pros and cons of confidentiality in healthcare pros and cons of confidentiality in healthcare

Pediatrics 2017;140:e20172858. Many Definitions of Patient Confidentiality, When You Cannot Expect Medical Information to Remain Confidential. Sexual misconduct. It is unclear how this issue affects confidentiality, and, many states have been hesitant to extend such a duty to health professionals. Don't use plagiarized sources. Shared decision making between patient, parent or guardian, and health care provider, when possible, is the goal in order to optimize the adolescents medical care 13. Identify and protect against reasonably anticipated threats to the security or integrity of the information. Any concern for a HIPAA violation should be addressed by individual health care systems. Available at: Promoting healthy relationships in adolescents. References Confidentiality extends beyond reproductive health for minors. Web2 Pros and Cons of Managed Care in America Introduction I. The Importance of Supplemental Disability Insurance. In the former situation, liability may be imposed for failing to disclose. J Adolesc Health 2016;58:3747. Ensuring privacy will also guarantee proper communication the patient and the physician; this is quite important as it will ensure provision of quality of care, improved autonomy, prevention of economic harm, discrimination and also an embarrassment. These unique issues include: The diversity of stakeholders. Many associations of health professionals caring for minors, including the American College of Obstetricians and Gynecologists, the Society for Adolescent Health and Medicine, the American Academy of Pediatrics, the American Academy of Family Physicians, and the North American Society for Pediatric and Adolescent Gynecology, recognize the importance of confidentiality in providing health care for adolescents 7 8 9. With respect to children under 18, however, these protections are generally thought to be appropriate, particularly in cases when a physician may suspect a child's injury he or she has been called upon to treat may be the result of child abuse. Conclusion ACOG Committee Opinion No. When going for the socialized medicine, an individual is required to give his or her personal health records. It is helpful to conduct staff sensitivity training on the following topics: Comfort with issues regarding adolescent sexuality, Knowledge about confidentiality issues, including state and local laws, How to provide relevant information to parents or guardians and patients about private conversation time with the adolescent patient and obstetriciangynecologist, How to identify appropriate contact information for the adolescent patient (eg, personal cell phone) and parents or guardians for future follow-up, How to set up a code word to ensure the identity and security of the adolescent patient, Comfort with lesbian, gay, bisexual, transgender, or questioning (LGBTQ) issues and pronoun (she, he, they) usage. The rapid development of technology geared toward healthcare services has led to the creation of the term telehealth, which essentially means virtual care. Cons: Physicians have less autonomy and less continuity with patients. The bottom line is that not all information, even medical information, is automatically granted legal protection from disclosure: only information that is particularly sensitive is protected (and even sensitive information may be disclosed under certain circumstances). In the event that an individuals personal health information is disclosed for example to the insurer, family members, or family members; this may lead to stigma, discrimination, and also embarrassment. Adolescents often have questions or concerns that they may feel embarrassed to talk about in front of their parents or guardians. HMOs often only cover Obstetriciangynecologists and other health care providers should be active in educating their staff and patients regarding the confidentiality of services. This can actually slow their recovery. An example of how to address this request: the health care provider can review the record to ensure there is no violation of confidentiality (eg, information on sexual activity, STI screening, or gender identity) and then contact the patient directly to make sure that the patient approves of the information contained before its release. Recommendations for electronic health record use for delivery of adolescent health care. One of the biggest problems in confidentiality protections is the lack of clarity about when patient confidentiality can be breached. If notes automatically submit to EHRs, issues regarding sexuality, gender identity, substance use, mental health, and STIs may be included. Ability to share health information with family members and other relevant clinicians. Any concerns the patient has regarding the presence of a chaperone should be elicited and addressed if feasible. The first three categories are circumstances in which physicians obligations to maintain health (usually of the public, or sometimes of a particular individual) outweigh the need to maintain patient confidentiality. Consequentialist theory suggests that without assurances of confidentiality, patients are less likely to disclose important medical information to their doctors. There are times when a parental or guardian proxy to the adolescents patient portal may be appropriate, such as when an adolescent lacks the capacity for decision making, including those adolescents with severe intellectual or development disabilities. Breaching an individuals confidentiality and privacy do not only affect an individuals dignity, and might as well cause harm (Gostin, Levit & Nass, 2009). Advantages of Medical Technology in Healthcare: 1. ACOG Committee Opinion No. These are the kinds of questions that are important to consider, and difficult to answer using legal theories of confidentiality. However, there are some circumstances when it is necessary for the obstetriciangynecologist to share private information with a parent or guardian or others. 