Privacy in the context of use of Electronic Health Records

Privacy in the context of use of Electronic Health Records

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Privacy in the context of use of Electronic Health Records

The health care sector in the United States of America adopted the Electronic Health Record based system in the last decade, almost going paperless in terms of documentation of patient management. With this comes the issue of patient privacy and confidentiality due to the ease of both accessibility and dissemination of electronic based records as compared to paper-based records. There is need for patients to have confidence that the information they provide in the healthcare setting remains private and therefore enable patients to provide sufficient information for purposes of clinical management. Healthcare professionals appreciate the value of appropriate sharing health information that is not essentially individually identifiable in patient management.

There is a large increase in the complexity in modern healthcare in that patient information is accessible to other individuals and businesses as part of their routine operations. These include employers, government employees who handle medical cover for government workers and insurance companies that pay for the medication provided to individuals in hospital. Because of this, there is emergence of debate nationally over the privacy of individually identifiable health information and there is question by privacy advocates on the adequacy of the Health Insurance Portability and Accessibility Act of 1996 Privacy Rule in providing for patient privacy and confidentiality in terms of electronic medical records. There is tension between those who want to use the information beyond its need in patient care and those who want the individual to hold it because of the probability of inappropriate disclosure.

In the recent past, there have been reports of both accidental and intentional disclosure of individually identifiable patient information by various involved parties. This triggered the call for restrictions by privacy advocates in order to prevent inappropriate disclosure of individually identifiable health information. If there is imposition of restrictions and stringent rules on the access of individually identifiable health information, there may be a difficulty in accessing important patient information especially during emergencies. An argument presented by privacy advocates highlights that the Health Insurance Portability and Accountability Privacy rule is inadequate to meet patient privacy needs. These advocates also argue that the emergence of health information exchange and the development of a national health information network lead to new classes of disclosure not addressed in the current legislation and regulation. There are new policies in states including New York, California and Massachusetts in response to the push by privacy advocates for changes in health information technology to ensure privacy.

There are various solutions to the problem of privacy in the context of electronic medical records. These include the option to engage technology experts in designing programs to restrict inappropriate and unnecessary disclosure of individually identifiable patient information. Another option is to introduce change in legislation to accommodate the emerging issues in patient privacy when it comes to use of electronic medical records. Alternatively, there can be involvement of various relevant parties including organizations, insurance providers and other classes of providers, government, consumers in the development of a comprehensive framework for ensuring privacy and consent for privacy in the context of use of electronic medical records.

The best solution from among the alternatives listed chosen based on criteria as described below is likely change in legislation. This is because this alternative fits the criteria described as follows. The criteria for choosing the best alternative is that it should be relevant to the problem at hand, should have the ability to bring progress and results, should be efficient, effective and bring desired impact. The alternative should be flexible in order to accommodate the emerging issues. The alternative should be more acceptable to the society and less likely to encounter opposition from privacy advocates and other interested parties. In addition to these, the alternative chosen should be more practical as compared to the other alternatives since it is procedural, involves sufficient research around the issue, it is open to participation by various relevant parties and the involvement of these parties in the formation of the key points in the legislation. In addition to these, the alternative chosen should be a sure way to ensure that the changes required in the context of privacy in health information technology apply in electronic health records.

Policy changes in the context of privacy in health information are likely to bring the desired outcomes as described below. A change in policy regarding patient privacy is likely to solve the problem of inappropriate disclosure of patient information, especially that which privacy advocates show concern. Policy formation will provide clear guidelines on the disclosure of patient information by healthcare professionals. This policy will promote the use of electronic medical records which is lower cost compared to paper based system, while putting in check the privacy issues associated with the use of this form of health information technology. It will reduce the number of issues raised and the need by various states to introduce new regulations regarding patient privacy that may bar access to medical services during emergencies. The policy guiding patient privacy will enable patients to have privacy in the context of individually identifying patient information.

Without this policy, there is an impending problem when it comes to the use of health information technology. Privacy advocates and individual patients may have genuine concerns concerning their privacy in terms of electronic medical records. It is important to address this issue for health information technology to work. Various states in the United States of America may have to introduce new policies to govern health information technology and electronic medical records without the introduction of a federal policy. The variation in the nature of these policies may not accommodate the needs of relevant parties and may affect patient management by healthcare professionals in these states. It also affects interoperability standards among states. Lack of a working policy to guide use of electronic medical records may retard the use of information technology in healthcare and in turn reduce the quality of service and the variety of services available to the patient.

In the context of patient privacy in terms of electronic health records, a recommendation is that changes in legislation are necessary, if the electronic system of health records is to be useful. There is need to address the privacy issues in order to address the privacy needs of patients. To achieve positive outcomes from changes in legislation, there is need to involve various relevant parties in policy formation including the government, the department of health and human services, insurance providers, employers and consumers in order to come up with legislation that is flexible and acceptable. Health information technology is an important part of improvement and modernization of patient care. Issues in this sector should therefore be addressed to avoid conflict among concerned parties and to optimize quality and efficiency in patient care.

References

Collins, T. (2006). Health Policy Analysis: A Simple Tool for Policy Makers. The George Washington University, Department of Global Health, Washington DC.

Hristidis, V. (2009). Information Discovery on Electronic Health Records. CRC Press.

Nass, S. J., Levit, L. A., & Gostin, L. O. (2009). Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research. National Academies Press.

Weiner, J. (2006). Health Policy Analysis Checklist. Johns Hopkins Bloomberg, School of Public Health.