The Ethics of Online Medical Records
Abstract: This paper describes the ethical implications of developing a national online medical database. Such a database would contain the lifetime health records of every U.S. resident by combining information from a variety of sources. The advantages of such a system are many, but in the end, the question remains whether patients want to trade privacy for better healthcare.
A lonely ninety-year-old Chinese woman walks into a clinic. Without any medical records, the physicians diagnose her with stroke, and she is immediately hospitalized. Two days later, her son arrives at the hospital, apparently quite angry with the doctors. He informs the physicians that her mother has
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Today, the medical records of most Americans are scattered across multiple clinics and hospitals, possibly across several states. The task of piecing together a patient's medical history can become quite time-consuming and laborious, as the files first need to be located and then faxed [5]. The possibility of combining medical records into a central medical database would solve many of these problems, as well as bring new benefits. With a shared medical database, doctors would have vital information about a patient at their fingertips. Very little time would be lost in looking for a patient's medical records and piecing the data together.
A shared medical database would save lives by providing accurate and complete information to doctors, especially those not familiar with their patients. For instance, if a person had a serious accident while vacationing in a different state, the doctors there would have instant access to his medical records in his home state. Locating the patient's family doctor and faxing the patient's medical history would be unnecessary. If the patient has allergies to certain drugs, the doctors would be aware of it, thus avoiding further complications [6]. With more complete information, doctors would be given the power to treat an unfamiliar, out-of-state patients in a timely and effective manner.
Sharing medical data would also enormously benefit organizations
The advancement in technology has rapidly transformed the world today, and the increase in the number of web-enabled devices has completely changed peoples ' lives especially the way they communicate. Electronic Health Record system, which is a digital copy of a patient’s medical history is one of the revolutionary ideas that have come with this advancement. Electronic Health Records (EHRs) are instantaneously updating records that are patient-centered designed with the aim of providing real-time information to the authorized users (Cohen, 2010). It contains all the patient’s information that is in the hand of the medical providers including their medical history, treatment dates and types, immunizations conducted to the patient and their dates, radiology images and all the laboratory results from the tests conducted in the past. All this information is held in a digital format and can only be updated by authorized users who are stationed in the medical facilities. Electronic records are designed to make it easy for different health providers and organizations to share patients’ information which streamlines their operations since all the necessary information and history can be accessed from any location at any time.
After decades of paper based medical records, a new type of record keeping has surfaced - the Electronic Health Record (EHR). EHR is an electronic or digital format concept of an individual’s past and present medical history. It is the principle storage place for data and information about the health care services provided to an individual patient. It is maintained by a provider over time and capable of being shared across different healthcare settings by network-connected information systems. Such records may include key administrative and clinical data relevant to that persons care under a particular provider. Examples of such records may include: demographics, physician notes, problems or injuries, medications and allergies, vital
The article, Keep Privacy in Health Records, was written by the Monitor's Editorial Board on February 2, 2009. It condemns some of the provisions of a House Bill that was passed by the ACLU and other privacy groups. According to this bill, data encryption would ensure that authorized persons are barred from accessing patient’s health records in the institution. Audit trails are also crucial in determining and tracking who accessed the records, at what time and what type of information did he/she get. Lastly, the patients should be allowed to see their records to improve their notification and strengthen enforcement in health institutions. However, despite these initiatives to improve accountability and confidentiality of patient’s records in most institutions, the board believes that the bill has not solved some of the privacy issues as far as patient health records are concerned.
Patient privacy has been a major concern for patients and medical staff for many years. Patient privacy goes hand in hand with HIPPA and the privacy rule. This protects the privacy of any person of all health information (U.S. Department of Health and Human Services, 2010). Even with this a concern for many, a study conducted by Zogby Internation studies more than 2000 adults to obtain their views on patient privacy. This studied determined that individuals would rather have individual choice and control over personal health information instead of others (Patient Privacy Rights, 2010).
(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.
Medical records are not electronic, but paper, which causes them to become lost or misfiled. Physicians need readily access to patient records so they can treat patients effectively.
Health care providers as well as nurses must keep track of all pertinent patient information and failure to do so leads to detrimental effect on the patient's life. CIS clinical information systems are "large, computerized database management systems that support several types of activities that include physician order entry, result retrieval, documentation and decision support". CIS is intended to replace medical records department of a hospital or any other medical institution. Physicians and clinicians can safely and quickly access information, order medication and treatments and implement appropriate care. CIS will hopefully improve productivity, increase quality care and reduce costs across the organization.
In today’s health care industry providing quality patient care and avoiding harm are the foundations of ethical practices. However, many health care professionals are not meeting the guidelines or expectations of the American College of Healthcare Executives (ACHE) or obeying the organizations code of ethics policies, especially with the use of electronic medical records (EMR). Many patients fear that their personal health information (PHI) will be disclosed by hackers or unauthorized users. According to Carel (2010) “ethical concerns shroud the
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.
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
Electronic Medical Records (EMR) is a computerized database that stores all of the personal and medical information of the patient’s care and billing information by the health care providers. Today, only the providers and medical practices can implement these systems. Also there are neither known national central storage systems nor regional sharing of information between the networks on a regional level or the national level. This is something that needs to be changed because it is important to be able to see this information globally. This
In this paper, I will discuss the principles that permit disclosure of protected health information with or without the patient’s consent for each of the four categories, government agencies, legal agencies or representatives and research groups. I will also state whether I feel privacy safeguards are adequate to support those principles.
Privacy and confidentiality are basic rights in our society. Safeguarding those rights, with respect to an individual’s personal health information, is our ethical and legal obligation as health care providers. Doing so in today’s health care environment is increasingly challenging (OJIN, 2005).
The first principle is that with very few exceptions, health care information about a consumer should be disclosed for health purposes only. The information should be easy to use for those purposes, and very difficult to use otherwise. The second principle is that technical security safeguards be maintained for computerized data. Including audit trails that identify who accessed the data and the prosecution against anyone who used the records for illegal or improper purposes. The third principle is consumer access. The patient should have ability to access his or her records and know others that also have access to them. Patients should be aware of the laws, regulations, and policies that protect their information. The fourth policy is defined as accountability, which is of relation to security and consumer control. Fines and imprisonment are required to those who breach security of personal health information. The final policy is public responsibility. Legislation must be balanced between personal, private interests and national priorities of public health, research, and law enforcement. The excessive flow of information, without patient authorization, is essential to the immediate discovery and investigation in public health crisis. AHIMA's acknowledgement of these five principles are abroad outline of a sensible public policy that balances personal privacy
The correlation of increased potential patient rights violations and sensitive personal health data among electronic medical records than paper records is growing at an alarming rate. An estimated 52,000 public comments was reviewed by the Department of Health and Human Services requiring privacy regulations governing individually identifiable health information since the passage of Health Insurance Portability and Accountability Act of 1966 (HIPPA). The individually identifiable health information includes demographic data that relates to the individuals past, present, or future physical or mental health condition. In addition, the provision of health care rights of the individual, confidentiality, protection of