803. People take this matter There if an individuals privacy is not protected or guaranteed, people find it hard to give complete and candid information about their health even to their own personal physicians leave alone to the insurer. With appropriate safeguards, EHRs may offer more security than traditional paper-record systems. American College of Obstetricians and Gynecologists. There are many ways to define confidentiality, and how we conceptualize it affects how it functions in our everyday lives. Being aware of alternate health care referral centers for free or substantially decreased costs may be of benefit for the adolescent if there is a risk of billing disclosure. It has increased paper work for health care professionals (Livestrong, 2015). Confidentiality, Privacy, and Unreliable Technology Keeping your personal information private is a major concern in psychotherapy, but online treatment adds a layer Abstract. Leaving out details when you post information or images does not protect client confidentiality. Cloudy confidentiality: clinical and legal implications of cloud computing in health care. A wide assortment of hardware and software. J Adolesc Health 2007;40:21826. Optimally, obstetriciangynecologists should ensure that medical record information, including EHR information, for care provided under minor consent or mature minor provisions is considered confidential and should not be disclosed to parents or guardians without adolescent consent. As your adolescents doctor and as the parent (or guardian), we have two roles here. While ACOG makes every effort to present accurate and reliable information, this publication is provided as is without any warranty of accuracy, reliability, or otherwise, either express or implied. Top of Page In some states, physicians may experience serious disciplinary action for revealing a minors confidential sexual information. Again, it is a matter of weighing the pros and cons between keeping and breaching confidentiality. The immediate occasion is 2009, which is shown through the copyright year or the year of Ererere. Parents are often too quick to give medications to lower a fever and make a child more comfortable. WebThe Cons Confidentiality and the institution of HIPAA hasnt been all positive. 409 12th Street SW, Washington, DC 20024-2188, Privacy Statement Ensuring the confidentiality and security of patients data is primordial to the 758, Promoting Healthy Relationships in Adolescents, for potential talking points when discussing confidentiality with parents, guardians, and patients 10. Genetic information is likely to be regarded as extremely useful to family members for predicting their own health care needs (possibly even more so than other types of medical information), and thus there may be a strong argument in favor of disclosure after a patient has died. Society for Adolescent Health and Medicine. Not socialized medicinean Israeli view of health care reform. An overview of consent to reproductive health services by young people . Because research allows better treatments to be developed and in this way serves the general public, it seems reasonable that disclosure should be permissible under certain circumstances, provided that individuals have the option of remaining anonymous. Because It Works, Nature Documentaries Could Help Save the Planet, Use of this site is your Agreement to the Terms. WebConfidentiality. Identify the patients preferred route of contact. She had been admitted with HIV-related complications from pneumonia. Although laws vary by state, all minors have a right to some confidential health care. Implementation toolkit. WebCharge capture refers to tracking each charge to a patient for medical services given. Given the health concerns, at least one court has held that a physician may have a duty to disclose genetic information about a patient to immediate family members. Reduction in Medical Errors: 5. Although this can be viewed as a good thing because patients do have the right to see their own health data, it also opens doors for security concerns. Finally, the clinician has weighed up the pros and cons, the rights and the consequences, and has determined that on balance, confidentiality should be breached to parents and/or other authorities. Obstetriciangynecologists and other health care providers who care for minors should be aware of federal and state laws that affect confidentiality. Marcell AV, Burstein GR. Unlike electronic medical records stored on cloud servers, paper medical records need physical space for storage purposes. WebHere are some Pros and Cons of personal health records: Pros: Correction of medical errors within the medical record was possible Patients had a broader knowledge base of their health concerns and decreased utilization of healthcare services Opportunities were provided for increased effective communication between patients and physicians In addition, some states have statutes that require reporting of abuse of hospital patients or long-term care patients, elder abuse, spousal abuse, and domestic abuse. In fact, quite a lot of personal information is not protected at all. Additionally, they should be informed of any restrictions to the confidential nature of the relationship. Obstetriciangynecologists should not misinterpret consent required to provide health care services with consent required to provide education and counseling; that is, even when consent is required by a parent or guardian for provision of contraception, an obstetriciangynecologist may still provide counseling about contraceptive options. Any updates to this document can be found on acog.org or by calling the ACOG Resource Center.While ACOG makes every effort to present accurate and reliable information, this publication is provided as is without any warranty of accuracy, reliability, or otherwise, either express or implied. For example, it is much easier to obtain a persons credit history (even legally) than it is to gain access to his/her medical history, even though both may be considered highly personal and private information. The American College of Obstetricians and Gynecologists encourages obstetriciangynecologists and other health care providers to ensure that their existing EHR systems protect the confidentiality of minor patients, including any OpenNotes features. Obstetriciangynecologists and other health care providers who care for minors should be aware of federal and state laws that affect confidentiality. Read terms, Number 803 (Replaces Committee Opinion Number 599, May 2014). My patient was a petite woman in her mid-forties with long dark hair. In as much as it is the right of the patient to keep his or her health information private, it is prudential for the person to consider that this would interfere with his or her health (Ventola, 2014). WebHealth Care Providers: Any provider of medical or other health services, or supplies, who transmits any health information in electronic form in connection with a transaction for which standard requirements have been adopted. Modern healthcare organizations have turned to electronic medical records (EMRs) in an Journal of the American Academy of Psychiatry and the Law Online, 39(4), 571-578. Additionally, it is costly for