Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice NUR 514

Sample Answer for Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice NUR 514 Included After Question

The Health Insurance Portability and Accountability Act (HIPAA) is a critical federal law and regulation passed in 1996 with the aim of protecting patient information used through health technology platforms like the electronic health records (EHRs). The HIPAA privacy regulations mandate health care providers and organizations as well as their associated third parties to develop and follow certain provisions aimed at enhancing the security, integrity, confidentiality and privacy of the information, especially under its privacy rule on protected health information (PHI) (McGonigle & Mastrian, 2021). One ethical issue that can arise based on HIPAA rules is the disclosure of PHI on social media. While nurses have the freedom to use social media to share experiences and even trends on nursing practice, they cannot share and disclose patient information on these platforms, even if they constitute part of the experience. The disclosure of such information can lead to legal suits because of violation of the privacy rule. Further, the disclosure leads to reduced levels of trust and compromises the integrity of such data. Therefore, such violations and breaches have a direct impact on advanced registered nursing practice.

The possible consequences include reduced levels of trust in nurses by patient, reputational damage to the registered nurse and their organization, including a possible termination of their employment contract. Nurses become liable to legal suits as the patients may sue them for compensation because of disclosing private and personal information (Bergren & Maughan, 2020). Nurses may also have their licenses revoked and even barred from practicing forever.

The protection of patient data improves and adheres to the privacy and confidentiality requirements. Therefore, having policies on usage of social media and adherence to HIPAA provisions are critical measures that can enhance privacy and confidentiality (Keshta & Odeh, 2021). These measures will ensure that nurses do not violate the privacy rule and use social media in the best way to protect the nursing practice and profession.

References

Bergren, M. D., & Maughan, E. D. (2020). Data and information literacy: A fundamental nursing

competency. NASN School Nurse, 35(3), 140-142. DOI: 10.1177/1942602X20913249.

Keshta, I., & Odeh, A. (2021). Security and privacy of electronic health records: Concerns and

challenges. Egyptian Informatics Journal, 22(2), 177-183. https://doi.org/10.1016/j.eij.2020.07.003

Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice NUR 514

McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge.

Jones & Bartlett Publishers.

Topic 7 DQ 2

Review HIPAA, protected health information (PHI), and requirements for privacy and confidentiality in EHRs. Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice. Consider the emerging role of the telehealth and the EHR in patient care delivery and compromise of patient data using telehealth applications and measures you can implement in your own practice to protect patient privacy and confidentiality.

A Sample Answer For the Assignment: Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice NUR 514

Title: Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice NUR 514

REPLY TO DISCUSSION

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Privacy Officer & Citations

You have been promoted to the privacy officer in your organization. Choose one of the following and provide a detailed response with citations of how you would address it.

Tracking each point of access of the patient’s database, including who entered the data.
Encouraging employees to report privacy and security breaches.
The health care professionals are using smartphones, iPads, and other mobile devices.
You observe one of the health care professionals using his smartphone to take pictures of a patient. He sees you and says, in front of the patient, “I am not capturing her face!” How do you respond to this situation?

~ Dr. Hartje

REPL

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A key to protecting patient information and preventing security breaches is to encourage ways for employees to report privacy and security breaches. According to the AAPC, way to encourage staff to report by mitigating obstacles, open communication channels, motivational perks, and never penalizing reporting (Lindsay, 2015). Reporting violations should be an easily accessible work flow met with no resistance or penalty. Reporting tools should allow for detail and the ability to follow up with employees to ensure action was taken or an any informative details. Employees want do what is best and follow-up information offers an opportunity to validate that the employee has done right by the institution (Lindsay, 2015). When encouraging employees to report potential or actual breaches it is crucial that employees are not penalized. An open channel to report allows for employees to feel safe and openly report without hesitation. Lastly, providing motivation when employees self-report encourages employees to continue to mitigate risk of security breaches. Examples of motivation can be in the form of recognition from leadership, PTO, monetary, and prizes (Lindsay, 2015).

Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice NUR 514

At my organization, our information security team provides easy links for reporting that are ad-ins in the EHR and in our email. Periodically, the department sends out test for employees to “catch”. When employees catch the test email they instantly receive a congratulations email for catching a security breach. This simple tool has made a positive game out of catching and reporting breaches. Employees are encouraged to report because of the frequent testing with positive outcomes.

