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.
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.
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.
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.
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.