ELECTRONIC HEALTH RECORD 1
Anelectronic health record (EHR) refers to a patient’s medical datastored in a digital format1.EHRs contain information such as medical history, allergies,medications, diagnoses, progress notes, imaging reports, lab data,and vital signs (Amer, 2015). In addition, they include demographicdata and insurance information. An EHR ensures that healthinformation is readily accessible to care providers when needed. Inthis regard, patient records are instantly shared with otherclinicians to coordinate care and inform medical decisions.
Relationshipto Information Technology
Electronicrecords are typically shared through enterprise-wide exchanges.Network-connected systems are used to link imaging facilities,workplace clinics, specialists, labs, and emergency facilities (Amer,2015). An EHR utilizes information technology to store large amountsof patient information accurately. It also minimizes the occurrenceof data replication by using a single modifiable patient file.Furthermore, electronic health records allow digital information tobe stored in a searchable file (Amer, 2015). Therefore, medicalpractitioners can extract invaluable details on long-term changes andpossible trends in a patient`s condition. Moreover, an EHR usesadvanced technology to trigger reminders and warnings to medicalpersonnel (Amer, 2015). Information networks are also useful insending and receiving results, reports, and orders. In some areas,ambulance services have adopted the use of automated handwritingrecognition software (Amer, 2015). Such technologies facilitate theconversion of paper-based medical documents into digital formats.
EthicalIssues related to EHR
Theaccessibility and portability of electronic health records raisevarious ethical concerns. For example, it jeopardizes the ownershipof health information (Sittig & Singh, 2011). Customarily, apatient has exclusive rights to their personal information. In thisrespect, unauthorized parties are not permitted to access privatedetails about a patient. The health care practitioner is charged withthe responsibility to prevent any breach of privacy. Providers mustalso inform patients of the likelihood of exposure (Sittig &Singh, 2011). Many patients are primarily concerned with the enhancedrisk of information disclosures through EHR. Some health careorganizations have sold copies of their records and databases toresearchers and pharmaceutical companies (Sittig & Singh, 2011).Medical device-makers have also acquired patient records to guidetheir production activities. Although most of the commercializeddatabases are deidentified, some software programs can be used toreinstate personal details (Sittig & Singh, 2011). Consequently,an ethical dilemma arises concerning the appropriateness of makingfinancial gains from patient information. It is also vital toconsider the sufficient amount of privacy safeguards in the casewhereby selling patient databases is justifiable.
Moreover,current standards have led to the firing of personnel accused ofaccessing patient information without proper authorization. Auditlogs are used to determine the identities of staff members guilty ofprivacy breaches (Sittig & Singh, 2011). Although paper-basedrecords also experienced breaches in privacy, such occurrences weredifficult to detect and limited in scope (Sittig & Singh, 2011).Therefore, the recourse adopted for EHR violations needs to considerthe situations where unauthorized personnel used falsifiedcredentials to access patient records.
Furthermore,the adoption of plans to collect statewide patient records wouldrequire the redesign of the country’s health care and paymentsystems (Sittig & Singh, 2011). Consequently, ethical issuesarise concerning which parties would be responsible for dataverification, aggregation, analysis, and validation. Other ethicaldilemmas arise concerning how practitioners should handle the recordsof adolescent patients (Cushman, Froomkin, Cava, Abril, &Goodman, 2010). Granted, teenagers can protect their personalinformation while consenting to treatment for particular conditions.Such an allowance exists because some conditions are quite sensitivesuch that care would be hampered by parental involvement (Sittig &Singh, 2011). Nevertheless, parents must provide consent beforeadolescents receive other therapies. Although some agencies haveproposed having separate EHR systems, it remains unclear how parentalaccess to sensitive information can be restricted. Inevitably,adolescents become emancipated when they reach adulthood. Someethical issues arise with regards to when the electronic recordsshould be transmitted (Sittig & Singh, 2011). It is alsodifficult to determine who decides whether care providers should giveup control over such files.
Trendsrelated to EHR
Electronichealth records have been updated to include more than diagnosis andtreatment information. Consequently, any details regarding thegeneral condition of the patient are included. Such modificationsensure seamless integration among different health careorganizations. They also help to improve the level of coordination inall kinds of practice (Amer, 2015). Given the ethical challenge ofprivacy, some advocacy groups have defended patients’ rights to optout of storing their information on an EHR. In recent years, therehas occurred a steady increase in the number of organizations usingelectronic health records (Sittig & Singh, 2011). Consequently,there have been several complications associated with the accurateidentification of individual patients. Also, the requirements tomaintain data integrity and patient privacy have intensified.Therefore, various proposals have been created to develop a national,unique patient identifier (UPI) system2(Sittig & Singh, 2011).
Impactson Individuals and Organizations
As mentioned, many patients have elected tohave their personal information separate from an EHR. Consequently,health care providers will be required to spend more time andresources to maintain paper records (Sittig & Singh, 2011). Suchfiles would be kept separate from digital formats. Besides,practitioners may show less willingness to care for patients thatlack digital health records. Some clinicians will be unable toreceive Medicare payments from such patients. In addition,implementing a statewide collection of health records requires theinput of various stakeholders such as patient advocates, clinicians,ethicists, informaticians, and statisticians (Sittig & Singh,2011).
Indeed,electronic health records have revolutionized medical care. Digitalformats can be used to store various aspects of patient informationsuch as medical history, diagnoses, and treatments. Subsequently,health care providers can transfer and access such information tofacilitate accuracy in medical decisions. However, the use ofelectronic health records raises ethical issues concerning breachesof privacy. Many patients have campaigned to exclude their privateinformation from EHRs. In response, practitioners have been lesswilling to treat patients without comprehensive digital records.
Amer, K. (2015, May 8) Informatics: EthicalUse of Genomic Information and Electronic Medical Records. OJIN:The Online Journal of Issues in Nursing, 20(2).doi: 10.3912/OJIN.Vol20No02InfoCol01
Cushman, R., Froomkin, A. M., Cava, A.,Abril, P., & Goodman, K. W. (2010). Ethical, Legal and SocialIssues for Personal Health Records and Applications. Journalof Biomedical Informatics, 43(5),51–55. doi:10.1016/j.jbi.2010.05.003
Sittig, D. F., & Singh, H. (2011).Legal, Ethical, and Financial Dilemmas in Adoption and Use. Pediatrics,127(4), 1042–1047. doi:10.1542/peds.2010-2184
1 Although Electronic Medical Record (EMR) is used interchangeably with EHR, EMRs are limited in their transfer among various types of practice
2 Federal policies and public outcry on the potential for privacy infringement have hindered the full-scale adoption of the UPI