Essay on "Security in Healthcare"

Essay 10 pages (3250 words) Sources: 10 Style: APA

[EXCERPT] . . . .

Also, while wireless systems (WiFi) are a wonderful technological tool, Glaser reminds readers that these systems provide yet another way for hackers to invade private medical files. Yet another concern Glaser mentions (41) is the fact that physicians are now communicating with other physicians through Internet-based systems and while "improved care" may result from these devices, they may also become "a means for inadvertent and inappropriate release of patient identifiable health information."

Virginia Sharpe writes in The Hastings Center Report that among the virtues of electronic records is the ready access to personal healthcare by doctors and other medical professionals during emergencies such as Hurricane Katrina. For example, the Veterans Health Administration (where she is an employee, or was at the time of her article) was able to back up all digital medical files for some 50,000 patients in New Orleans during the terrible floods that devastated the city in the aftermath of the hurricane.

By backing up those records, that allowed technical people to "re-enter them into a computer in Houston within four days of the storm" (Sharpe, 2005). Another event took place after the hurricane that shows the usefulness for this technology; the Office of the National Coordinator for Public Health Information Technology interacted with pharmacies to set up a central database. That database allowed for the digital filing of prescription drug records for 800,000 people that had been negatively affected by Hurricane Katrina. Hence, healthcare providers would have access to those prescription drug records, making it easy for a doctor in another part of the country (perhaps Houston) to learn instantly what any given patient's health history has been, and what medications are needed.

If those records had not been logged into digital databases, some information that is vital to the health of a patient might be, as Sharpe explains, "…buried in a paper chart" somewhere. That said, Sharp adds that "sufficient attention" must be paid to privacy and security when it comes to those records; if that attention is not sufficient, "the virtues quickly become vices" and a patient's life can be negatively affected. "Unprotected electronic records can be hacked by identity thieves," Sharpe continues; she notes that files have already been hacked into and personal private information has already been stolen.

In July of 2005, for example, 57,000 patient records that were kept on back-up tapes in a managed-care company in Phoenix, Arizona were stolen (Sharpe). While the author admits that the most recent legislation -- the Health Insurance Portability and Accountability Act and the Privacy Act -- does offer security and provides federal funds for local and state-related databases. Still, she goes on, a centralized database can be "misused"; and moreover, since patient records are available to "many users," any one along the line could breach the confidentiality of an unknowing patient. At the time this article was written, there were still decisions to be made regarding the converting of millions of medical files into digital database files; Sharpe insisted that in order to keep privacy rights "such as notification, opt-in/opt out, confidentiality, and personal access" save and secure, the government must work with professionals and private citizens to make sure things are done correctly.

Meanwhile the U.S. Department of Health & Human Services (HHS) has implemented a new regulation that is part of the Patient Safety and Quality Improvement Act of 2005 (PSQIA), according to an article released by the HHS. The PSQIA established a reporting system that is voluntary and will point towards enhancing all the data available regarding patient safety and quality of healthcare matters (HHS). There are some federal guidelines within this legislation that are important. To wit, there are federal confidentiality protections for patient safety information called "patient safety work product," which includes all the information that has been collected and created when there are patient safety events that have been held. A patient safety event occurs when information is being uploaded or downloaded to a database and within that window of time breaches could technically occur.

This patient safety confidentiality regulation means that during the time that providers (healthcare IT people or others involved in logging in data about patients) may report "and examine patient safety events" they can do so without fear of liability (HHS). The increased data that can be provided is important to the health of the patient, of course, and the government is showing through this legislation and through these guidelines that it is committed to the safe retrieval and protection of all personal health-related information.

When it comes to providing better access to individuals' healthcare and medical records, an article in the American Journal of Managed Care (AJMC) suggests that personal health records (PHRs) should be available not just to doctors and other medical professionals, but to the patients themselves. Consumers should be allowed to -- and should understand how to -- "access, manage, and share their health information" (Patel, et al., 2011, p. 104).

When personal healthcare records are "tethered" to a healthcare providers' own system of record-keeping, it can include data not just from that healthcare provider but from other health records that the patient has accumulated along the way through life. But not all electronic health records are complete, and not all databases offer thorough records, although it is expected as time goes on that there will be upgrading of all the systems to make records up-to-date, accurate, and available (Patel, 104).

Having electronic records available certainly is a help to doctors when the patient has chronic healthcare conditions. In New York State, a system is being launched called the Western New York Clinical Information Exchange (HEALTHeLINK) that allows providers "to access their patients' clinical information," Patel goes on. This system is only one of 17 that communities across the country are developing; with that in mind, the authors of this article launched a study to see what particulars that are associated with PHRs consumers have issues with or comments about.

The survey described PHR as "primarily used by you to view your health information and manage your healthcare… on the Internet" (Patel, 105). Respondents were asked about what kinds of information they would like to have included in their PHR, about the kinds of activities they might conduct relative to their healthcare histories and current status, and "with whom they would feel comfortable sharing their information" (Patel, 105). The respondents were also asked to "gauge" the potential good that they could derive out of this digital storage system. How did the survey work? There were 1,750 phone numbers called, and 252 people were willing to and considered eligible to participate; of those, 77% said they were "somewhat or very satisfied" with the healthcare services that had received over the last five years; 84% said they had access to the Internet (Patel, 108). Importantly, Patel goes on, 70% of participants said they would use a PHR "at lease every six months"; 52% agreed to use a PHR every 3 to 6 months; 37% wanted to use a PHR "at least monthly"; and 9% said they would use it weekly while 3% asserted they would use a PHR every day (109).

Conclusion and Future Direction

"…In most cases [databases with medical records] function independently and do not share their information… [which] raises the need for adoption of integration technologies for the sharing of data and knowledge…" (Khoumbati, et al., 2007).

How safe are the medical records being stored in databases today? How comfortable should patients feel given the current security realities relative to personal, private healthcare information? According to Matt Graham from the Maine Business School, many patients' healthcare records "…are now at greater risk of being compromised through unauthorized user access in its digitized form" (Graham, 2010, p. 402). Graham goes on to assert that over the past few years, "…hundreds of thousands of people have had their personal records and data compromised," a situation that, in conclusion, is entirely unacceptable to both the professionals in the healthcare industry, and also it is an unconscionable intrusion into the private records of individuals receiving healthcare.

Graham writes (402) that these compromised records were due to "…lapses in information security management and practices in almost every industry" in the United States, and that includes banking, finance, insurance companies, government agencies and of course, in the healthcare industry. Moreover, Graham insists that these threats are "not new"; indeed, the personal, private patient information data has been accessed "or disclosed" to thieves and hackers in numerous instances.

Given the promise of keeping healthcare records in electronic / digital form, and the benefits of this technological advance vis-a-vis patients and doctors, it is absolutely imperative that governments, states, healthcare providers, security professional, independent researchers and others find ways to make these data safe.… READ MORE

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