ROLE OF TELEHEALTH AND THE ASSOCIATED ETHICAL ISSUES PAPER
The world is now being propelled by information and communication technologies (ICT) based services and the field of health is no exception. The emerging technologies ranging from consumer, mobile and, telehealth have played a critical role in bridging the geographical distance between health officers and patients in rural and inaccessible areas in developing countries (Vesselkov et al., 2018). With all of these technological advancements, however, there has been a need to protect the privacy and security of certain health information to avoid any ethical or legal issues that may arise as a result of the leakage of such information.
Such issues can have a significant impact on a registered nurse’s practice. According to Layman (2020), these ethical and legal issues have led to the publishing of what is commonly known as the HIPAA (Health Insurance Portability and Accountability Act of 1996) Privacy Rule and the HIPAA security rule by the Department of Health and Human Services (HHS).
The main primary goal of telemedicine of expanding access to health care to millions of additional Americans is now possible with the advanced consumer, mobile, and telehealth technologies (Vesselkov et al., 2018). Using mobile and telehealth, it is now possible to provide medical expertise and health services to remote communities in primary care and emergencies. Sportspeople can now use telehealth to monitor their health and performance. Patients in remote areas can now easily consult medical experts about their health concerns through the use of teleconsultation (Bokolo, 2021). In the event of an emergency, direct patient care has been made possible through the exchange of information between people on the ground and medical experts via mobile, allowing for the diagnosis, treatment, and prevention of diseases and injuries (Bokolo, 2021).
The development of Electronic Health Records (EHR) is one of the emerging telemedicine technologies that allow the creation of a centralized database containing information about a patient that is managed and consulted by authorized clinicians and staff across multiple health care organizations (Layman, 2020). This has played a critical role in ensuring continuity of care even if the patient migrates to a different geographical location. The use of data exchange and vocabulary standards in EHRs has enabled data exchange among authorized clinicians to be interoperable. Data storage and retrieval technology in EHRs have facilitated easy and fast retrieval of health information. Through electronic document (ED) and content management (CM) workflow can be managed and many forms of documents accessed simultaneously (Layman, 2020).
EHRs are governed by certain ethics that protect the patient’s information from unauthorized access. One of these ethical concerns is privacy and confidentiality (Layman, 2020). This is defined as a person’s right to prevent his or her personal information from being shared with others without his/her consent. Patient information shared with clinical experts is considered confidential and should be kept private. As a result, only the law or the patient can authorize the release of this information to others. If the individual is incapacitated or not in the right frame of mind to decide to share his or her health information, the decision should be made through the patient’s legal representative or legal guardian.
When an individual’s health information is made available to others without the individual’s consent, a security breach occurs. This can have a significant impact on a registered nurse’s practice, especially if he or she is involved in the breach. Firstly, this undermines the nurse’s and patient’s pre-existing trust. As a result, the patient withholds information critical to his/her care, making it difficult for the nurse to perform their duties in caring for the patient. Otherwise, the patient could file charges against the involved nurse in court, which could result in serious punishment for the nurse and interfere with their ability to practice nursing.
One of the legal issues surrounding EHR is the breach, theft, and unauthorized access to protected health information (Balestra, 2017). This is one of the issues raised by the Department of Health and Human Services (HHS). Theft of medical records and security breaches allow unauthorized access to the patient’s health information. As a result, the level of trust established between a patient and a registered practicing nurse may be reduced. This has a significant impact on the free exchange of information between the patient and the nurse, making it even more difficult for the nurse to establish a correct nursing diagnosis. It also reduces the patient’s trust in the nurse’s diagnosis, treatment, and drug prescription, which can lengthen the patient’s recovery period and make the nurse’s job more difficult (Balestra, 2017).
To protect patients’ privacy and confidentiality, health care facilities should educate their staff and technicians about the importance of medical record confidentiality and have them sign a confidentiality declaration. One of the most common causes of health information security breaches is when employees unknowingly share confidential information with unauthorized individuals (Balestra, 2017). By making sure that the staff is well-versed in how to protect patient’s privacy and confidentiality, ignorant sharing of patient health information is avoided. Signing a confidentiality declaration holds health care staff accountable for any security breaches caused by their activities, making them cautious of breaching their patients’ privacy and confidentiality.
ROLE OF TELEHEALTH AND THE ASSOCIATED ETHICAL ISSUES PAPER REFERENCES
- Balestra, M. L. (2017). Electronic health records: Patient care and ethical and legal implications for nurse practitioners. The Journal for Nurse Practitioners: JNP, 13(2), 105–111. https://doi.org/10.1016/j.nurpra.2016.09.010
- Bokolo, A. J. (2021). Application of telemedicine and eHealth technology for clinical services in response to COVID‑19 pandemic. Health and Technology, 11(2), 1–8. https://doi.org/10.1007/s12553-020-00516-4
- Layman, E. J. (2020). Ethical issues and the electronic health record. The Health Care Manager, 39(4), 150–161. https://doi.org/10.1097/HCM.0000000000000302
- Vesselkov, A., Hämmäinen, H., & Töyli, J. (2018). Technology and value network evolution in telehealth. Technological Forecasting and Social Change, 134, 207–222. https://doi.org/10.1016/j.techfore.2018.06.011
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