Healthcare Privacy Issues PDF

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Final paper for Prof. Cochran's class. received an A- ...

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HEALTHCARE PRIVACY ISSUES 1

Healthcare Privacy Issues HCMN 305, Section 2 Professor Cochran

HEALTHCARE PRIVACY ISSUES 2 Abstract As more and more healthcare organizations are digitizing heath records, ethical issues have emerged as an immediate result. Electronic health records (EHR) facilitate and improve many aspects of the healthcare process such as access, quality, and costs (Ozair, Jamshed, Sharma, & Aggarwal, 2015). The ethical issues arise here because more often than not, patient EHRs are shared with other doctors and personnel without their permission. This leads to patients reserving information from doctors out of fear of the poor security covering their health data and ultimately resulting in compromised treatments (Ozair, Jamshed, Sharma, & Aggarwal, 2015). Its enhanced portability raises many ethical red flags for patients and the responsibility of clinicians to inform patients of potential security breaches (Sittig & Singh, 2011). The ethical issues emerged when pharmaceutical companies, healthcare device makers, and researchers purchase patient deidentified data from EHR vendors (Sittig & Singh, 2011). Those de-identified patient data can be found using external data sources and that’s when the ethical concerns hit a boiling point (Sittig & Singh, 2011).

Electronic Health Records and Breaches The ethical concerns of electronic health records are privacy and confidentiality, security breaches, system implementations, and data inaccuracies. The unauthorized portability and share among other healthcare professionals are what worries many patients (Ozair, Jamshed, Sharma, & Aggarwal, 2015). This is where the privacy and confidentiality issues kick in because healthcare professionals aren’t the only ones who need this data, healthcare institutions and insurance companies also require this information (Ozair, Jamshed, Sharma, & Aggarwal, 2015). Creating lists of authorized users and gauging their level of access based on prearranged roles and responsibilities is a step in the right direction (Ozair, Jamshed, Sharma, & Aggarwal, 2015). The users with access are also responsible for the application of the information they saw. Meaning they’ll be held responsible for the misuse of this information if something were to happen (Ozair, Jamshed, Sharma, & Aggarwal, 2015). This maybe the best possible action to control the portability of patient information but confidentiality is a persistent issue only strict and effective privacy policies can combat (Ozair, Jamshed, Sharma, & Aggarwal, 2015). There have been strict measures taken to reduce the flow of patient confidential information, but the major issues lie in how quickly security breaches can be caught. For instance, a security breach at Howard University hospital resulted in, “over a 17-month period, Laurie Napper used her position at the hospital to gain access to patients' names, addresses and Medicare numbers in order to sell their information” (Ozair, Jamshed, Sharma, & Aggarwal, 2015). In addition, this also shows the poor management skills of staff activities by managers and supervisors because employee activities need to be closely monitored when dealing with

HEALTHCARE PRIVACY ISSUES 3 sensitive information. Management issues and encryption effectiveness are interrelated in managing EHRs considering another incident where, “A contractor working with the hospital had downloaded the patient's files onto a personal laptop, which was stolen from his car” (Ozair, Jamshed, Sharma, & Aggarwal, 2015). This serves as another example of what can happen when poor employee management meets inadequate encryption. Now anyone who can guess the password, has access to all of the patients’ health information (Ozair, Jamshed, Sharma, & Aggarwal, 2015). Cost One of the biggest issues preventing the widespread implementation of EHR systems aside from ethical is the cost and clinicians’ role management. The million-dollar unanswered question is: who’s funding EHR systems? A small practice would have to pay approximately $162,000 for the installation and $85,000 annually for maintenance costs (Palabindala, Pamarthy, & Jonnalagadda, 2016). The high additional costs create a discouraging environment for hospitals and physicians to utilize these systems in their operations (Palabindala, Pamarthy, & Jonnalagadda, 2016). The federal government invested $25 billion under the Health Information Technology for Economic and Clinical Health Act into these systems without analyzing the barriers they create (Palabindala, Pamarthy, & Jonnalagadda, 2016). Implementation During the transitioning process, it’s essential that managers and supervisors help clinicians and physicians be aware of their responsibilities to reduce any possible breaches and risks (Palabindala, Pamarthy, & Jonnalagadda, 2016). In order to reduce chances of malpractice and lawsuits, strong administrative systems need to be in place to prepare for an easy implementation. This administrative system would consist of liaison between EHR providers and administrators of hospitals with clear communication on how to make a smooth data transitions as this phase is fragile and must be meticulously performed. These strict measures of policy and management fall on hospitals to execute as declared by HIPAA that, “hospitals are solely responsible for their EHR system, including how it is used” (Palabindala, Pamarthy, & Jonnalagadda, 2016). All the more reason to carefully establish policies and develop heavily monitored employee activities. Medical Errors The increased risk of medical errors pertaining to EHRs have a common root of excessive dependency on these systems. As physicians get more and more comfortable with EHR systems, they tend to lose human critical decision making (Palabindala, Pamarthy, & Jonnalagadda, 2016). Medical errors start with simple misspelling or wrong diagnoses entered that with increased portability of patient files, can create a chain of erroneous treatments and lead to many health complications (Palabindala, Pamarthy, & Jonnalagadda, 2016). Preventing these from happening takes continuous skill building, quick mistake detection, and requires that the hospital administrative team take responsibility in creating training requirements (Palabindala, Pamarthy, & Jonnalagadda, 2016). Since it’s the physicians’ responsibility to know what’s entered in the system, any large-scale mistake created jeopardizes their autonomy and practice (Palabindala, Pamarthy, & Jonnalagadda, 2016).

HEALTHCARE PRIVACY ISSUES 4 Electronic health records have many advantages like preventing wrong surgeries and medicine, don’t require significant space, and reduce the chances of lost patient health records. However, EHRs have many exploitable loopholes that if not managed strictly can create dangerous problems for hospitals and patients alike. Stricter policies are one way to reduce patient data thefts and heavy monitoring of users’ access is also an effective measure to combat these issues. According to HIPAA, hospitals have the burden to thwart these potential dangers and these are just a few ways of dealing with them.

References Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394583/.

Palabindala, V., Pamarthy, A., & Jonnalagadda, N. R. (2016, October 26). Adoption of electronic health records and barriers. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5089148/.

HEALTHCARE PRIVACY ISSUES 5 Sittig, D. F., & Singh, H. (2011, April). Legal, ethical, and financial dilemmas in electronic health record adoption and use. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065078/....