vendors to develop and maintain the levels of mandated confidentiality because the laws regarding confidentiality vary by state 4. If, after counseling, the patient refuses the chaperone, this decision should be respected and documented in the medical record 11. All rights reserved. Leawood, KS: AAFP; 2018. By concealing the information about health, the patient may under cover through the socialized health cover. Missouri specifically requires physicians to report drug dependent minors to the health department, and New Jersey expands the requirement to all drug dependent patients. Over time, however, regulations have been developed to protect the privacy and security of certain health information. State laws typically either address the type of information (usually based on disease or illness) or the entity holding the information (such as government agencies), or both. This section outlines the mandatory reporting situations (those that require disclosure to specific authorities) as well as the permissive exceptions (those that allow a physician to use his or her own discretion in deciding whether to disclose a patients information). Online Therapy: Security, Ethics, and Legal Issues. Bright futures: guidelines for health supervision of infants, children, and adolescents . The American College of Obstetricians and Gynecologists offers the following recommendations and conclusions: Confidential care for adolescents is important because it encourages access to care and increases discussions about sensitive topics and behaviors that may substantially affect their health and well-being. Mature minor: An adolescent younger than the age of majority who, even if living at home as a dependent, demonstrates the cognitive maturity to give informed consent. On the other hand, the social health insurance is defined as those systems whereby which people transfer their financial risk of medical bills to a risk pool. The ACOG policies can be found on acog.org. Ensure compliance by their workforce. Patient portals are mechanisms within the EHR system that provide patients with electronic access to their personal health record. As adolescents navigate this important developmental period, obstetriciangynecologists should engage with them and promote best practices that protect adolescents vulnerability and assist them in developing autonomy. (Health care providers should be cognizant of potential coercion by parent or guardian to maintain access.). This document has been updated to include information on patient portals, guidance on the release of medical records, examples of ways to safeguard adolescent patients confidentiality, and talking points to use with parents and guardians. Since its much easier and faster to access patient details and history through an electronic health record, its also much easier to immediately place imaging and laboratory work orders. WebSafeguarding data confidentiality is not always easy as technological advances also provide means of easily accessing information from remote locations and making it Miscommunication during handovers can lead to unnecessary Farnan, J. M., Sulmasy, L. S., Worster, B. K., Chaudhry, H. J., Rhyne, J. Washington, DC: NIHCM; 2011. Emancipation: A legal procedure whereby minors become legally responsible for themselves, and their parents or guardians are no longer responsible (financially or otherwise). All states and the District of Columbia allow minors to consent to sexually transmitted infection (STI) testing and treatment without parental permission 14. Therefore during this era of socialized medicine; the providers should ensure that they put in place measures that would guarantee the privacy, security, rights, and confidentiality of the patients. The Pros of Using AI. All Rights Reserved. Beyond the HIPAA privacy rule: enhancing privacy, improving health through research. What Is Supplemental Disability Insurance? The bill consists of 11 sections and was Any updates to this document can be found on acog.org or by calling the ACOG Resource Center. Any potential conflicts have been considered and managed in accordance with ACOGs Conflict of Interest Disclosure Policy. Universal healthcare can increase overall life expectancy. What is managed Care One form of medical coverage is the managed-care plan. My first patient living with HIV came to me when I was a new nurse in a Chicago hospital. Although there are multiple benefits of EHRs, these benefits may conflict with the protection of confidentiality. Another problem, however is what to do regarding the patient who has discovered a breach of confidentiality. It is not intended to substitute for the independent professional judgment of the treating clinician. Disclosing this information would prolong his or her life, but it might also prolong suffering. During this era of increased socialized medicine, it has come with its pros and cons on the confidentiality, rights, safety, and the security of patients. Allow parental or guardian access to the EHR to expire at the age state law requires confidentiality. Hospital rounds and kids' confidentiality, Why Do Politicians Weaponize Medicare? The U.S. Supreme Court has stated that "disclosures of private medical information to doctors, to hospital personnel, to insurance companies, and to public health agencies are often an essential part of modern medical practice." As a result, officials have tried to develop privacy protections that apply to different settings and circumstances. Obstetriciangynecologists should make clear to the patient what limitations, if any, exist in the EHR system. Society for Adolescent Health and Medicine, American Academy of Pediatrics. The bill consists of 11 sections and was created as a reaction to high numbers of fraud and business misbehavior in major US corporations. ABSTRACT: Confidential care for adolescents is important because it encourages access to care and increases discussions about sensitive topics and behaviors that may substantially affect their health and well-being. We may have to disclose private information to protect a patients safety. The problem is that personal information (which is whats at stake with medical confidentiality) is not protected at law in the same way ones home or bodily integrity is protected. Although most While gaining the adolescents trust, we still encourage them to discuss issues with their parents or guardians. Ethical theories provide many different ways to view confidentiality laws. Having a physician or other health care provider advocate may be helpful to explore system limitations and to provide support for an adolescent-friendly EHR system, if possible.