Computer Applications in Health Care and Legal and Ethical IssuesThrough the advancement of science and technology, the use of computers in processing information becomes the trend in the world. Computer has paved the way to a man’s new style of living.
Most of the business transactions now are supported by computers. Distance is not a hindrance now in carrying out business transactions because aside from cellular phones, communications at present are conducted through electronic mail; learning as well as entertainment is also carried out with the aid of computers. Through the use of computers, it only takes “one click” to learn anything under the sun. Computers indeed make all things possible.Health care is the avoidance, cure, and management of sickness and the maintenance of intellectual and bodily welfare through the services rendered by the medical and “allied” health professions. According to President Bush, the majority industries in America have utilized information technology to formulate their businesses to become more cost effective, more competent and more dynamic. He had observed, however, that healthcare still do not implement the said technology.
According to him it is embarrassing to know that a lot of medicines that can support life have been discovered yet most of the doctors are still using their paper and ball pen to keep medical records. In line with this, the White House suggested to the federal government to allot a budget for the applications of computers in bookkeeping of health records (Press, 2007).The application of information technology in healthcare is believed to alleviate its safety and quality. This project is currently implemented in the United States, however, problems like misinterpretation of patients’ medical record that leads to death had arise (Press, 2007). According to Dr. David Brailer, whom President Bush had appointed as coordinator of the project, there should be a “centralized” format to be followed and “shared” by medical doctors to solve this problem. The American Health Research Quality Council has developed a program that could lessen errors in prescribing medicine. The program was called computerized physician order entry (CPOE).
This computer-based system ensures proper dosage and medication, avoids repetition of test and develops subsequent, conditional and upshot orders (Prottis, 2007). Another problem encountered in computer application in healthcare is the supplying of wrong information by the patient due to failure to understand correctly the terminologies used by the computer system. To be able to solve this problem, Susan W. Mc Roy introduced a project which she called as the Patient Education and Activation System (PEAS) which intends the participation of concerned individual in decision-making regarding healthcare. She called her system as the Layman Education and Activation Form (LEAF). This on line system provides the patient with only applicable questions to be answered for the doctors to obtain medical history. This system allows users to brows any resources on line for them to be familiar with some medical terminologies. As patients fill up the provided form in the computer, they could acquire hints about questions they could ask their doctor for them to establish a good relationship (Susan W.
McRoy, 1998). The computerization of medical records aims to lower the cost and improve healthcare quality. The use of computers in healthcare is envisioned to spread out resources and to facilitate proficient trade of information to alleviate patient care (Herdman, 2007).
The trade of information, however, poses a negative effect in health care. The biggest issue in automated healthcare is confidentiality and privacy. Usage of automated healthcare involves filling up a form regarding personal information. This includes family background, DNA testing, moral and psychological state and other information that are too confidential. These pieces of information are kept in the medical record of the patient. This record is very important because any information contained is a strong basis for the person’s privilege to enjoy his right to education, employment and insurance. Any wrong information on this record could prohibit one to acquire personal and financial requirements in life (Herdman, 2007; Ruth Clifford, 1999). The quality of healthcare to be given to patient is also dependent in the personal information.
The more accurate is the personal information, of course, results to more accurate diagnosis and prescription. The biggest dilemma occurred in this aspect because the patient needs to choose between privacy and high quality health care. If he wants privacy, he may opt not to tell other information required in the personal information sheet. He may provide vague or wrong information to secure privacy. When this happens, the medical doctor assigned to evaluate his case will have a wrong diagnosis of his illness. On the other hand, if he chooses high quality health care, he is obliged to provide all the necessary information to cure his illness.
He has no choice other than accepting the fact that other people will know all his “secrets” in life. He has to take the risk of using his data for him not to enjoy the benefits to be employed or to be enrolled in a school that he wants to join just in case an insider against him exploits his personal information. One should know that “The Ethical Principles of Psychologists and Code of Conduct” permits psychologists to disclose information even in the absence of permission from the patient but be reminded that “The Principles for the Provision of Mental Health and Substance Abuse Treatment Services: A Bill ofRights”,on the other hand, which was adopted IN 1996 by most of the national mental health professional associations, states that “any person shall not be obligated to release private, confidential or other information other than: diagnosis, prognosis, type of treatment, time and length of treatment, and cost” (Ruth Clifford, 1999). According to J. Michael Fitzmaurice, “upgrading the quality of care through the application of computer-based health care must not circumvent the necessity to conserve individual rights to privacy.
One must advocate strong protection of confidentiality. The rights of patients, providers and other concerns are being considered to avoid negligent exposure or changes in medical records”. The Agency for Health Care Policy and Research (AHCPR) suggested firm boundaries on connection and severe punishment for exploitation (Fitzmaurice, 1996). Another issue is regarding the contract made by the person to manage care systems.
