1. Describe four ethical issues that arise when storing electronic information about individuals.

PRIVACY AND CONFIDENTIALITY:

Health care institutions, insurance companies and others will require access to the data if ERs are to function as designed. The key to preserving confidentiality is to allow only authorized individuals to have access to information. This begins with authorizing users. The user’s access is based on pre-established role-based privileges. The administrator identifies the user, determines the level of information to be shared and assigns usernames and passwords. The user should be aware that they will be accountable for the use and misuse of the information they view. They have access to the information they need to carry out their responsibilities. Hence assigning user privileges is a major aspect of medical record security.

SECURITY BREACHES

Security breaches threaten patient privacy when confidential information is made available to others without the individual’s consent or authorization.

Security measures such as firewalls, antivirus software, and intrusion detection software must be included to protect data integrity. Specific policies and procedures serve to maintain patient privacy and confidentiality. For example, employees must not share their ID with anyone, always log off when leaving a terminal and use their own ID to access patient digital records. A security officer must be designated by the organization to work with a team of health IT experts.

SYSTEM IMPLEMENTATION

Health care organizations encounter major challenges in the course of EHR implementation these challenges result in wasted resources, frustrated providers, loss of confidence by patients and patient safety issues. The development, implementation, and maintenance of EHRs requires adequate funds and the involvement of many individuals, including clinicians, information technologists, educators, and consultants.

When any two systems are integrated, an interface is created. By the user interface, we mean an interface between the user and the computer system. These interfaces are critical to the overall success of the implementation process. Interface issues are the greatest system risk because these failures can be invisible initially. Lack of systemic consideration of users and tasks often results in poor user interface. Poorly designed user interface account for unintended adverse consequence leading to decreased time efficiency, poor quality of care and increased threat to patient safety. Improperly designed user interface fail to deliver the much needed quality of care, which lead to user dissatisfaction. The faulty user interface issue, which was small earlier on, increases over a period of time that leads to abandonment of EHR. Maintenance and testing of these interfaces on a routine basis is essential in controlling this major risk. Practice disruption during EHR implementation can negatively impact the quality of care or endanger patient safety along with financial loss.

DATA INACCURACIES

Integrity assures that the data is accurate and has not been changed. ERs serve as a way to improve the user’s safety by reducing errors, reduce disparities.

Loss or destruction of data occurs during data transfer; this raises concerns about the accuracy of the data base as user care decisions are based on them. A growing problem is of identity theft. This results in the input of inaccurate information into the record of the victim.