Thesis on "Utilizing Electronic Medical Health Records Increase Patient Safety"

Thesis 18 pages (5456 words) Sources: 10 Style: MLA

[EXCERPT] . . . .

Electronic Medical/Health Records

Utilizing Electronic Medical Records Increase Patient Safety?

A large majority of the American public expresses deep anxiety about their private health information, and over half of them are concerned that data they provide to insurance companies might be seen by an employer and used against them to reduce job opportunities. This is an upsurge from 1999, when only one-third of the public expressed concern. More precisely, in light of the fact consumers already have agreed to share such information, their concerns are about confidentiality, or the ability to control access to information (Ball, Smith and Bakalar).

In addition, the American public wants to have its own electronic medical/health records. In late 2005, almost two-thirds of Americans said they preferred the establishment of a secure online Electronic Health Record service for their own use. They believed this could improve safety and offer convenience.

Two-thirds of those responding indicated they would use it to check for errors in their health/medical records, and about the same number said they would use the records to check and fill prescriptions. Another 58% said they would use these "Personal Health Records" (PHRs) to get results online, and over half would turn to PHRs to conduct private e-mail correspondence with their doctors (Ball, et al.).

PHR systems are more than just information files for patients; they combine data, knowledge, and software that help people become actively involved in their own care. When PHRs are combined with electronic health record (EHR) systems, they provide greater benefits than would separate systems for consumers (Tang, Ash and Bates).

PHRs are patient-centered records that engage individuals in organizing their own health and healthcare through a composite, all-inclusive view of their health data, including medical history, medications, immunizations, allergies and other personal health information (Kaiser Permanente).

Since the purpose of this paper is not to differentiate between the two types of files and define them, but rather to discuss their safety factor in regards to the patient, we will deal with them under these circumstances as if they are, for the most part, the same. We will use the term "EHR" to serve as all-inclusive, except in those instances that it is necessary to differentiate for reasons of clarity.

Problem Statement

December 23, 2008...This morning, the Los Angeles Times reported that more than 1,000 patients at Cedars-Sinai had their personal information stolen by a former employee in the hospital's billing department. This problem is not unique to Cedars-Sinai.

Similar problems have surfaced at one of the hospital's major competitors, UCLA Medical

Center, where at least 165 staff members have been disciplined for improperly accessing the files of more than 1,000 patients, including California First Lady Maria Shriver, actress Farah

Fawcett and singer Britney Spears (Szwarc).

When a patient's medical records are compromised, it can hurt more than their wallets, experts warn. Victims of this kind of fraud face a greater risk of injury if doctors make treatment decisions based on incorrect information contained in their records. Many employers also demand access to medical records when making hiring, promotion or benefits decisions, according to the nonprofit Patient Privacy Rights Foundation (Szwarc).

And, on the other hand we have the case of Hurricane Katrina which has been the loudest wake-up call so far for the need for electronic health records (EHRs), according to some prominent policy figures. Floods from the storm erased the medical records of about one million people in the central Gulf Coast because they were written on paper and stored in boxes in hospitals and physicians' offices (Byers).

Feeling insecure about your health data security? If so, it is no wonder, considering the frequent security breach headlines and the eHealth Vulnerability Reporting Program's declaration in September that many electronic health record (EHR) systems are at risk for security threats. How worried should providers be, and what should they do to bolster security against would-be hackers (Take extra precautions...)?

"Hackers look for vulnerabilities in it infrastructure," says Norm Martel, president of Medical Technology Research Corp. In East Kingston, NH. "Whether you're a hospital or a high-tech company, the infrastructure is what ties everything together. All of your computers, all of your software, all of your equipment -- and for a hospital that might include x-ray equipment -- is connected to the organization's it infrastructure, which means you need to be concerned about it from a security point-of-view," he says (Take extra precautions...).

"Good security is a fine balancing act between accessibility and privacy. You have to decide how secure you want to be vs. how complex you want to be. You need to think about the ability to access and use your systems," Martel says (Take extra precautions).

Is online security for patient electronic health records adequate to protect the data and individual privacy? And how does online safety compare to physical security for paper files?

Literature Review

There has been much written about the efficiency advantages of systems that electronically provide an individual's health/medical information. There has also been a lot of statements provided regarding the disadvantages of such a system in terms of security and safety of patient records.

There is not an abundance of verifiable, empirical data available testifying to the fact that electronically-delivered health data is safe and secure either while it is being stored or utilized and transferred between physicians and medical facilities.

The Wall Street Journal / Harris Interactive poll quoted in this paper, (Beckey, 2007) also gives some inclination of how Americans feel about the security of their personal health records online. A majority believes electronic data is less likely to keep their personal information private.

Most of the research concentrates on the benefits of the processes of an electronic system and how efficient they are -- (Byers, 2008), (Denmark, 2008), (Tang, 2005). but, it is evident that these sources don't want to discuss the safety issue. They tend to treat it as a given -- which, of course, it is not. I believe that is the one big gap in the research I found -- the lack of the safety discussion in those articles that speak positively of other aspects of electronic records.

This area is open for more study by those whose research reflects these positive benefits of such a system. If not, their conclusions seem unbalanced, and, therefore, rather specious. This is reinforced by the fact that, in this day of serious hacking online, almost nothing can possibly be guaranteed safe. To skip the argument, is to admit that it merits review.

It would seem also that the same argument could be held in reverse for those who claim, and rightfully so, that electronic records bear some vulnerability to discovery and exposure. The gap in their research is that there seems only one consideration==that of safety -- and other benefits are briefly addressed or ignored (Szwarc, 2008), (Hoholik, 2008).

Future research in this subject, particularly in light of President Obama's push for nationwide electronic medical records, should use more empirical data as opposed to opinion. In the past this has been impossible due to the lack of long-term studies of electronic health and medical records' systems, such as the North Bay Healthcare Group case study (Denmark, 2008). It must be noted that this particular study did not discuss the results of electronic record security, yet empirically reported the successful usage of the many capabilities of the system.

I believe the contribution that existing research makes to the field is to reveal the lack of balanced studies to include long-term surveys and empirical data which can prove the safety and security of electronic health and medical studies, one way or another.

Trends, Factors, and Influences in Medical Record Security

The Health Insurance Portability and Accountability Act (HIPAA) is an extension of this age-old concern, consisting largely of common-sense requirements to ensure the continuing confidentiality of patients' medical information in all of its forms. The regulations stemmed from growing concerns about the security of electronically stored and transmitted data. Since its inception, though, the rule has expanded to include not only electronic medical records, but also oral communications and paper medical records (Fiske).

For years, a debate has been waged over the safety and security of paper vs. electronic records in the medical community. On one side is the argument that paper records are easier to manage and control because access is necessarily limited. By their nature, paper records are impervious to computer hackers, and, unless they are manually converted to electronic form, there is far less potential for the errors that occur during the transcription process. Electronic records, others say, are more efficient because most billing, including Medicare and Medicaid, is done electronically. Electronic records are less likely to be misplaced or lost and allow for safety precautions, such as computerized monitoring of prescriptions to prevent allergic reactions or undesirable drug interactions (Fiske).

In the end, most believe that there is, and may always be, a place for both electronic and paper records in the medical industry. The… READ MORE

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