Medical Records, Patient Consent, and Information Management
Order Instructions:
Medical Records, Patient Consent, and Information Management
As your fourth assignment toward completion of the Session Long Project, you will need to discuss the fragile balance between the need for public health agencies to acquire data and the demand for security of sensitive information. Review the article Ethics in Public Health Research.
As public health director in a small county, you must maintain records that track diabetes rates, the incidence of HIV, and immunization records. Recently, there have been at least two breaches when computers were stolen from employees or an outside hacker broke into the system and downloaded data.
Now you must write an open letter addressing the community and explain how the department is going to protect the information. In your letter, address the following questions.
1.Explain why the health department collects this information conveying the idea of how it serves the greater good.
2.Discuss the public’s interest in privacy and why this is important in our society.
3.Discuss why the department needs to infringe on the community’s privacy.
4.Explain how the department might ensure greater security.
5.Be sure to identify at least one applicable regulation, statute, or source that supports the ability of the department to collect this information.
Module Overview
Informed consent requires more than just a good written form—it also requires preparation for a full discussion with the patient and a check to ensure that the messages have been received.
Informed consent is the process of communication between a patient and physician that results in the patient’s authorization or agreement to undergo a specific medical intervention [AMA 1998].
Disclosure of facts related to an individual’s healthcare, including level and location of care, are central to the fulfillment of informed consent. When an individual is unable to provide informed consent because they lack the decision-making capacity to process the information and/or they have been deemed legally incompetent, the healthcare team should obtain assent from the individual whenever possible.
Questions remain as to how to proceed when assent cannot be gained and the decision involved causes a level of distress for the individual that is difficult to resolve. A focus on maintaining hope and support with a clear transition and follow-up plan are important variables to consider for an ethical, caring response.
Traditionally, the ethical principle of patient confidentiality, including the right to personal privacy has been an important consideration in healthcare. Recent incidents involving identify theft, confidentiality, and patient privacy have led to increasingly restrictive policies on patient health information and access to records and data. Some believe that these restrictions can harm efforts to protect the public’s health. This has prompted discussions on a more appropriate balance between privacy concerns and the protection of public health.
Required Reading
A Practical Guide to Informed Consent. Temple Health (2007). http://www.templehealth.org/ICTOOLKIT/html/ictoolkitpage1.html
Informed consent Russell G. Thornton Proc (Bayl Univ Med Cent) 2000 April; 13(2): 187–190.PMCID: PMC1312305 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312305/
Informed Consent in Louisiana – Lugenbuhl v. Dowling, 701 So.2d 447 (La. 1997), rehearing denied (Nov 21, 1997) Guide http://biotech.law.lsu.edu/cases/consent/Lugenbuhl.htm
Am J Public Health. 2008 May; 98(5): 793–801. doi: 10.2105/AJPH.2006.107706
PMCID: PMC2374810 Ethics in Public Health Research: Privacy and Public Health at Risk: Public Health Confidentiality in the Digital Age. Meyers, Frieden, Bherwani and Henning. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374810/
Optional Reading
Improving the Informed Consent Process Krames StayWell Blog (2009). http://info.kramesstaywell.com/Portals/36339/docs/Krames%20Informed%20Consent.pdf
SAMPLE ANSWER
Medical Records, Patient Consent, and Information Management
The health department maintains community records that track diabetes rates and incidence of HIV and their management practices in the community. The collection of data is a systematic approach that ensures the department spends its resources appropriately to improve the health of the population in the most effective approach. The data collected is used for epidemiological, qualitative and comparative analysis to describe the health problems of a community. The data is used to identify the inequalities of the health services and to determine the priorities for effective use of resources. The health benefits are those that benefit the wider environmental and social changes. Successful health needs assessment require practical approach to understand what is involved and the resources necessary to complete the assessments, and to ensure sufficient integration of the study findings that will help in planning and commissioning of the local services (Nass, Levit, & Gostin, 2009).
