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Confidentiality in Allied Health Should corrections be and time stamped? In spite of the benefits provided by electronic health records (EHR), the potential for errors creeping in remain. These errors are likely to occur due to difficulties inherent in the system design, or from user error. Correcting these errors is essential to maintaining the quality of the data and the safety of the patient. The correct procedure for making such corrections involves several elements, consisting of retaining the ability to view the original; stamping of the date and time of when the correction has been made; disclosing the identity of the individual making the correction; and entering the reason for the correction.
Thus corrections of errors in EHR require the stamping of date and time. (1). 2. When should a patient be advised of the existence of computerized databases containing medical information about the patient? Respect of patient autonomy is integral to the ownership of EHR. This statement stems from the patient autonomy perspective that subscribes to patients being the real owners of the confidential information that is present in EHR. (2). Information regarding the existence of computerized databases in which the medical information of the patient will be stored has to be passed on to the patient.
This communication should occur prior to the release of the medical information to the entities maintaining the computer database. Included in this communication is the information on who will be in a position to access the EHR and the access levels that will be provided. This communication should occur prior to obtaining the informed consent for treatment. Through such a procedure it is possible to uphold ethic of patient autonomy in maintaining EHR. (3). 3. When should the patient be notified of the purging of archaic or inaccurate information?
Aging of the medical records of patients beyond utility value is quite likely to arise, along with the possibility of information on the medical record of the patient being no longer relevant or accurate. Purging such information then becomes necessary. There are defined guidelines on how this purging activity should take place. However, there is the recommendation that such procedures be established in the setting up of the databases. There is the requirement that the patient and physician be informed about the purging activity prior to its actual occurrence and also immediately after archaic or inaccurate information is purged. (3). 4.
When should the computerized medical database be online to the computer terminal? Access of patient medical information will require computers to have online access to the computerized medical database. This online linkage between the computerized medical database and the computer terminal used for this purpose is allowed only when authorized computer programs that require the patient medical information are in use. However, in keeping with confidentiality requirements, individuals or organizations outside of the clinical facility should not be given online access to a computerized medical database that is holding identifiable patient information in the medical records.
Furthermore, security measures that include encryption of the data and passwords that provide user identification are a must for monitoring and controlling access to computerized medical databases. In this manner security of patient information contained in the computerized medical database is the objective when providing online access to computerized medical databases to computers in a clinical facility. (3). 5. When the computer service bureau destroys or erases records, should the erasure be verified by the bureau to the physician?
The physician is the custodian of the medical information contained in an electronic health record of a patient. Any activity with regard to electronic patient records therefore is to occur with the knowledge of the physician. This means that when a computer service bureau decides to destroy or erase records it must inform the physician of the intent of erasure and ensure that a soft copy of the medical record is made available to the physician prior to erasure of a patient record. Once the erasure has occurred information confirming the erasure must be passed on to the physician.
In this manner the custodian of the medical record of a patient in the form of the physician is aware of the erasure, has a copy of the record for his and the patient’s future needs and has confirmatory information that there exists no other record other than the one possessed by the physician. (4). 6. Should individuals and organizations with access to the databases be identified to the patient? Patients have the right to control the dissemination of information contained in their medical records.
Information contained in their medical records cannot be provided to any individual or organization by the databases without the express permission of the patients. Seeking such permission calls for the identity of the individual or organizations that will have access to the databases holding the medical records to be revealed to the patients. Therefore the identity of individuals and organizations with access to the databases has to be indentified to the patients. (3). 7. Does the AMA ethics opinion mention encryption as a technique for security?
Maintaining confidentiality in patient medical records held in computerized medical databases forms a part of the AMA ethics in electronic health records. With limited online access permitted for the authorized use of patient medical records, there is scope for the breaching of confidentiality ethic of AMA. To ensure confidentiality of patient information being available for only authorized used AMA has suggested several security measures to be employed. Encryption is one such security technique suggested by AMA. (3). 8.
In regard to electronic medical records (EMRs), what is the policy for disclosing authorized data requested by third parties? Confidentiality of patient information is a binding principle in medicine. Along with that is the patient autonomy as a cornerstone of medical ethics. The confidentiality principle in medicine and patient autonomy in medical ethics are the controlling factors in the dissemination of medical information of patients. The policy for disclosing authorized data requested by third parties is governed by them.
Without patient consent no medical information of the patient can be provided to any individual or organization. Requests for authorized data from third parties can be given only if patient approval has been received for the giving the data and that too only for the purposes for which permission has been given by the patient. This sums up the policy on disclosing authorized data requested by third parties. (5). Works Cited 1. Samaritan Georgette. “Correcting Errors in Electronic Medical Records”.
23 April 2011. . 2. Mercuri, J. John. “The Ethics of Electronic Health Records”. 2010. New York University. 23 April 2011. . 3. “AMA Code of Medical Ethics”. 1998. American Medical Association. 23 April 2011. 4. Macios Annie. “Moving Mountains: The Proper Purge of Medical Records”. For the Record, 21.2. (20). 5. “HIPAA Physicians Guide”. 2011. 23 April 2011. .
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