1 Navpreet Kaur IT 104-002 10/16/16 Electronic Health Records Honor Code: "By placing this statement on my webpage, I certify that I have read and understand the GMU Honor Code on http://oai.gmu.edu/the-mason-honor-code-2/ and as stated, I as student member of the George Mason University community pledge not to cheat, plagiarize, steal, or lie in matters related to academic work. In addition, I have received permission from the copyright holder for any copyrighted material that is displayed on my site. This includes quoting extensive amounts of text, any material copied directly from a web page and graphics/pictures that are copyrighted. This project or subject material has not been used in another class by me or any other student. Finally, I certify that this site is not for commercial purposes, which is a violation of the George Mason Responsible Use of Computing (RUC) Policy posted on http://copyright.gmu.edu/?page_id=301 web site." http://oai.gmu.edu/the-mason-honor-code-2/ http://copyright.gmu.edu/?page_id=301
Electronic Health Records, 2 Introduction Electronic Health Records (EHRs) are the digital version of health records which includes a patient s reports, tests, medications, surgeries, treatment plans, medical history, which is all under one folder. EHRs are rapidly becoming the standard part of physicians and hospitals organization. The organizations are using electronic ways to organize patient charts and history. This will improve public health by keeping patient medical history up to date to potentially better understand patient health. EHRs will provide better communication and office efficiency and allow hospitals and other medical organizations to exchange/send patient information electronically if there is any transitioning from one place to another or if they need to see specialist. According to Ardito (2014), Health Information Technology for Economic and Clinical Health (HITECH) Act was signed in 2013, in which the US federal government paid $30 billion dollars to all the hospitals and physicians to change the paper records to electronic records. EHR has pros and cons. Electronic data is better than paper records because only authorized members can have access to them but on the other hand, it can be easily duplicated and accessed by unauthorized people. If the computer crashes and records are not shared in the cloud then physicians can lose all the data and there are no ways to back up. Current Use and Benefits EHRs will be standard among all hospitals and physicians. According to Douglas et al EHR adoption rates increased from 15% to 60% in 2012 which means that hospitals and physicians are in favor of this technology (Mack, Zhang, Douglas, & Sow, 2016). EHR will help reduce medical errors and result in positive health outcomes. Studies have shown that patients have given the portable devices which will help them to track their prescription, health standards, vaccinations and test results along with preventive measures. It will also help physicians to
Electronic Health Records, 3 diagnose the problem earlier as statistics/charts of patients will provide clinical assessment. Sharing data as anonymous with other physicians will help to facilitate new treatments and cures at faster rate and can lead to various clinical studies and trials. The rate of medication errors will decline and no one has to struggle with doctors illegible handwriting. In case, any doctor will prescribe wrong combination of medication then a pop up window will alert the doctor (Ardito, 2014). EHR also provide productivity and balance. If patient has hectic schedule and cannot go to doctor, then he/she can just email the doctor and ask him if he can prescribe the medications. It also improved the efficiencies and lower the health care cost as it decreases the paperwork, improved safety, and reduced duplication of testing (HealthIT.gov, 2014) Security breaches As the security breaches are increased since past years, there is a great threat to EHRs. Studies have shown that one quarter of the states health organizations reported at least one case of a breach in the previous two years. EHRs have security threats in physical and electronic ways. Health records can be stolen by internal or external intruders. Current employees or former employees can steal the health records by transferring to flash drive, emails etc. External intruders hack the system by using different passwords or some of them can threaten employees in many ways by kidnapping their family members or by direct gunpoint (Myers, Bherwani, & Henning, 2008). In 2013, large incidents of stealing or selling health records were seen and both were at the Howard Medicine University in Washington DC. First case was reported when the technician was accused of breaking HIPPA. She gained the access to patient s name, medical number and addresses to sell them. Another case was at the same hospital where the contractor downloaded patient s information on his personal laptop and stolen by someone from his car. The data was
Electronic Health Records, 4 unencrypted, therefore, whoever correctly guessed the password had access to the records. Laws that prohibit physicians from accessing patient information on their personal computers are necessary. Encrypted data should be used by all the hospitals and physicians as another security barrier. Due to increasing security breaches public health records should collaborate with government in order to develop laws and punishments for those who try to break laws (Myers, Bherwani, & Henning, 2008). In a survey conducted by Aggarwal et al, the researchers determined that about 73% of physicians texted each other about their work. If they were to share any confidential report, it could be easily stolen or damaged by anyone (Fouzia F. Ozair, 2015). Therefore, a secure mobile phone should only be used to discuss any confidential statements. Ethical and Social Implications Privacy measures are difficult to implement as EHRs have been shared with the third parties. Hospitals and physicians need EHRs to save health records for future references but in several cases they are giving patient s information to pharmaceutical companies and other brokers for their own benefit. Studies have shown that if genetic or medical information have been shared with data brokers or pharmaceutical companies, then not only do third parties know about patients current health condition but they can also assume their future health problems (Spinello, 1997). Careless use of electronic health records is an infringement of patients privacy. If the privacy of a patient s health condition is given to their neighbor or their relatives, their relationship could be affected. If someone has HIV+ but he/she is not willing to tell anyone it is his/her privacy; by revealing any information, we are disrupting their privacy, which can have bad social implications and it is against ethics.
