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.

Reference

Hebda, T., & Czar, P. (2013). Handbook of informatics for nurses & health care professionals (5th ed.). Upper Saddle River, NJ:

Pearson.

4. PRIVACY AND CONFIDENTIALITY:

The issue of privacy and confidentiality is presented in a case study in Neurodiagnostic Journal (2012). This article reveals the

threat to patient privacy posed by social media and the need for improved laws to respond to the increased use of electronic health web

sites. According to this article the internet has become very popular as a means for healthcare professionals to gain information,

consult and transfer patient data but laws presently in place are inadequate to safeguard the privacy of patient information.

It is reported that "no online activities can be guaranteed absolute privacy" (p.40). The article uses The Four Principles

Approach by Beauchamp & Childress to discusses and reflect on the case study presented.

Polito, J. (2012). Ethical Considerations in Internet Use of Electronic Protected Health Information. Neurodiagnostic Journal, 52, 34-

41

http://0-search.ebscohost.com.aupac.lib.athabascau.ca/login.aspx?

direct=true&AuthType=url,ip,uid&db=rzh&AN=2011557929&site=ehost-live

5. EHR:

At my place of work physicians work in teams and rotate in and out every one or two weeks. Through the use of Alberta Netcare, the

electronic health record used at my facility, doctors are able to view up to date medical information on each patient assigned to their

patient load. ?The accessibility makes it easier for patients who visit multiple providers to supply each one with an up-to-date

record? (Sewell & Thede, 2013, p. 232). Test results, lab results, and previous medical history are available at the click of a

mouse to review patient information, and helps provide the most timely and efficient health care to the patients. Unfortunately ethical

issues are created through this program. For example at my facility many different multidisciplinary teams have access to Alberta

Netcare. I have been witness to health professionals browsing Alberta Netcare to answer their own personal questions about previous

patients that are no longer under our care. Which is a complete breach of privacy of the patient?s electronic health record. Although

Alberta Netcare has taken many steps to create a secure and confidential system, abuse by staff members with those privileges needs to

be evaluated and addressed.

References

http://www.albertanetcare.ca/InfoForAlbertans.htm

Sewell, J. & Thede, L. (2013). Informatics and nursing: Opportunities and challenges (4th ed.). Philadelphia: Lippincott Williams

& Wilkins.

READ THE POSTINGS ABOVE AND THINK ABOUT HOW YOU CAN ADD TO THE DISCUSSION. RESPOND TO ONE OF THE ABOVE POSTING AND SHARE EXAMPLES FROM

YOUR PRACTICE SETTING. YOUR POSTING SHOULD BE SUBSTANTIVE( THAT IS, ADD TO THE DISCUSSION, NOT MERELY AGREE WITH WHAT SOMEONE ELSE HAS

SAID) AND SHOULD REFLECT A SOUND UNDERSTANDING.

LIMIT YOUR CONTRIBUTION TO THE POSTING TO ONE OR TWO IDEAS, CONCEPTS OR THEMES SO THAT OTHERS CAN FOLLOW YOUR CONVERSATION MORE EASILY

(MAX 150 WORDS)YOU ARE WRITING TO SHARE YOUR THOUGHTS AND INVITE YOUR CLASSMATEDS INTO AN OPEN DIALOGUE. LENGTHY POSTINGS WITH MANY

POINTS OFTEN GO UNREAD OR UNCHALLENGED BECAUSE THERE IS TOO MUCH INFORMATION TO RESPOND TO.