Electronic Health Records: Availability and Portability Vs. Privacy

Electronic Health Records: Availability and Portability Vs. Privacy

by Ricky Ocampo RN

Today's technological advances are out-pacing what we're able to expect or comprehend, and there are several aspects of today’s life and society that benefit greatly from this factor. However, there are several thinkers who stand against some of the consequences—or benefits (subject to perception)—that such technological advances provide. The Internet, for instance, is the pedestal for most of today's technology, and judging by how dependent the world has become  on its provisions, it's very likely that businesses, companies, and the world's industrial sector in general will be the one that has to bend and adapt, and not the other way around. The spread of information is one of such vital benefits the Internet provides, but such spread of information is sometimes at the costs of both private and government secrets and information, thus not all thinkers are on-board with this aspect of online information storage. Inevitably, the heavy shift from conventional file storage to online or “cloud” storage is a step also being taken by many medical institutions, but this step also comes with the risks of leaked or stolen information that could compromise the privacy of patients. In contrast of such risks and consequences, adapting such method of information storage can make patient identification, diagnostics, and information transfer considerably more efficient that the conventional method will ever be able to, thus it becomes very difficult to ignore these advantageous factors. This doesn't stop several thinkers from arguing the controversy, providing several standpoints and perceptions within their own premises. Generally, as already established, the risks and potential hazards/consequences aren't strong enough premises to not adapt the method and miss out on several advantages.

The Case for Availability and Portability

            Availability and portability would appear as mere, unimportant factors until one considers the fact that physical newspapers are practically dragging to a slow death, and being replaced by mobile devices and Internet-provided news and information (Greenslade, 2014). Generally, people arguing for the use of electronic health records (EHR) will find that they have an easier time finding premises to support their claims than those who argue against them. In Electronic Medical Records System it's expressed that “the availability of electronic data permits instant, sophisticated analysis of patient data. Moreover, the EMR system enables enhanced analysis of patient data by providing access to reference databases for diagnosis, procedures and medication” (Evans, 1999). Furthermore, Arthur and medical researcher, Linda Thede, expressed in Informatics: Electronic Health Records: A Boon or Privacy Nightmare that “there have been cases where paper medical records, especially parts of them, have disappeared” (Thede, 2010), a scenario nearly impossible and very abnormal to find in EHRs.

The Case for Privacy

            Researcher and author Lauren Bair Jacques, in Electronic Health Records and Respect for Patient Privacy: A Prescription for Compatibility expressed that “EHRs and patient privacy are compatible and may peacefully coexist” (Jacques, 2010), and he provides several premises to back his claim. For one, he mentions that presidential administrations such as President Clinton or President George W. Bush endorsed the idea of EHRs because the resource appear to fall in line with their overall goal which is to improve and strengthen the American healthcare system (goal). He also mentions that the establishment of government agencies and government-regulated acts such as the Health Insurance Portability and Accountability Act (HIPAA), which was instated as means for “improving portability and continuity of health insurance coverage in the group and individual markets; combating waste, fraud, and abuse in health insurance and health care delivery; promoting the use of medical savings accounts; improving access to long-term care services and coverage; and simplifying the administration of health insurance” (place). But HIPAA also contains several aspects that protect patients' information both from doctors and other institutions. According to the US Health and Human Services (HHS), the HIPAA Privacy Rule “establishes national standards to protect individuals' medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically” (Jacques, 2010). Generally, one can easily conclude that several safety precautions have been taken to protect patients' information and ensure fairness, thus the arguments based solely on the factor of privacy don't have very solid grounds to stand on.

The Writer's Opinion

            Contrary to the premises and concerns of thinkers arguing against the use of EMRs, the benefits of using EMRs appear nearly endless. For one, supporting a method that heavily involves the use of papers and other resources that are very costly to the environment and overall health of nature and life is a somewhat ironic argument for any health or medical expert to make.   The conventional information storage system involves typically frustrating goose chases of information about patients—information that aren't usually available in hand, meaning that a doctor would have to call the previous doctors or medical facilities of his/her patients to request for specific information. Authors Marcia Stanhope and Jeannette Lancaster, in Public Health Nursing Population-Centered Health Care in the Community, mention that “an innovative use of the electronic health record to meet the needs of the public health workforce is the ability to embed reminders or guidelines within the EHR” (Stanhope & Lancaster, 2013); such a resource would make tracking down vital details and information much easier. Privacy generally appears to be the only concern of most, but with government regulations and insurance measures, it can hardly be said to be a solid factor.

