NUR 514 Topic 7 DQ 2 Review HIPAA, protected health information (PHI), and requirements for privacy and confidentiality in EHRs

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Topic 7 DQ 2

Nov 10-14, 2022

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.

REPLY TO DISCUSSION

Jamie Buchanan

Nov 14, 2022, 4:33 PM

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Class:

As telehealth technology advances toward seamless data access regardless of distance or health system, how can patient privacy rights and the confidentiality of personal medical data be protected?

Thank you for sharing!

Take care,

Dr. B

Jamie Buchanan

Nov 13, 2022, 8:44 AM

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Class:

Which types of resistance to new technologies might be evident among patients, caregivers, and nurses? Which evidence and strategies might help to diminish these resistances?

Thank you for sharing?

Take care,

Dr. B

Sara Wood

replied toJamie Buchanan

Nov 13, 2022, 7:26 PM

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One example of resistance to new technologies that is seen among patients is resistance to using telehealth services, especially in patients who are elderly and did not grow up with advanced technology like younger generations did. These patients may not have access to internet at home, may not understand how to access telehealth links on their computer or smartphone, and may feel that the time and energy required to learn how to use telehealth services is not worth it. One strategy to help decrease this resistance would be to hold educational sessions for patients to learn how to access and participate in telehealth sessions. Patients could come in person and bring their device of choice to use for telehealth, and could practice logging in to a telehealth session while there is in-person support for them. This is preferable to having them attempt to login to a telehealth appointment at home when any support for them from the healthcare provider’s office would be virtual. This type of educational session would be particularly helpful for elderly patients who live alone and do not have anyone to help them troubleshoot issues they may have with their telehealth visit.

Corina Heimke

replied toJamie Buchanan

Nov 15, 2022, 11:58 AM

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For many nurses, new technologies and major job changes that come with them become “the straw that broke the camel’s back”, so to speak. Most nurses already feel overwhelmed with their workload, and learning a new technology just adds to that (Kirkley & Stein, 2004). When technology has an obvious benefit, nurses are more likely to adopt it. There is also the fact that many older nurses who often set the tone for an organization or unit were trained using much less technology and tend to be initially more resistant. Ultimately, personalities and determination usually dictate whether a nurse will succeed adopting a new technology in practice (Kirkley & Stein, 2004). If leadership wants to engage nurses in new technologies, there are a few options. It is important to involve nurses in early preparations, ensure the technology is readily available and appropriate for the care setting, and ensure that nurses fully understand the big picture and their role in the care team (Kirkley & Stein, 2004).

Kirkley, D., & Stein, M. (2004). Nurses and clinical technology: Sources of resistance and strategies for acceptance. Nursing Economic$, 22(4), 216–222,195.

Amber Dehority

replied toJamie Buchanan

Nov 16, 2022, 9:51 PM

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Over this past week, it has happened a couple of times, which I think is absurd. Patients have been complaining about electronic prescriptions being sent over; would rather have a written prescription…apparently, there is a lag in communication and my patient’s pharmacies are not getting the correct prescription. This builds up frustration. Not only are they getting the prescription but now have to run back to the emergency department to get a new medication. It cost money, time, and energy. Some of these patients do not follow through, so they end up not getting it. This could mean antibiotic resistance, not curing the disease, or even making things worse. This should not be a problem and should be fixed immediately. one way to accomplish this is to verify the correct pharmacy is listed in the patient’s chart, double check it was sent, and maybe even call the pharmacy to ensure its accuracy.

Jamie Buchanan

Nov 12, 2022, 8:50 AM

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Class:

Since we are considering roles as an advanced registered nurse in informatics, it is important that we keep in mind the patient’s privacy when considering data sharing and technology in the clinical setting. If you were the privacy officer in your organization, how would you address one of the following?

Tracking each point of access of the patient’s database, including who entered data.
Encouraging employees to report privacy and security breaches.
The healthcare professionals are using smartphones, iPads, and other mobile devices. How do you address privacy when data can literally walk out of your setting?
You observe one of the healthcare 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?

Choose one of the scenarios above and respond with your answer.

Thank you for sharing!

Take care,

Dr. B

LaChrisa Ginn

replied toJamie Buchanan

Nov 14, 2022, 3:24 PM

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You observe one of the healthcare 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?

I would ask the healthcare professional to accompany me to the director of nursing’s office where the two of us would explain that taking any type of pictures of a patient is a HIPAA violation, even if the HC professional thinks that the picture would not be seen publicly, it is a violation of the patient’s rights. I would then print out the HIPAA guidelines so that the employee would have a paper in hand copy to read over and keep for themselves. I would also encourage them that if they see others doing the same thing that they should report it immediately.

Jamie Buchanan

Nov 11, 2022, 11:30 AM

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Class:

How do you envision Health Level Seven and the HITECH Act evolving in the next decade?

Thank you for sharing!

Take care,

Dr. B

References:

McGonigle, D. & Mastrian, K. (2018). Nursing Informatics and the Foundation of Knowledge. (4th ed.). Jones & Bartlett Learning.

Tuova Williams

replied toJamie Buchanan

Nov 13, 2022, 11:33 AM

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Within the next decade I predict that, due to the Health Level 7 protocol and the Health Information Technology for Economic and Clinical Health (HITECH) act, there will be major advancements in the interoperability of health records across the nation. Interoperability is a major goal of the healthcare system nationwide and is necessary to fulfill the obligations of the Cures Act and the Medicare Access & CHIP Reauthorization Act (MACRA), to name a few. These acts mandate increased data sharing between healthcare systems. I anticipate an increase in application programing interfaces (API) usage that will facilitate communication between systems. Not only will the APIs allow patient’s personal health information to be readily available to organizations, but they will also make it extremely easy to access for the patients themselves. (Federated Health Information Model, n.d.) Although there has been development and use of innovative nationwide platforms such as the prescription drug monitoring program (PDMP), there is still much fragmentation between healthcare systems and the data they have access to and the data they will share. We recently had a

NUR 514 Topic 7 DQ 2 Review HIPAA, protected health information (PHI), and requirements for privacy and confidentiality in EHRs

patient present to the clinic that reported being admitted to a hospital outside of the healthcare system that I am employed in. Per the patient’s account, the reason that they were admitted may have some bearing on the condition that we were treating her for, but unfortunately, we did not have access to the other hospital system’s medical records and were unable to confirm the treatment that she received there. In ten years, I foresee that this will not be an issue and the increased access to patients’ records will lead to better patient outcomes.

Reference:

Federated Health Information Model (fhim). (n.d.). Brief History of Selected US Legislation Related to Interoperability (2006 – 2019). https://fhim.org/resources/page2#_ftn13

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