Electronic Health Records, 5 Security increases Health care organizations should implement rules and regulations with strong enforcement. There should be a technology or system which will alert patients as to whom is looking at their EHRs. Patients should have access to see when and where the last person had access to their account. Only authorized persons should have the access to patient s health history and all the records should be password protected. Studies have shown that portable EHR are the safest by using passwords, encryption and cloud storage. Firewalls, antivirus software, and intrusion detection software must be installed in the hospital and physician s computer in order to protect privacy. Other than that, a security officer should be always with technician or IT department whenever there is need to change or install any equipment. Authorized workers should never share their IDs or password with another worker and always log off when their task is done. All the activities such as modification in EHR or time of data entries in audit trails can help an organization can keep track of everything (Fouzia F. Ozair, 2015). Future Use EHRs allow physicians and health departments to access critical health data, which can help physicians diagnose a patient s condition before their arrival. If EHR will be regulated worldwide then hospitals, medical centers and researchers can collaborate with each other to better understand medical conditions, such as thru clinical studies. According to Ardito (2014), security issues are not insurmountable, they can be easily resolved and will not inhibit adoption by physicians and hospitals. Conclusion EHRs are the true wave of the future for health. They will allow physicians and hospitals to easily access important patient data that is critical to resolving health issues. Patients will be
Electronic Health Records, 6 able to better understand their own health and physicians will be able to diagnose health issues in an easier way. However, privacy is a major issue in EHRs. Given the dynamic nature of healthcare, security must be strong as many individuals may need access to EHRs. Higher security can help prevent breaches and other intrusions of data. EHRs have the ability to change the entire health care system by increasing efficiency, allowing collaboration, and helping diagnose and treat individuals.
Electronic Health Records, 7 References Ardito, S. C. (2014). Electronic Health Records. Online Searcher, 38-44. The study talks about Electronic Health Records and Electronic Medical records and determined that they are the same side of the coin. It also determined the benefits of electronic health records. Paper mainly focuses on the advantages of HER and the ways they can be beneficial in future. It determined that how it can reduce the mistakes which could make by doctors. Fouzia F. Ozair, N. J. (2015). Ethical issues in electronic health records: A general overview. Perspective in Clinical Research, 73-76. Electronic Health records improves the quality of health. The paper discusses the safety and disadvantages of the electronic health records. The paper determined the security and private breaches with electronic health records. On the other hand, it also shows the ways to improve the security breaches. Portable EHR options with encrypted passwords can protect from security breaches. HealthIT.gov. (2014, September 4). Retrieved from HealthIT.gov: https://www.healthit.gov The website describes the benefits of electronic health records. It determined that HER can improve patients health care and will be more efficient in terms of decreasing the paper load and prescribing medicines. Other than this, the website also talks about the how the medical errors can be reduced and convenience of health care. Mack, D. M., Zhang, S. M., Douglas, M. J., & Sow, C. M. (2016). Disparities in Primary Care EHR Adoption Rates. Journal of Health Care for the Poor and Underserved, 327-338.
Electronic Health Records, 8 This study was conducted in order to check the use of Electronic health records by hospitals and physicians. They also determined the different kind of insurances that patients were using and how they effect overall. The results of the study determined that the small practices are not using EHR as the same of big practices and hospitals. Myers, J. M., Bherwani, K. M., & Henning, K. J. (2008). Privacy and Public Health at Risk: Public Health Confidentiality in the Digital Age. American Journal of Public Health, 793-801. This paper focused on the threats or security breaches. The paper describes that there are many threats to electronic health records by intruders and extruders. Myers et al describes that intruders can tell the information to unauthorized person. Extruders can get the information through hacking or threating staff members. Therefore, strict actions and security steps should be taken to protect the privacy of patients. Spinello, R. A. (1997, Jan 4-11). The end of Privacy. America. New York, United States: American Press. The paper describes the meaning of privacy and showed that privacy has big place in person's life. Electronic Health Records are playing with patients privacy by giving their information to the third party members. Anyone can share their private information and can know about their future diseases. The paper described how can patients privacy are hurt by hospitals and physicians through brokers and insurance companies