Ethical Issues in Healthcare Healthcare ethics involves making well researched and considerate decisions about medical treatments, while taking into consideration a patient's beliefs and wishes regarding all aspects of their health. The healthcare industry, above any other, has a high regard for the issues surrounding the welfare of their clientele: their patients. This paper will focus on HIPPA, confidentiality, the efficiency and cost of information systems and doctor-patient relationship.
The Health Insurance Portability and Accountability Act of 1996, or HIPAA, is a law designed “to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes.
When confidential patient information is disclosed without consent it is a violation of the HIPAA Title II Security Rule. This rule was enacted in response to private information being leaked to the news and emails containing privileged information were read by unauthorized people. Identity theft is a real concern so patient privacy should be taken seriously. This is a rule can easily be broken without the offender feeling any malice towards the victim for example gossip and curiosity.
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Gossip in a medical office can have devastating effects on a health care facility’s reputation. Employees engaging in idle chatter to pass the time can inadvertently be overheard by patients or family members. Primarily, computer storage and exchange of information is the area where HIPAA intersects with technology. Anytime a computer stores patient information, the computer must have HIPAA precautions. For instance, the computer should only be accessible by certain persons who have a special access code and/or password to utilize the computer.
Also, when a computer is not in use, it should be locked and the screen must be inaccessible from unauthorized persons. Furthermore, monitors and screens should be turned away from the public to prevent anyone from seeing private medical information. http://www. ehow. com/about_5220807_hipaa-law-affects-technology. html#ixzz2PPhpfXnD According to the textbook “healthcare companies must appoint a privacy officer to develop privacy policies and procedure as well as train employees on how to handle sensitive patient data.
These actions must address the potential for unauthorized access to data by outside hackers as well as the more likely threat of internal misuse of data. Some medical personnel and privacy advocates fear that between the increasing demands for disclosure of patient information and the inevitable complete digitization of medical records, patient confidentiality will be lost” (George Reynolds 2012). Confidentiality is one of the most important ethical issues in health care. Maintaining confidentiality is becoming more difficult.
While information technology can improve the quality of care by enabling the instant retrieval and access of information through various means, including mobile devices, and the more rapid exchange of medical information by a greater number of people who can contribute to the care and treatment of a patient, it also can increase the risk of unauthorized use, access and disclosure of confidential patient information. Within healthcare organizations, personal information contained in medical records now is reviewed not only by physicians and nurses but also by professionals in many clinical and administrative support areas.
The meaning of patient confidentiality is that personal and medical information that are provided to the providers of healthcare cannot be disclosed to others not unless the patient has provided authorization for the release. In fact permission is not supposed to be granted to health care professionals to disclose the patient’s medical information. This is because there could be professional or personal problems by disclosing the medical information of the patients for patients depends on the physicians in keeping private their medical information.
Normally it becomes difficult for medical records to be completely sealed up. The greatest factor that affects confidentiality is when clinicians turn to share medical information as case studies. In any case such data happens to be published in professional journals, then the patient’s identity is never divulged and the entire data that identifies the patient become either eliminated or changed. However, if at all the confidentiality is breached; the patient may have the right of suing (Claire McGowan, 2012).
The cost of upgrading the organization and bringing it into the 21st century will be rather expensive however it is important to understand that this is a necessary expense and the new computer system will pay for itself in a relatively short time. HIT can raise quality and can also generate the statistics to prove you have done so. Perceived higher quality allows organizations to increase market share and to negotiate higher prices from payers whose members demand access to those organizations, even if they have to pay slightly higher premiums to get it.
In a competitive fee-for-service environment, greater market share increases revenues and may also permit some economies of scale (Morton Shekell, Keeler EB, 2006). The use of health information technology (HIT) has been promoted as having tremendous promise in improving the efficiency, cost-effectiveness, quality, and safety of medical care delivery in our nation's healthcare system. The realization of these benefits is especially important in the context of reports that show five years of consecutive annual double-digit increases in healthcare costs and increases in the numbers of adverse health events.
At the same time, reports have suggested that 50 percent of all healthcare dollars are wasted on inefficient processes. Legislators and organizational leaders at the federal and state levels have emphasized the need for healthcare to follow the example of many non-healthcare industries, in which implementation of computer information technology has been critical in increasing the accessibility of mission-critical information, automating labor-intensive and inefficient processes, and minimizing human error (Morton Shekell, Keeler EB, 2006).
Special computer servers should be utilized to store private patient information. There should also be special firewall programs and other safety software installed on the computers like virus protection. These protections must be available on any computer that is used to store and/or exchange patient medical information. These precautions also impact the use of fax machines and computer printers as well. Anytime patient information is exchanged via facsimile, there must be redaction of confidential information or a limitation on who will access the incoming faxes.
The same issue must also be addressed with use of computer printers. In other words, the printer must be accessible only by authorized personnel. Physician-patient relationships are very important. Ethical dilemmas also extend to safety of the patient and other healthcare workers, because medical records are meant to convey all information to other healthcare providers. A patient’s request that healthcare-related information be kept off the record, places the physician in a difficult situation.
While physicians are obligated to protect a patient’s private information and to maintain confidentiality, they are also obligated to keep accurate records of relevant information, to avoid harm to patients, to make treatment recommendations that are likely to benefit the patient, to be responsible stewards of healthcare resources. Key considerations include the precedent the act will establish and both the short-term and long-term consequences of the act to the patient and others.
While electing to prioritize confidentiality may appear justified or inappropriate in the immediate situation, reflection on the implications is important. The physician should work with the patient to assess the options available, such as honoring the request, documenting fully, documenting only what is necessary, and using alternative language. How present is the idiom ‘off the record’ in healthcare? In closing, right to confidentiality of a person on the part of the providers of healthcare is held by government as well as the law.
Such position is reaffirmed as well in the language of the codes of professional conduct. Both the ethical and the legal principles of confidentiality tend to be rooted in a set of values concerning the relationship between the patient and the caregiver. It is important for a patient to trust a caregiver in order to facilitate a warm and accepting relationship to develop. References Shekelle P, Morton SC, Keeler EB. “Costs and Benefits of Health Information Technology. Evidence Reports/Technology Assessments” No. 132. April 2006. Retrieved from http://www. ncbi. nlm. ih. gov/books/NBK37992/ “How present is the idiom ‘off the record’ in healthcare? ” Medical Ethics Advisor September 1, 2011: Vol. 27, No. 9 pp. 97-108 Retrieved from UMUC Library McGowan, Claire. “Patients’ Confidentiality” Critical Care Nurse Vol. 32, No. 5 October 2012 pp. 61-65 Retrieved from UMUC Library Reynolds, George W. (2012). Ethics in information technology (4th ed. ). Independence, KY: Cengage Learning, Inc. Nogara, J. S. “How HIPAA Law Affects Technology” Retrieved April 3, 2013 http://www. ehow. com/about_5220807_hipaa-law-affects-technology. html
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