This is important because it does not only help the department to monitor but also to improve the healthcare services and well being of the community. The information gathered is important in assessing the health needs of a community. This is because the health needs of a patient collected in their respective clinics may reveal the community health needs. Therefore, this information is important in assessing the wider needs of a community in planning and providing the local health services. If the needs are ignored, the community health needs will not be addressed thereby putting more and more people in danger. Using the information collected, the department is able to assess the residents cost of care, safety, accessibility as well as the quality of health; and or use the information to partner with other institution for regional health planning (Meyers et al., 2008).
The privacy Act of 1974 states that all persons information obtained from individuals and have personal identifiers such as social security number, name or any other identifier should not be disclosed without prior written consent from the individual. The issue of Health Insurance portability and Accountability Act (HIPAA) comes into place when the health information is collected and discussed. The issue of confidentiality refers to the professional obligation to hold the health information collected as confidential. This obligation is supported by the professional association codes of ethics found in the first principle of the American Health Information Management Association Code of Ethics (AHIMA) “advocate, uphold and protect individual’s right to privacy and confidentiality when disclosing healthcare information (Nass, Levit, & Gostin, 2009).”
The public’s interest on the issue of privacy in this department arises from the breach of privacy due to the stolen laptops. The concern is caused due to worries that the information in those two stolen laptops may negatively affect the resident’s dignity, and is likely to cause harm. The public is scared that the breached information may contain personally identifiable health information, which can lead to embarrassment or discrimination. In addition, the medical information collected in this department include the most intimate details regarding patient’s behavior, and may also include information about their social behaviors or personal relationship or economic status. This brings forth the major concern for the medical data privacy. Thus, the society needs some sort of assurance that the information that got lost with the stolen laptops is protected and will not be disclosed to the public (Meyers et al., 2008).
All institutions that are involved in collection of resident’s healthcare information, they must establish strong measures that ensure that people’s personal data is not disclosed by taking strong strategies that safe guard the health data. All the organizations should take additional measures to strengthen the data protection. In this context, the department understand the value of individual rights, personal choice and is doing all it can to protect intrusion of the private sphere. The department understands the importance of maintaining the medical information confidential. For this reason, this organization have appointed security officers who have the responsibility of assessing effective strategies of data protection, and implementing staff training that will help implement the solutions. The departments also make greater use of encryption in order to further protect the resident health data (Krames StayWell Blog, 2009).
Effective data protection needs effective security measures. The HIPAA security rule sets floor for data security standards. However, the HIPAA security and privacy rule have not improved the public confidence that their personal information will be kept confidential. With the recent spate of the stolen laptops that contain patient health information, encryption has been done on other laptops and other removable media that contains such data (Meyers et al., 2008). Enhanced security measures will reduce risks associated with data theft and will reinforce the public’s trust and diminish the anxiety about potential risk of unintentional disclosure of the information. In addition, the department is considering applying new strategies such as pseudonymization strategy. This is a strategy used to replace the identities of the people’s information in the organizations database. The use of pseudo IDs ensures that the medical information cannot be linked directly to a person (Nass, Levit, & Gostin, 2009).
References
Krames StayWell Blog (2009). Improving the Informed Consent Process. Retrieved from http://info.kramesstaywell.com/Portals/36339/docs/Krames%20Informed%20Consent.pdf
Meyers, J., Frieden, T. R., Bherwani, K.M., and Henning, K.J . (2008). Ethics in Public Health Research: Privacy and Public Health at Risk: Public Health Confidentiality in the Digital Age.. Am J Public Health. 98(5): 793–801. doi: 10.2105/AJPH.2006.107706 PMCID: PMC2374810 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374810/
Nass, S.J., Levit, L.A., Gostin, L.O. (2009). Institute of Medicine (US) Committee on Health Research and the Privacy of Health Information: The HIPAA Privacy Rule: Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research. Washington (DC): National Academies Press (US); 2009. 4, HIPAA, the Privacy Rule, and Its Application to Health Research. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK9573/
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