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The electronic health record (EHR) is an evolving concept that is defined as a longitudinal collection of electronic health information about individual patients and populations (Gunter & Terry, 2005). The primary purpose of the EHR is for integrating health care information that is currently collected in both paper and electronic medical records in order to make health care more efficient, accessible and portable. However, as EHRs continue to form an integral part of the healthcare system, patient privacy and safety has become an important issue in the healthcare industry. “The continuing spread and development of electronic data interchange in health care settings is fueling significant global debate about the practicality, ethics and legality of such a practice” (Weitz, Drummond, Pringle, Ferris, Globerman et al, 2003, p. 292).
Access to traditional medical records has been relatively easy to control. However, when considering the computerized patient record, access becomes a much more complicated issue. “The advent and increased use of the computerized medical record has created an environment where it is possible to access sensitive medical data from any terminal attached to the system” (Veronesi, 1999, p. 77).
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The general fear is that knowledge and capabilities of new technology are developing faster than the guidelines and principles needed for practitioners to practice ethically (Dyer, 2001). While there are a number of legal and legislative ways to protect health information privacy such as the Health Insurance Portability and Accountability Act (HIPPA) in the U.S. and the Personal Information Protection and Electronic Document Act (PIPEDA) in Canada, there are also ways in which EHRs are given moral direction. “Codes of professional ethics have evolved within almost every health-care profession, framed in such a way that they bear a close resemblance to the fundamental legal obligations incumbent on that profession: not harming others (non-maleficence) and respecting their privacy and autonomy” (Stanberry, 2006, p. 166). With respect to the nursing profession in Canada, the Canadian Nurses Association Code of Ethics (2008) outlines the ethical behavior expected of Registered Nurses in Canada. “It gives guidance for decision-making concerning ethical matters, serves as a means for self-evaluation and self-reflection regarding ethical nursing practice and provides a basis for feedback and peer review” (Canadian Nurses Association [CNA], 2002, p. 4). Therefore, throughout this presentation we will discuss the ethical issues that surround granting healthcare providers’ remote access to EHRs. We will also discuss how the CNA Code of Ethics can be used to provide professional guidance when faced with such ethical uncertainties.
Access to traditional medical records has been relatively easy to control. However, when considering the computerized patient record, access becomes a much more complicated issue. “The advent and increased use of the computerized medical record has created an environment where it is possible to access sensitive medical data from any terminal attached to the system” (Veronesi, 1999, p. 77).
Click on figure below to enhance image.
The general fear is that knowledge and capabilities of new technology are developing faster than the guidelines and principles needed for practitioners to practice ethically (Dyer, 2001). While there are a number of legal and legislative ways to protect health information privacy such as the Health Insurance Portability and Accountability Act (HIPPA) in the U.S. and the Personal Information Protection and Electronic Document Act (PIPEDA) in Canada, there are also ways in which EHRs are given moral direction. “Codes of professional ethics have evolved within almost every health-care profession, framed in such a way that they bear a close resemblance to the fundamental legal obligations incumbent on that profession: not harming others (non-maleficence) and respecting their privacy and autonomy” (Stanberry, 2006, p. 166). With respect to the nursing profession in Canada, the Canadian Nurses Association Code of Ethics (2008) outlines the ethical behavior expected of Registered Nurses in Canada. “It gives guidance for decision-making concerning ethical matters, serves as a means for self-evaluation and self-reflection regarding ethical nursing practice and provides a basis for feedback and peer review” (Canadian Nurses Association [CNA], 2002, p. 4). Therefore, throughout this presentation we will discuss the ethical issues that surround granting healthcare providers’ remote access to EHRs. We will also discuss how the CNA Code of Ethics can be used to provide professional guidance when faced with such ethical uncertainties.
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At the end of this presentation participants will be able to:
1) Understand the ethical considerations related to granting remote access of EHRs to healthcare workers
2) Discuss the implications for both patients and healthcare workers if remote access to EHRs is granted
3) Discuss the legal and professional consequences of not adhering to the privacy and confidentiality regulations of EHRs
4) Be able to differentiate between informed, competent and voluntary consent
5) Understand the role of professional code's of ethics in dealing with ethical uncertainties
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ReplyDeleteJack
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ReplyDeleteDeb:)
Great stuff! Thanks.
ReplyDelete- Madeleine