Digital Ethical Issues for Healthcare Administrators

 

I apologize for a late post this week friends. I was on the road traveling to two different conferences that were both focused on healthcare.

Hand writing So Many Things in To Do List, vector concept

The first conference was in Scottsdale, AZ and from here I traveled to Washington, DC was where I asked to be a panelist for a session. I tried to have my post submitted on time, but realized quite quickly that a bit more time was needed given how little free time I had available. I am happy to report that my speaking session went well. Now, let us transition into digital ethical issues for healthcare administrators.

Before jumping into the healthcare I would like to revisit the definition of ethics as Gerd Leonhard discusses that ethics are beliefs that manage an individual’s or group’s behavior. It is important to revisit this definition because of its role in relation to digital ethical issues in healthcare.

Healthcare has experienced many changes within the United States since its inception. Healthcare, within the United States, began in the 1920s when hospitals noticing that their services were not being used frequently. A Baylor hospital created the very beginnings of a small health insurance program to encourage consumers to invest a little in their healthcare. Eventually, this program Baylor created became popular and went on to become Blue Cross (NPR, 2009). Decades past, then in the 1960s, Medicaid and Medicare were established to help provide care to the young, disabled, and elderly. Healthcare relied heavily on paper charts and nowadays, technology.

How has technology impacted the U.S. healthcare system? Immensely. As mentioned earlier, paper charts were the norm. Doctor’s offices had shelving to hold all the charts in alphabetical order. As technology progressed, healthcare shifted to integrated technology into the medical practice. When I worked at a community health center, the federal government offered funding to incentive centers to begin switching over to electronic medical records. (Below is an example of a vendor used in the health center I worked for). Technology within healthcare allowed for telemedicine, or the idea of doctors providing care to patients in remote areas via technology, continues to increase especially in rural areas.

nextgen

With the integration of technology, comes training for the staff to ensure they can properly use the software to provide care to patients. With the use of electronic medical records staff have access to many patient charts literally at his or her fingertips. Privacy of patient charts is imperative and many trainings within healthcare organization stress the importance of keeping information confidential. One such law is HIPAA, or the Health Insurance Portability and Accountability Act of 1996, safeguards medical information. What this means is that patient information cannot be shared unless it is to provide direct care. For example, two different doctor’s offices may share a patient’s chart information as it relates to treatment. A violation of HIPAA would be if a nurse shared a patient’s personal and medical information with another staff person that was not involved directly with the patient.

Correct access to patient charts

One challenge with technology that healthcare administrators encounter is ensuring that staff are accessing the charts he or she actually needs in relation to medical care. Limiting access to certain areas within electronic medical records for staff is cumbersome. Healthcare administrators want to trust their staff to do the right thing, but some staff may get nosy. An example of this occurred when I worked at the health center. There was a staff member who accessed her husband’s and daughter’s medical charts without their permission. The administration staff, myself included, found out because the employee was sending messages through the charts to the doctors. The employee should have been fired as policy stated that would be grounds for firing. Instead, the employee was allowed to continue working at the health center.

Hacking

Another challenge is hacking. Safeguarding patient files by encryption or password protection does not fully guarantee that the medical information is safe. Insurance companies, medical practices, and countless others have become victims to hacking. Ransomware is a growing hacking technique that gathers information and, for a price, will release the information back to the rightful owner. Healthcare administrators must proactively ensure that their electronic medical records system is protected by working with their IT vendor and having processes in place in case a hack occurs.

Mobile technology

Aside from hackers, many medical practices use laptops, tablets, and other mobile technologies to practice care. Mobile technology allows healthcare providers to carry the patient information with them wherever he or she goes. One downside to mobile technology is that the equipment could easily be misplaced or stolen. Back in 2012, a Massachusetts organization had a laptop stolen from one of their providers. The laptop was not encrypted which led to the organization paying over $1 million dollars to settle their violations.

In conclusion, healthcare has seen a drastic change in how it is practiced due to technology. While technology allows for innovative care to be provided, there are many ethical issues that can greatly impact the organization. Healthcare administrators work to ensure that patient charts are protected and use properly by staff. Outside of health administrators control is hacking which has the potential to halt medical care in its footsteps. Lastly, mobile technology allows providers the flexibility of taking computers, tablets, etc. with them wherever they go, but can be used to access patient files if not carefully protected.

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5 thoughts on “Digital Ethical Issues for Healthcare Administrators

  1. I enjoyed your post this week. I recently took a position with the state medical association in Ohio. We advocate for the rights of physicians for delivering the best possible health care and solutions for patients. I appreciated your take on the ethics that are required for protecting patient identity as well as the right level of access to information. While the government mandates have required many of these, which are good, did you consider how this technology might have negatively impacted the medical profession? This news brief discussed that half of a clinician’s time is spent on paperwork and EHRs. http://www.jwatch.org/fw111995/2016/09/06/half-physician-time-spent-ehrs-and-paperwork
    Do this provide another level of ethical issues beyond security and privacy?
    Thanks-Krista

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    • Krista,
      Thank you for your question. I did think about how technology has negatively impacted the medical profession, specifically, how much time is spent by providers entering patient notes. When I worked at a community health center, we had providers that would spend hours at the end of the day ordering tests and entering notes. There were also other providers who had all their notes and tests in the system right after visiting with a patient. I think it is important for providers to know their EMR (electronic medical records) system very well. I think there could be improvements on the EMR systems to become more user friendly. The challenge with the EMRs is that they contain so much information given that health cases are so vast. These are just my initial thoughts, but you raise an excellent question.
      By the way, congrats again on your new position. I hope it is going well.
      Keshia

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      • Thanks, Keshia!
        And you’re right on those EMRs. It is clearly a change in mindset as well as understanding the technology. Once those things are mastered, I do believe the time spent on these activities will decrease and will benefit all interested parties (patients, physicians, insurance, etc.)
        -Krista

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  2. Nice post. One area that is starting to get attention comes from the health data from wearables. I am 2 weeks into owning my first Apple Watch, and already amazed by the apps that check my pulse, urge me to move when sedentary too long, etc. In the not too distant future, I could see insurance companies providing wearables…but charging variable rates based on the data they receive. So issues of privacy will now include the data collected from our wrists as well as our other devices.

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  3. Pingback: Eight Days a Week. – Cat on the Keyboard

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