There are four major ethical issues that arise when soring electronic information are Privacy and confidentiality, security breaches, system implementation, and data inaccuracies. Health care institutions, insurance companies and others require access to the data if emergency rooms are to function as designed. The key to conserving confidentiality is to only allow authorized individuals to have access to information. This begins with authorizing users, and the user’s access being based on pre-established role-based privileges. The administrator identifies the user and determines the level of information to be shared and assigns usernames and passwords. The user should know that they will be responsible for the use and misuse of the information they have access to. Having 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 threaten patient privacy when confidential information is made available to others without the person’s permission. To protect data integrity security measures such as firewalls, antivirus software, and intrusion detection software must be included, as well as specific policies and procedures serve to maintain patient privacy and confidentiality. For example, employees must not share their credentials with anyone, always log off when leaving a terminal and use their own credentials to access digital records.

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

The interface between the user and the computer system are critical to the overall success of the implementation process. Interface issues are the greatest system risk because these failures can be missed initially. Lack of complete consideration of users and tasks often results in a poor user interface. Poorly designed user interfaces account for undesirable consequences leading to decreased time efficiency, poor quality of care and increased threat to patient safety. Improperly designed user interfaces fail to deliver the much-needed quality of care, which lead to user dissatisfaction. The faulty user interface issues increase over a period that leads to abandonment of the electronic health record. Maintenance and testing of these interfaces on a routine basis are essential in controlling this risk. Practice disruption can negatively impact the quality of care or endanger patient safety along with financial loss. Integrity assures that the data is accurate and has not been altered. Emergency rooms serve to improve the user’s safety by reducing errors and 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