The manage care systems normally do not permit termination of contract because the patient’s records according to them should always be accessible for examination. This is against the “interdisciplinary bill of rights” which states that, “Any revelation to another social gathering will be time limited”. Ambiguity in waivers signed any the client is another issue because according to international disciplinary bill of rights clients must be informed to any revelation that will be done by the manage care company and to whom and why such information are being released.
The wavers signed by the client, however, do not comply with the above-mentioned policy. According to Constitution: Article 1, Section 1 of the California law, privacy is one of the absolute right of everyone and so one must do his best to protect it and one should not also reveal information to others (Ruth Clifford, 1999). If one subscribed to healthcare, he must be knowledgeable enough of his rights as a client. These rights include: right to request restrictions. As patient one could ask for restrictions to disclosure of personal information and he can also request for him to limit the information that he wants to give. It is also the right of the patient to receive confidential communications. One may opt to tell the agency to communicate with you secretly. One also has the right to know his health status and may also asked for the records of the bill.
One should also be aware of the information being input in the medical records and make sure that all the written information are correct. One could ask the agency to update his record or change any wrong information in your profile. This implied that one must monitor his record regularly and should not just leave everything in the hands of the agency.
Always be reminded that any wrong information and disclosure could prohibit one to enjoy life’s necessities. One has also the right to monitor his bills. Any member of the family can be provided with “authorization” to be able to obtain such information. A copy of a notice is usually provided to the patient. One could exercise his right to secure a separate copy of that notice which could serve as his guide in protecting his “image” and avoid disclosure.The issue of confidentiality enters in the exchange and sharing of information from one facility to another.
In this process, the profile of the patient can be viewed by other people, thus, the personal information of the patient became unprotected. The precautionary measure applied to solve this problem is the use of username and password. Organizational education, customs, and penal measures are also implemented to protect confidentiality of personal information. In spite of the implementation of policies, privacy of the patient’s information is not yet assured because of the possible exploitation of confidentiality by trusted insiders. To be able to solve this problem a law that protects confidentiality of medical records, punishes disclosure of information and monitors the development of the technology should be implemented (Herdman, 2007). The patient has the responsibility to secure his privacy.
Legislative acts are of great help to protect patients subscribing to computerized health care but people must be informed that as concerned individuals one should become cautious to the status of his medical records. One must become vigilant, too. There are some careless mange care companies that committed errors in transferring information like unintentional switching of charts and letter of authorization sent to wrong persons using mail and fax. Another problem encountered by manage care system is the clarity of the word “confidentiality”. The limits and scope of confidentiality is vague and are not well-explained. Certain information released by the patient was told to be “confidential” but the system itself does not know or rather do not have a control by the time the information are being transferred from one facility to another. Issues regarding the length of time a certain record could be stored and when it will be eliminated by the company remains questionable. Another issue is with regards to the susceptibility of medical records to unknown outsiders.
The use of computer in this manner poses a negative point of view because through this technology leakage of information is very possible. International leaks have been documented. The interdisciplinary Bill of Rights stated that, “Information technology will be applied only for diffusion, storage, or data administration only with procedures that eliminate individual identifying information and guarantee the safeguard of the individual’s confidentiality Information should not be transferred, sold , or otherwise utilized (Ruth Clifford, 1999).
“The need to succeed in upgrading the public health through computer-based systems requires taking into account customers before improving and assessing fresh and accessible tools. To be able to attain these, significant efforts must be exerted to alleviate the knowledge of consumers in computer-based systems and endorse more dynamic, competent, and reasonable involvement of individuals in the research process.Fitzmaurice, J.
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htm.Herdman, R. C. (2007). Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest. Retrieved march 21, 2007, from http://www.
netreach.net/~wmanning/otadig.htmPress, T. A. (2007). Bush pushes computerized medical records.
Retrieved March 21, 2007, from http://www.msnbc.msn.com/id/6876192/#storyContinuedProttis, P. D. J. (2007). The Use of Computers in Health Care Can Reduce Errors, Improve Patient Safety, and Enhance the Quality of Service – There Is Evidence [Electronic Version].
Retrieved March 23 from http://www.connectingforhealth.nhs.uk/worldview/protti2/.Ruth Clifford, P. D. (1999, April 3, 1999).
CONFIDENTIALITY OF RECORDS AND MANAGED CARE: LEGAL AND ETHICAL ISSUES. Retrieved March 20, from http://www.ccemhc.org/confid.htmlSusan W. McRoy, P.
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Interactive Computerized Health Care Education Retrieved March 22, 2007, from http://tigger.cs.uwm.edu/~mcroy/research-projects/LEAF98/leaf98.html