We can, but Dare we?
Advances in technology continue to impact on medicine. Smartphones are mobile phones designed on a mobile operating system. They have more advanced connectivity and computational capability. Smartphone are amongst the most permeating and dynamic developments in communication. In addition to the ability to call, they can be used to send and receive emails and perform internet searches using specific applications. Whilst they portend a number of advantages to healthcare, their use in the field is not without challenges (Ozdalga, Ozdalga, & Ahuja, 2012). This paper will examine the merits and demerits of use of smartphones in healthcare with reference to a case scenario. The case scenario involves a nurse who took photo images of a famous musician after the latter was brought to her department unconscious after having been in a motor vehicle accident. She was in a dilemma after being requested to sell the images she had captured on her smartphone to a magazine.
Selling of the patient’s photos would be unethical and in breach of the nursing code of ethics as well as the law. Nurses have an ethical duty of care towards their patients. This duty calls for them to protect the confidentiality of their patient’s information. They should not share any information gained about their client during care provision with any other individual without the explicit consent of the client. Client information can only be shared between healthcare professionals involved in the patient’s care on a need to know basis. Nurses also have an ethical duty to act in the best interest of the patient and to do no harm to their patients (ethical principles of beneficence and maleficence respectively). Selling of those pictures would be contrary to the two ethical principles because it would not be in the interest of the patient and would most likely lead to the patient’s harm. Therefore, selling of the patient’s images to a magazine that would most likely publish the pictures without any due regard to the patient’s right to privacy would be unethical.
The law requires nurses to treat all patient information as private. In specific, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 stipulates standards for transmission of health information verbally, in writing, or electronically. It also provides for ways of assuring the confidentiality, privacy, and security of personal health information. The goal of the law is to safeguard against misuse of a patient’s health information by insurance companies, healthcare providers, and business associates. It provides for use and sharing of patient information for patient treatment and care coordination, reimbursements of physicians and hospitals for care rendered to patients, with patient’s significant others with the patient’s consent, to protect the health of the public, and making of police reports. The law protects all information documented in a patient’s medical record by the various healthcare providers, conversations between healthcare providers with respect to the care of a patient, patient’s billing information, information about clients held by health insurers, and any other personal information held by all individuals or parties who must abide by the law. The law grants patients a number of rights with regards to their health information. Patients have a right to request for and be availed with a copy of their health records. They also have a right to be informed about how their health information can be used and shared. Further, they have a right to make decisions on whether their health information can be utilized or shared for purposes such as marketing. Lastly, they have a right to be informed about when and why their health information was shared for some purposes (Mathews & Martinho, 2012).
In view of the provisions of the HIPAA privacy rule, the images of a patient captured using a smartphone contain information about a patient’s identity as well as confidential information about their health. Selling of such images without the patient’s knowledge would thus be in breach of the various provisions of HIPAA. For one, such selling would be done without the patient’s consent and knowledge. Further, selling of the patient’s images would be in contradiction of HIPAA’s provisions on who can access patient’s personal and health information held by healthcare providers. In addition, capturing of a patient’s images on a personal phone is in breach of HIPAA’s regulations on how information can be collected and stored. Lastly, sharing of the patient’s information with a magazine would contradict HIPAA’s provision on how a patient’s health information can be utilized.
On the merits and demerits of smartphone use in healthcare, the advantages of use of smartphones in healthcare lie in the convenience and easy accessibility to medical references that smartphones apps foster. Smartphones have varied medical applications which include drug references, reference guides, and medical calculators. Medical applications in smartphones allow access to current and relevant clinical and research information at the bedside. Such information provides support for clinical decision making. In addition, they enable smartphones to be used for a number of tasks such as patient monitoring and education, communication, information and time management, and research (Wyatt & Krauskopf, 2012). Smart phones are also easily portable and hence ensure that healthcare providers can be easily reached.
The main demerits of smartphones can be conceptualized as workplace distraction, security and confidentiality, and acceptance and image. Evidence from research indicates that smartphones are a source of significant distraction especially for decision-based tasks. They reduce focus and increase reaction time. They also reduce performance on tasks that require mental concentration as well as decision making. In healthcare, they pose a great risk as mistakes and omissions in this field can have fatal consequences (Gill, Kamath, & Gill, 2012). On security and confidentiality, the use of smartphones to relay patient information poses great risks. If such information is sent over unencrypted phones, it can be accessed by other parties for instance if a phone is hacked. Additionally, it can be forwarded to others easily breaching patient’s confidentiality. Relaying of patient information over smartphones is also not reliable as there is no future evidence that such communication took place. Moreover, even though there are numerous health-related smartphone applications, the content of most of them is not evidence-based. Regarding the issue of acceptance and image, some healthcare providers and consumers are of the view that use of smartphones at work is not acceptable as it is a sign of unprofessionalism (Bedno & Vicsik, 2012).
In summary, this paper has examined the merits and demerits of use of smartphones in healthcare in relation to a case scenario. The nurse in the case scenario should not sell the images to the magazine as this would constitute unethical conduct and is in breach of HIPAA. The advantages of use of smartphones in healthcare are the fact that they are easily portable and permit quick access to medical references enabling them to provide staffs with support for clinical decision making. The demerits of their use in healthcare mainly center on issues of security and confidentiality, acceptance, and work distractions.
References
Bedno, S. A. & Vicsik, D. M. (2012). Public health in the smartphone era. Retrieved from http://www.medscape.com/viewarticle/776278_3
Gill, P. S., Kamath, A., & Gill, T. S. (2012). Distraction: AAn assessment of smartphone usage in healthcare work settings. Risk Manag Helathc Policy, 10-114.
Mathews, C. & Martinho, A. M. (2012). Patient-physician confidentiality:‘Til death do us part?’ Virtual Mentor, 14(9), 720-723.
Ozdalga, E., Ozdalga, A., & Ahuja, N. (2012). The smartphone in medicine: A review of current and potential use among physicians and students. Journal of Medical Internet Research, 14(5), e128.
Wyatt, T. & Krauspkopf, W. T. (2012). E-health and nursing: Using smartphones to enhance nursing practice. Online Journal of Nursing Informatics, 16(2).
