Legal and Ethical Aspects of Health Information Management

Health care spending in the United States exceeds $2 trillion annually and on a per capita basis far exceeds any other industrialized nation.  As many studies have documented, this money is often spent frivolously and has contributed and linked to much of the inefficiency and waste in both the public and private health care sectors.  Despite the trillions of dollars spent and the ever increasing high cost of health care, the United States continues to lag far behind other developed countries in key measures such as infant mortality and life expectancy (Rothstein, 2007). 

The expansion and improvement of health information technology (HIT), such as the nationwide implementation of electronic health records (EHRs), has been proven to improve health outcomes and increase the effectiveness and efficiency of health care delivery.  “Supporters of EHRs assert that they avoid duplication of history taking and tests, promote coordination of care, reduce medical errors, ensure access to records from remote locations and in emergencies, permit better disease management, and facilitate electronic decision support” (Rothstein, 2007, p. 488).  Health care providers have been able to adopt and increase their use of HIT without compromising the quality of health care delivery.

The advent of HIT has dramatically changed the practice of health information management.  Along with this change, many new challenges dealing with the ethical and legal aspects of how patient health information is collected, processed, stored, and transferred have come to the forefront and must be addressed by health care professionals when handling patient health data.  Health care professionals are faced with core health information issues that include what information should be collected, how the information should be handled, who should have access to the information, and under what conditions the information should be disclosed (Cassidy, 2011).

The terms privacy and confidentiality are often used interchangeably; however, in health care these two terms are very different.  Privacy refers to the ability of a patient to prevent their personal health information from being disclosed to other individuals unless the patient otherwise granted permission through consent.  There are exceptions to this, for instance, if a person is thought to be in danger or potentially could endanger another person.  Confidentiality is the conditions under which the personal health information was obtained or disclosed within a confidential relationship with a health care provider and will not be re-disclosed without the written permission of the patient (Rothstein, 2007).

Ethical principles are integral to all patient consultations with confidentiality being the key issue (Edwards, 2009).  During and after a patient consultation the patient’s confidentiality should be protected.  The provider must ensure that consent is obtained to share information outside of the immediate health care team treating the patient.  This information should only be shared on a ‘need-to-know’ basis.  Measures should be taken to ensure that every patient’s medical information remains confidential.  For instance, text messaging is a new method that many providers are using to communicate with their patients and other providers.    It allows patients to have access to their information or have discussions with their provider about their health issues without having face-to-face contact (Edwards, 2009).  Health care organizations should ensure that there is an up-to-date organizational confidentiality policy in the patient’s file.  In addition, providers must make sure all messages are documented in the patient’s records and when done the messages should be deleted from the mobile device and/or computer that was used to transmit these messages. 

Finally, healthcare professionals often look to codes of ethics specific to their practice when seeking ethical guidance.  The code of ethics for a professional association incorporates values, principles, and professional standards (Flite & Harman, 2013).  “Professional values for health information management (HIM) include the importance of education and technical competency, patient safety, data validity and accuracy, truthfulness, compassion, and dedication to providing quality services in professional roles” (Flite & Harman, 2013, p. 2).  In other words, the main health information issues include what information should be collected, how the information should be handled, who should have access to the information, and under what conditions the information should be disclosed (Cassidy, 2011).

References

Cassidy, B.  (2011).  AHIMA's Code of Ethics. Journal of AHIMA, 82(3), 10.  Retrieved from             http://www.ahima.org/

Edwards, M. (2009). Patient confidentiality and data protection. Practice Nursing, 20(8), 411-413. Retrieved from http://www.practicenursing.com/

Flite, C. A., & Harman, L. B. (2013). Code of ethics: Principles for ethical leadership. Perspectives in Health Information Management, 1-11. Retrieved from www.ahima.org
Rothstein, M. A. (2007). Health Privacy in the Electronic Age. Journal Of Legal Medicine, 28(4), 487-501. doi:10.1080/01947640701732148