Medical Laws and Ethics - Information Technology
Introduction
Because of modern technology, it is no surprise that doctors and other health care workers use electronic devices when they are catering to their patients. Managing modern day medical information has been easier thanks to the involvement of information technology and other resources. Health informatics systems can modernize medical care and also reduce or duplicate procedures and tests done to the patient. Many believe that information technology can also help improve patient education as they can easily access their records and they stay informed about the health care process. However, the health care system is still facing some ethical and legal issues when it comes to using information technology inside the organization. Other doctors also believe that using electronic devices to take care of the patient makes the interaction between them impersonal (Ramachandran, 2013).
The most common tool being used in the health care system today is the Electronic health records which are believed to be the tool to reform the organization. However, despite the potential, there are currently legal, ethical and even financial issues which threaten the widespread use of this tool. This paper will discuss on the legislation of the implementation of information technology inside the health care system and also address the ethical and legal issues that surround it. The advantages and disadvantages of these tools in terms of physician-patient relationship will also be explored. It is also important to determine how the government is acting in order to protect valuable health information from fraud and identity theft, in which the patient’s confidentiality will be at risk. With that, the Health Insurance Portability and Accountability Act of 1996 will also be included and discuss how this can protect the patients’ records.
The Health Insurance Portability and Accountability Act of 1996
The Health Insurance Portability and Accountability Act of 1996 were enacted in 1996 by President Bill Clinton. It tackles on the protection of health insurance coverage for workers and their respective families in case they lose their jobs. It also aims to maintain the privacy and security of the individual health information and also specifying the numerous offenses relating to the penalties for the violation of the law. Specifically the Title II of the act creates several programs in order to prevent fraud and abuse of the information within the health care system. The Title II of the act has a Privacy Rule which regulates the use and disclosure of the Protected Health Information which is held by the entities who are generally involved in the health care system.
This law requires health care providers and other health care personnel to disclose the needed information to the patient within 30 days upon the patient’s request. They are also required to disclose the information required in reporting suspected child abuse. The health care providers are also required to disclose the protected health information to the law enforcement as required by the law including in court orders and warrants. It is up to the health care provider or personnel to take a reasonable effort in disclosing the information only to a minimum in order to also protect the patient from fraud or identity theft. Each personnel must ensure the confidentiality of the communications with the patients and also ensure the protection of the information. Violation of this law will entitle the involved entity to civil and criminal penalties that will involve fines and imprisonment of not less than 1 year (U.S. Department of Health & Human Services, 2016). The Office of Civil Rights was able to publish Privacy Rule guidance in order to implement nationwide security framework for the exchange of information in the health care system.
Health Information Technology: Electronic Health Records
One of the information technology tools that are protected under the HIPAA Title II is the Electronic Health Records or EHR. It contains medical details on the patient including their history, physical examination, test results and treatment, all in digital format. Health care providers and hospitals are using this because it offers several advantages over having paper records. One of which is that it increase the access to health care records and improve the quality of care the patient receives. It was also said to decrease cost of the system as they won’t need to invest in papers and manual recording that will take up a lot of time of health care staff and space inside the hospital.
In the past, medical records are documented on paper so that it can be used in education and research. However, one of its major drawbacks was in terms of accessibility and it was only available for one user at a time. The completion of one medical record can also be delayed because it has to be updated manually. This is the main reason why many believe that EHRs are a big help in reforming the health care system. Aside from improving the access to medical records, errors in prescriptions and doctor’s orders was also significantly reduces with the use of EHRs. When EHRs are connected to drug manufacturers, pharmacies and drug banks, information can be used to discuss adverse drug reactions to cut it substantially. Therefore, EHRs can overall affect the help improve patient care by providing them with the correct treatment, medication and information about their health concerns. A lot of people are affected by medical errors done by misreading prescription and instructions, that is why, EHRs are truly effective tools in ensuring patient care and safety. Because it contains important information, major ethical priorities must be done to make sure its protection (Jamshed, Ozair, Sharma, & Aggarwal, 2015, p. 73).
Electronic Health Records: Ethical and Legal Issues
Although the implementation of the Electronic Health Records is protected by the HIPAA Title II, there are still ethical and legal issues that surround this tool. In case the patient’s health data is shared or linked without the patient knowing it, the autonomy of the system is jeopardized. Also, when the patient does not have the confidence to the system, they may not show all the information needed and then their treatment can be compromised. Aside from that, medical records may also contain credit card and insurance information. Once it falls in the wrong hands, this might be at risk for information leaks and potential identity thefts. That is why aside from making sure that employees and health care providers follow the HIPAA Title II, organization leaders and policy makers should also discuss the ethical implications of EHRs and formulate policies addressing these issues.
Because many believe that EHRs must be accessible and accurate, this raises legal issues and considerations for many health care providers. For those physicians who may miss critical details which can affect the treatment of the patient while reviewing the EHR could easily be liable for negligence. This increase the physicians’ legal responsibility and accountability which many physicians in the country are already wary. There will also be cases that an abnormal test result may be reviewed but not acted on as some would assume that another physician might be responsible for it. With the increasing volume of data and the increasing number of physicians, the network of information can be traced to anyone and this makes the health care providers fear that the legalities surrounding the system might assume that they neglected a patient (Sittig & Singh, 2011, p. 1042). With that, this brings about complex legal ramifications and this restricts the physicians on reporting problems related to HER without the fear of being accused of negligence.
The main ethical issues about EHRs would first include deciding which categories of personal and private information is the health care provider entitled to record and share. This question is of utmost important as there still should be patient-physician confidentiality between sessions. What personal information must be shared for the sake of future reference or research and what personal information must only be kept between the physician and the patient? Should this information be recorded? These questions must be answered because of the possibility that these medical records will be used other than the original purpose of recording it like for research or education. Therefore, the ethical issues about the use of information technology in medical records is the purposes for which the information may be used. This will raise the questions on the rights of the patient in terms of the use and distribution of this data as it may contain personal information. Patients must also have the right to verify the information to make the record as accurate as possible.
Conclusion
Although information technology through EHRs brings innovation in terms of providing service in the health care system, there are still ethical and legal considerations that must be addressed most especially for the patients and the health care personnel who are using it. Privacy and security is provided by the HIPAA Title II, but this is not enough to ensure the safety of the patient’s information. Ethical issues surrounding the rights of the patient to know where, when and how their information will be used is something that must be addressed so that the patient will have confidence in the system. If the patient won’t have confidence in this system, their course of treatment may be compromised. The legalities surrounding the system must also be organized so that physicians will be more transparent in reporting wrong recordings and other problems without being accused of negligence to their patient.
References
Jamshed, N., Ozair, F., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspect Clin Res, 6(2), 73. doi:10.4103/2229-3485.153997
Ramachandran, V. (2013, August 16). How Is Information Technology Changing Healthcare? Retrieved from http://mashable.com/2013/08/15/healthcare-and-it-health-informatics-infographic/#nWxj0HdMB5qI
Sittig, D. F., & Singh, H. (2011). Legal, Ethical, and Financial Dilemmas in Electronic Health Record Adoption and Use. PEDIATRICS, 127(4), e1042-e1047. doi:10.1542/peds.2010-2184
U.S. Department of Health & Human Services. (2016, February 29). Enforcement Highlights - Current. Retrieved from http://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/data/enforcement-highlights/index.html
