kemp, 2014). He also differentiates between the use of the term electronic medical record (EMR) and electronic health record (EHR). An EHR is more “comprehensive” than an EMR. It allows for data sharing across multiple practices. The use of both EMRs and EHRs has gained in notoriety in the last decade. And it appears that the use of these two terms is interchangeable. The idea of data sharing and having one’s health records at the click of a button is highly appealing. While there are several ethical implications to explore when dealing with computerized charting, the objective for this research review will focus primarily on three interesting concepts: autonomy, finance, and privacy, as it relates to information technology.
Autonomy
Autonomy explores the idea of every person having rights in regards to healthcare and decision making. “Autonomy is an agreement to respect another’s right to self-determine a course of action and support independent decision making” (Beauchamp & Childress, 2009). In 1990, the ideas of autonomy lead to the Patient Self Determination Act which allows competent people to make their wishes known about end of life. The act includes living wills and health care power of attorneys, which deals with end of
Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment
.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).
Although the EHR is still in a transitional state, this major shift that electronic medical records are taking is bringing many concerns to the table. Two concerns at the top of the list are privacy and standardization issues. In 1996, U.S. Congress enacted a non-for-profit organization called Health Insurance Portability and Accountability Act (HIPAA). This law establishes national standards for privacy and security of health information. HIPAA deals with information standards, data integrity, confidentiality, accessing and handling your medical information. They also were designed to guarantee transferred information be protected from one facility to the next (Meridan, 2007). But even with the HIPAA privacy rules, they too have their shortcomings. HIPAA can’t fully safeguard the limitations of who’s accessible to your information. A short stay at your local
The purpose of this paper is to discuss the electronic health record mandate. Who started it and when? I will discuss the goals of the mandate. I will discussion will how the Affordable Care Act ties into the mandate of Electronic Health Record. It will describe my own facility’s EHR and what steps are been taken to implement it. I will describe the term “meaningful use,” and it will discuss possible threats to patient confidentiality and the what’s being done by my facility to prevent Health Information and Portability Accountability Act or HIPAA violations.
Several years ago, a mandate was ordered requiring all healthcare facilities to progress from paper charting and record keeping to electronic health record (EHR). This transition to electronic formatting has pros and cons associated with it. I will be describing the EHR mandate, including who initiated it, when it was initiated, the goals of the EHR, and how the Affordable Care Act and the Obama administration are tied into it. Then I will show evidence of research and discuss the six steps of this process as well as my facilities progress with EHR. Then I will describe meaningful use and how my facility attained it. Finally, I will define HIPAA law, the possible threats to patient confidentiality relating to EHR, and how what my facility
To begin with the person is the centre of the plan, to be consulted with and their views must always come first: It should include all aspects of their care, and every professional should work together to provide it. (Leathard 2000) Autonomy refers to an individuals’ ability to come to his or her own decisions and requires nurses to respect the choices patients make concerning their own lives (Hendrick 2000).However Gillon Argues that the principle respect for autonomy may need some restriction, otherwise we may be morally obliged to respect an autonomous course of action with unthinkable consequences.( Gillon 1986) Every human being has an intrinsic value, they all have a right to well being, to self-fulfilment and to as much control over their own lives as is consistent with others (British Association of Social Workers 2002).Professional Judgement and patient preference cannot be suspended if practice is to be safe and effective rather than routine(DOH 2005) Alex had to attend this session as it was within his Timetable, how could it have been effective?, he was unhappy and
In 2009, the Health Technology for Electronic and Clinical Health Act (HITECH) of 1996 was expanded. This expansion included mandated guidelines for health care systems in the Unites States to continue implementing of Electronic Health Records (EHR) in health care settings by 2016 and added a provision to improve protection of patient health information through privacy and security Turk (2015) . The implementation of this program has created a debate in the medical community. In addition, many healthcare organizations and institutions have conducted research studies and surveys to evaluate the effects of the EHR on documentation of care and other aspects of the EHR. Challenges surrounding the HER include, the cost of implementing EHR’s, time spent performing documentation, and patient outcomes and safety and security concerns. Let’s further delve into a few of these challenges.
This affects the delivery of healthcare in that the information needed by providers, physicians, medical staff, and the patients themselves, may not be delivered correctly, timely, and of course securely. Various systems will be discussed and each how they affect healthcare delivery, in particular Electronic Health Record (EHR), Electronic Medical Records (EMR) and Computerized Physician Order Entry (CPOE) (also sometimes referred to as Computerized Provider Order Entry).
(ONC) is to coordinate “national efforts to implement and use the most advanced health information technology and the electronic exchange of health information … to improve health care” (Health and Human Services [HHS], n.d., website). However, sharing confidential information found in the electronic health record (EHR) for research and quality improvement potentiate legal, financial and ethical challenges.
As the emergence of electronic health records (EHRs), the subject of transforming the delivery method of healthcare is prominent in the United States. The use of EHRs is a major key in the way physicians practice in healthcare organizations through communication and management of patient information. Henricks (2011) points out that EHRs are a part of an objective aimed at improving all aspects of health care and reducing health disparities, making the healthcare of patients and families appealing to them, refining the direction of healthcare, along with population and public health improvement, continuation of privacy maintenance and the security of health information, and finally reducing costs. In the perspective of health information technology
An Electronic Health Record is a computerized form of a patient’s medical chart. These records allow information to be readily available to authorized providers during a patient’s encounter with the healthcare system. These systems do not only contain medical histories, current medications and insurance information, they also track patients’ diagnoses, treatment plans, immunization dates, allergies, radiology images and lab tests/results (source). The fundamental aspect of EHRs is that they are able to share a patient’s information quickly across service lines and even between different healthcare organizations. Information is at the fingertips of lab techs, primary care physicians, pharmacies, clinics, etc. The
Prior to the Information Age, medical records were all stored in folders in secure filing cabinets at doctor’s offices, hospitals, or health departments. The information within the folders was confidential, and shared solely amongst the patient and physician. Today these files are fragmented across multiple treatment sites due to the branching out of specialty centers such as urgent care centers, magnetic resonance imaging, outpatient surgical centers, and other diagnostic centers. Today’s ability to store medical records electronically has made it possible to easily send these files from one location to another. However, the same technology which can unify the fragmented pieces of a patient’s medical record has the ability to also create
“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an
In a world full of electronics it would only seem logical to have health records electronic. Not only are medical records efficient, reliable, and quick to access, new technology allow patients to access their own personal medical records with a simple to use login and password. “People are asking whether any kind of electronic records can be made safe. If one is looking for a 100% privacy guarantee, the answer is no”(Thede, 2010). At my hospital, upon every admission we ask the patient for a password for friends and family to have to have if they would like an update on the patient 's condition. We do not let visitors come up and see the patient without the patient 's consent. In doing these things, we help to ensure the safety and protection of the patient 's health information and privacy.
Electronic Medical Records (EMRs) are now exercising a more significant impact on healthcare practices than ever before. The United States healthcare system stands on the brink of a new age of electronic health information technology. The potential for innovation within this new technology represents a great opportunity for the future of medicine. However, in seeking to implement EMRs caution must be exercised to ensure that implementation does not have adverse effects on the personal nature of the patient-physician relationship an important issue that must be addressed in order preserve the integrity of healthcare in the new electronic age.