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Reference

Lindsay, E. (2015, July 1). Encourage Employees to Report Compliance Violations. AAPC Knowledge Center.

https://www.aapc.com/blog/31343-encourage-employees-to-report-compliance-

violations/#:~:text=Offer%20employees%20direct%20communication%20to%20the%20compliance%20department

Marie Cherise

Jan 11, 2023, 11:38 PM

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Use of EHRs

Ethical Issue

One ethical issue related to EHRs is the potential invasion of privacy due to unauthorized access or misuse of PHI. This can lead to embarrassment or humiliation for patients and potential legal action if their rights are violated due to negligence by healthcare providers and staff members managing EHRs (McBride et al., 2018). Therefore, it is essential for healthcare providers using EHRs should ensure that appropriate measures are implemented. For instance, restricting physical access when not in use; providing secure internet connections; maintaining strict authentication procedures such as two-factor authentication protocols; training employees on how to properly use and handle personal data when using an EHR system; regularly monitoring activity logs; encrypting sensitive patient personal data whenever possible; establishing a system log review process; requiring all external entities who receive patient data from practices with whom they interface abide by HIPAA regulations which must be documented; and regularly testing the security of EHR systems.

Legal Issue

The legal issue related to EHRs is their potential for violating patient privacy rights. If a healthcare provider does not adequately protect PHI, it can result in litigation or even criminal charges under HIPAA. Therefore, healthcare providers must take special care to ensure that all policies and procedures are followed when using an EHR system (McBride et al., 2018). This includes ensuring that data is encrypted if stored electronically; creating meaningful use audit logs to track access to PHI; limiting access to only those employees who need it; implementing authentication protocols such as two-factor authentication; providing secure means of transferring data outside the organization through approved channels; training personnel on proper usage of the system and confidentiality requirements; and keeping patients informed of the measures taken to protect their privacy.

Emerging Role of the Telehealth and the EHR in Patient Care Delivery

The emergence of telehealth and EHRs have revolutionized patient care delivery by providing convenient access to quality services from anywhere at any time. Despite the advantages, this also presents a potential risk of compromising patient data if proper protocols are not followed. To minimize this risk, healthcare providers must implement security measures such as encrypting all PHI stored electronically; requiring two-factor authentication for accessing the system remotely; restricting access to only those employees who need it; training personnel on proper usage of the system and confidentiality requirements; and keeping patients informed of these measures. Additionally, practices should ensure that they comply with applicable HIPAA regulations related to telemedicine when using such applications (Badowski et al., 2018). By implementing these measures, healthcare providers can ensure that telehealth and EHRs remain secure and efficient platforms for providing quality care.

References

Badowski, M. E., Walker, S., Bacchus, S., Bartlett, S., Chan, J., Cochran, K. A., Coon, S., Liedtke, M., Phillips, B. G., & White, T. (2018). Providing Comprehensive Medication Management in Telehealth. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 38(2), e7–e16. https://doi.org/10.1002/phar.2071

McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and addressing ethical issues with use of electronic health records. Online Journal of Issues in Nursing, 23. https://doi.org/10.3912/OJIN.Vol23No01Man05

Sahida Usman

Jan 9, 2023, 11:13 PM

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Some of the HIPAA guidelines related to EHRs are ensuring the access to health information is monitored and secured and only authorized users may be able to access it, a system of monitoring and tracking unauthorized use should be in place, as well as a system to communicate the health information should be secured and monitored for breaches. Some practical applications of these guidelines include the use of unique passwords and periodic changing of passwords, remote monitoring and the ability to delete information remotely if there is a breach (lost mobile device, or work laptop), automatic log-off if the system has been idle for a certain period, use of HIPAA-compliant information exchange portals (secured or encrypted emails, secure messaging or apps), use of privacy screens for computer monitors and ensure that devices are kept in secure locations that may allow some privacy (HIPAA Journal, 2023).

The nurses’ primary commitment is to their patients. Effective communication is vital to this relationship. EHR may have a negative effect on this relationship, potentially reshaping the nurse-patient interaction, and diverting the nurse away from the patient. Nurses are at the forefront to ensure that EHR is patient-centered and contributes to safe and ethical practice. The current impact of EHR in quality and outcome is significant, however, the ethical issues around organizational priorities versus patient-centered practice is presented as one of the more significant issues related to EHR (McBride et al., 2018).

Another area where ethical legal issues arise while using EHR relates to consent, privacy and confidentiality. The use and exchange of patients’ data and information may present legal issues. Hence, providers must abide by the fundamental principles of consent, disclosure, and willingness of patients (Afzal & Arshad, 2021).

References:

HIPAA Journal (2023). HIPAA guidelines on telemedicine. https://www.hipaajournal.com/hipaa-guidelines-on-telemedicine/

McBride, S., Tietze, M., Robichaux, C., Stokes, L., Weber, E. (2018). Identifying and addressing ethical issues with use of electronic health records. The Online Journal of Issues in Nursing 23 (1). https://doi.org/10.3912/OJIN.Vol23No01Man05

Afzal, S. & Arshad, A. (2021). Ethical issues among healthcare workers using electronic records: A systematic review. Computer Methods and Programs in Biomedicine Update 1. https://doi.org/10.1016/j.cmpbup.2021.100030

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