Conclusion

            In conclusion, as Linda Thede provides, “although Americans are concerned about the privacy of medical records, survey data shows that despite this concern, the majority of Americans are aware of the benefits of electronic records and believe that they outweigh privacy concerns” (Stanhope & Lancaster, 2013); one would really have to search for solid premises as to why EHRs aren't a resourceful approach, and one would really have to nitpick at unsubstantial details to gather any attention. Inevitably, such search will drag to a frustrating end as one is forced to acknowledge that EHRs are only going to become more integrated into healthcare as the world continues to advance technologically.

References

Greenslade, R. (2014, July 11). Latest ABCs show newspaper market decline running at 8% a      year. Retrieved October 22, 2015, from         http://www.theguardian.com/media/greenslade/2014/jul/11/abcs-national-newspapers

Evans, J. A. (1999). U.S. Patent No. 5,924,074. Washington, DC: U.S. Patent and Trademark       Office.

Thede, L. (2010). Informatics: Electronic Health Records: A Boon or Privacy Nightmare? OJIN: The Online Journal of Issues in Nursing, 15(2).

Jacques, L. B. (2010). Electronic health records and respect for patient privacy: A prescription      for compatibility. Vand. J. Ent. & Tech. L., 13, 441.

Stanhope, M., & Lancaster, J. (2013). Public Health Nursing-Revised Reprint: Population-            Centered Health Care in the Community. Elsevier Health Sciences.

IMPORTANCE OF PATIENT’S INPUT DURING CRITICAL CARE

IMPORTANCE OF PATIENT’S INPUT DURING CRITICAL CARE
by Ricky Ocampo RN

            The work of nurses is to act as caregivers for patients. Their job involves the application of skills and knowledge that has been acquired from school and experience. However over the years there has been various researches conducted that expect the nurses to seek patient participation as they deal with them. This situation is quite difficult since the patients do not possess the training or experience needed in conducting a nursing job (Dankwa-Mullan, 2015). Through Evidenced Based Approach (EBP), I have researched widely on the topic where I sought to find out if patient’s input can improve the quality of health care.  I have formulated a research question and utilized the PICOT method in carrying out the study.

            The research question that I have chosen for this analysis is: does the patient’s input in clinical remedies quicken healing in critical care? This research question has been widely influenced by my job as a critical care nurse at the Kaiser Permanente’s Northern California division. During my profession, I have worked with many patients with many different needs that warranted different approaches. The different methods can be aided by the patient’s participation since the patients are the ones that feel the illness or pain. Some of the patients might have gone through similar treatments and may possess crucial information about their experience that may be helpful in the present scenario.

With the use of the PICOT format of evidenced based research, I have analyzed the question in this topic. PICOT stands for Population/Patient, Intervention, Comparison, Outcome, and the Timeframe (Boswell, 2012). On the Population/Patient, I used a middle-aged man of Asian origin who is in critical care after undergoing a successful craniotomy surgery. As a critical care nurse, I am responsible for taking care of the patient during his recovery period. This gives me the opportunity to engage the patient through asking for and listening to his views regarding the care he receives. I can also observe firsthand on the importance of incorporating the patient’s opinion in the recovery process.

            In this case, the intervention includes integrating clinical solutions coupled with the man’s input about care and what he prefers. After a proper relationship has been established with the patient, he can share his personal goals in regards to his recovery such as the time he expects to get back to his normal work routine. With his personal goals in mind, I offer the patient advice and suggestion on the clinical solutions. The patient offers feedback, which is used in providing clinical solutions. The clinical solutions include administration of painkillers to the patient. With the patient’s input, the painkillers administered will be regulated by the patient’s pain level at the given time. This will ensure that the patient gets enough painkillers when he needs which will reduce his pain levels. Patient input can also be important while observing his body’s reaction to some medicine. The patient can express freely how the medication makes him feel which will subsequently lead to the prescription of more comfortable medication (Dankwa-Mullan, 2015).

