One of the key ethical issues with the use of electronic health records (EHRs) is ensuring the data is secure and safe.
As many other posters have pointed out, a main point of concern in facilities using EHRs is that users frequently forget to log-out of their user accounts in a timely fashion. The consequence is other users having access to the EHR, viewing data and changing information, all while using another?s authorization. This has been a common problem in both the acute care units where I have worked that used EHRs. Being able to track users? activity and ensuring only authorized users can view and edit the data of the EHR is one of the cornerstones of security.
Biometric technologies are a promising technological solution for securing access to EHRs as a mechanism for unique verification of an individual identity. Scanning a fingerprint, for example, to access an EHR is quicker and more secure than standard password-based authentication schemes. Accordingly, EHR programs can be made to automatically log a user out faster as users will not have to type a username and password to reenter the EHR, but merely press a thumb to the reader and be automatically logged back in. Biometrics not only offer speedier access to EHRs they are inherently more secure: after all passwords and usernames can be shared.
Some of the main reasons why an Electronic Health Record (EHR) can be beneficial include; improvement to quality and safety of record transmission, sharing of information between facilities and specialty services, and to improve privacy and security of that shared information (Hebda & Czar, 2013).
I recently started working in an institution where EHR is used for documentation of most care I provide, with the exception of some paper charting. An issue that has come up repeatedly, is that the system does not automatically log you out. Since we are a fast paced unit, we are logging into several client records throughout the day, as they are admitted prior to surgery and then re-admitted post surgery. There are times when a nurse will forget to log off and move on to the next client, with the ability to login again without being “kicked out” of the other client’s record. The risk is for another nurse to start documenting under another nurse’s username. This becomes an ethical issue, as the security and privacy of the client’s record has been breached since care has not actually been provided to them by this particular nurse. Errors in documentation then occur and this becomes part of the client’s record.
Since starting work on this unit, I have suggested the possibility of having the system automatically log a nurse out after they have been inactive on it for a specified amount of time. Here’s hoping!
3. AN ETHICAL ISSUE RELATING TO EHR
In relation to the earlier posting on privacy and confidentiality, here is my perspective about this issue.
Preservation of the client?s privacy is a required expectation by every health- care provider (Hebda & Czar, 2013). Additionally,, the protection of patient’s health information not only enhances the success of EHR but also ensures that an established trust occurs between patients and their health providers
Despite the adoption of user?s computer password or code in order to access patient records,challenges facing patient EHR in relation to privacy and confidentiality issues persist. It becomes an ethical issue when these essential aspects of EHR are either consciously or unconsciously violated by the health providers. For instance, it has become a serious concern at my workplace because of continous failure of some staff to log off after the completion of patient care,, thus leaving patient health information exposed to other staff or patients relatives who may have a dangerous ulterior motive. Recently, an incident occurred when patient?s relative was caught copying patient?s medication profile, lab results etc. from the hospital computer to his personal notebook for a planned lawsuit. I
believe that, the importance of the privacy and confidentiality in relation to EHR should be reinforced among all health workers to overcome security lapses.
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