Electronic Health Records (EHR) is a dynamic development in healthcare that is causing a lot of debate. The California Department of Managed Health Care as well as the rest of the HMOs are watching as Kaiser Permanente deploys the largest EHR system in the nation, deployed at facilities across the nation…
But attention must also be paid to the risks.
EHR are used by may different types of healthcare delivery systems, from hospitals to private practice. By definition, "To be defined as an Electronic Health Record, an electronic approach to collecting storing and manipulating data must be able to accomplish: collection of patient health information and data, results management, order entry management, and decision support" (Health, 2007). Although this system often makes dealing with patient records more orderly and efficient, some have raised concerns over how the process of keeping these electronic records relates to issues of patient confidentiality and privacy. Because there is so much more access to the information electronically, there is also more possibility that the information will wind up in the wrong hands.
In many ways, this is an ethical issue that comes down to the individual using the EHR system. This comes from the perspective that a universal ethics is possible and also that it must be based on choice. This pattern of choice must start with the individual; there cannot be a group ethic that is in agreement without individual ethics. The individual healthcare professional is a person who must make choices regarding how to behave. This behavior can be broken down into two categories: the choice as it effects the society around the person making the decision, and the decision as it affects the person making the choice. An individual could make an ethical choice to respect patient confidentiality and keep this in mind when using EHR with passwords and encryption. They could choose whether or not to tell the truth. They can make an ethical distinction between giving and taking. The list goes on and on. Ethics is ultimately seen to be a personal decision that may or may not be effected by an external group or group philosophy. In this ethical mix, "As information technology expands throughout healthcare, opportunities for breach of confidentiality become abundant, from information left on the fax machine and patient data left visible on a computer screen" (Jenkins, 2002). Therefore, it is up to the individual professional to be as vigilant as possible, and work within a technological system in a way that shows responsibility and ethics.
This issue is relevant because as mentioned, today's healthcare environment is one that is quickly changing as new technology is constantly being adopted, and this technology brings risks as well as rewards. Patient privacy and confidentiality also remain relevant concerns from an ethical as well as a legal perspective in the healthcare environment. In today's healthcare setting, "Computer systems designed for clinical use apply technology that is protective of data. In addition, an electronic patient record is backed up according to hospital policy' and as the chart is modified by caregivers, those changes are automatically saved and an audit trail created" (Conner, 1999). But at the same time, this efficient means of keeping data could lead to possible compromises in patient confidentiality, because even encryption and passwords are not fool proof security systems.
Confidentiality is an important aspect of any client-professional relationship. It is
intricately involved with issues of trust between the ...
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