            In this case, the comparison is between a case where the patient's input is not taken into consideration and when the patient’s views are listened and used in his care. The alternative is that the nurse does not take the patient’s opinion and instead caters for the patient with his experience and knowledge alone. The lack of consideration of the ill person’s patient view makes the patient feel dehumanized. The patient may also feel abandoned since nobody is interested in his well-being. The patient who was not involved in the decision-making feels ignored and let down. The patient can also feel that the nurse is trying to incorrectly exert authority by ignoring the patient (Dankwa-Mullan, 2015). All these feelings will make the patient doubt the care that is given to him, which can in turn derail his ability to heal. On the other hand, proper communication with the patient will make the patient feel acknowledged and make him more informed. This will make the patient have a positive attitude and be more willing to follow advice and suggestions from the nursing personnel (Pender et al. 2014).  

            The outcome, in this case, is a full recovery to the patient that had undergone craniotomy surgery. The recovery process should be satisfactory to me where I will ensure that it is going the way it should based on my nursing knowledge and experience. The recuperation process should also be suitable for the patient where he will have met his personal goals, and he would have felt respected throughout the whole period. This outcome is to be achieved through proper communication with the patient where the patient is briefed on every important thing about his recovery. The abundance of information from the nurse and the patient makes the job easier for both of them. Various researchers have found that patients that had a good communication with nurses had a more positive outcome to their treatment than those who had a poor exchange (Peile & Fulford, 2015). The ones that experienced poor communication felt that if the nurses had listened to their opinions, then the recuperation  would have been faster and with less pain or devoid of complications.

            The timeframe that is intended to be used to achieve the outcome is six months. It begins with the first interaction with the patient where I establish a rapport, and I brief the patient on everything that he needs to know regarding his treatment. The timeframe ends when the patient is fully recovered and is satisfied with the care given to him during the recovery process.  The time frame is important since it will quantify the results that are obtained. Achieving full recovery at the minimum possible time is imperative to the concerned patient (Peile & Fulford, 2015). The satisfactory level of persons is very high when they recover quickly since they get to move on with their daily routines. This includes work that will enable the patient to earn a living as opposed to when he is bedridden. The patient can also participate in leisure activities that require much physical energy such as sports. The patient will also be free from the many side effects experienced while using medicine such as nausea.

            Nurses are trained caregivers, and they get much experience while dealing with patients. It is, however, important that the nurse involves the patients in everything that they do as they take care of them. This topic is important to me due to my occupation as a critical care nurse at Kaiser Permanente. With the help of the PICOT method, an analysis of this topic is made easy. The population, in this case, is a middle-aged man of Asian origin who is in critical care after a successful craniotomy surgery. The intervention shows the incorporation of clinical solutions coupled with the input from the man concerning his preferences. The comparison shows the alternative where care was given with no regards to the man’s input. The outcome shows the expectations of a quick recovery from incorporating patient’s opinion. The timeframe is the time that is expected to be used to achieve the desired outcome. In this case, it is six months.

  

References

Boswell, C. (2012). Introduction to Nursing Research: Incorporating Evidence-Based        Practice (3rd ed.). Burlington: Jones & Bartlett Learning.

Dankwa-Mullan, I. (2015). Precision Medicine and Health Disparities: Advancing the       Science of Individualizing Patient Care.American Journal of Public Health, 105S368. Doi:10.2105/AJPH.2015.302755

Peile, E., & Fulford, B. M. (2015, July). Values-based practice: Translating values and       evidence into good clinical care. International Journal of Therapy & Rehabilitation.       pp. 306-307.

Pender, N., Mardaugh, C., & Parsons, M. (2014). Health Promotion in Nursing Practice    (Pender) (7th ed.). Upper Saddle River, N.J.: Prentice Hall.