“Doing Ethics” in the Context of Sharing Patients' Personal Health Information

2004 ◽  
Vol 23 (3) ◽  
pp. 197-202
Author(s):  
Margaret A. Somerville

ABSTRACTThere are at present two inconsistencies with respect to the sharing of personal health information (PHI) among health care professionals caring for a patient whom the information concerns. First, there is an inconsistency between what is in theory the ethics and law governing the confidentiality and privacy of this information—it may only be disclosed with informed consent—and what is the actual practice of health care professionals—they share it without such consent. Second, there is an inconsistency between what ethics and law demand in theory and what all parties want: They all approve of the current practice. Ethics and law can be brought into line with what is needed to act in the patient's best interests and with what people want, without opening up any serious potential for abuse of privacy and confidentiality, by establishing a safeguarded, provision-of-care exception that allows co-caring health care professionals to share patients' PHI. The requirements for a system establishing such safeguards are proposed. The basic governing presumption is respect for the person and for rights to autonomy, self-determination, privacy, and confidentiality. Therefore, disclosure may only be made with the informed consent of the competent person to whom the information pertains, unless a defence of necessity applies. Where there is doubt about someone's competence, there should likewise be doubt about disclosure without that person's informed consent. Where the person is incompetent, such a disclosure can be made to the patient's substitute decision makers, most often the family, if that is necessary for the care of the patient and in the patient's best interests. To the extent possible, consistent with the best interests of the patient, the wishes of incompetent people should be respected.

2017 ◽  
Author(s):  
Sujin Kim ◽  
Donghee Sinn ◽  
Sue Yeon Syn

BACKGROUND With abundant personal health information at hand, individuals are faced with a critical challenge in evaluating the informational value of health care records to keep useful information and discard that which is determined useless. Young, healthy college students who were previously dependents of adult parents or caregivers are less likely to be concerned with disease management. Personal health information management (PHIM) is a special case of personal information management (PIM) that is associated with multiple interactions among varying stakeholders and systems. However, there has been limited evidence to understand informational or behavioral underpinning of the college students’ PHIM activities, which can influence their health in general throughout their lifetime. OBJECTIVE This study aimed to investigate demographic and academic profiles of college students with relevance to PHIM activities. Next, we sought to construct major PHIM-related activity components and perceptions among college students. Finally, we sought to discover major factors predicting core PHIM activities among college students we sampled. METHODS A Web survey was administered to collect responses about PHIM behaviors and perceptions among college students from the University of Kentucky from January through March 2017. A total of 1408 college students were included in the analysis. PHIM perceptions, demographics, and academic variations were used as independent variables to predict diverse PHIM activities using a principal component analysis (PCA) and hierarchical regression analyses (SPSS v.24, IBM Corp, Armonk, NY, USA). RESULTS Majority of the participants were female (956/1408, 67.90%), and the age distribution of this population included an adequate representation of college students of all ages. The most preferred health information resources were family (612/1408, 43.47%), health care professionals (366/1408, 26.00%), friends (27/1408, 1.91%), and the internet (157/1408, 11.15%). Organizational or curatorial activities such as Arranging, Labeling, Categorizing, and Discarding were rated low (average=3.21, average=3.02, average=2.52, and average=2.42, respectively). The PCA results suggested 3 components from perception factors labeled as follows: Assistance (alpha=.85), Awareness (alpha=.716), and Difficulty (alpha=.558). Overall, the Demographics and Academics variables were not significant in predicting dependent variables such as Labeling, Categorizing, Health Education Materials, and Discarding, whereas they were significant for other outcome variables such as Sharing, Collecting, Knowing, Insurance Information, Using, and Owning. CONCLUSIONS College years are a significant time for students to learn decision-making skills for maintaining information, a key aspect of health records, as well as for educators to provide appropriate educational and decision aids in the environment of learning as independent adults. Our study will contribute to better understand knowledge about specific skills and perceptions for college students’ practice of effective PHIM throughout their lives.


1996 ◽  
Vol 26 (4) ◽  
pp. 197-201 ◽  
Author(s):  
Tina Magennis ◽  
Jennifer Mitchell

As electronic patient health information systems become more fully developed and widespread, there are persistent concerns about the privacy and confidentiality of the personal health data being stored and disseminated. Standards Australia has released two Standards which provide useful guidelines for the organisational, technological and human behaviour solutions required to protect privacy and confidentiality in health care organisations. The major requirements of these Standards are outlined and the implications of the Standards for health information managers are discussed.


2016 ◽  
Vol 24 (e1) ◽  
pp. e173-e177 ◽  
Author(s):  
Sue Peacock ◽  
Ashok Reddy ◽  
Suzanne G Leveille ◽  
Jan Walker ◽  
Thomas H Payne ◽  
...  

Background: Access to online patient portals is key to improving care, but we have limited understanding of patient perceptions of online portals and the characteristics of people who use them. Methods: Using a national survey of 3677 respondents, we describe perceptions and utilization of online personal health information (PHI) portals. Results: Most respondents (92%) considered online PHI access important, yet only 34% were offered access to online PHI by a health care provider, and just 28% accessed online PHI in the past year. While there were no differences across race or ethnicity in importance of access, black and Hispanic respondents were significantly less likely to be offered access (P = .006 and <.001, respectively) and less likely to access their online PHI (P = .041 and <.001, respectively) compared to white and non-Hispanic respondents. Conclusion: Health care providers are crucial to the adoption and use of online patient portals and should be encouraged to offer consistent access regardless of patient race and ethnicity.


2003 ◽  
Vol 31 (S4) ◽  
pp. 70-72 ◽  
Author(s):  
Lora Kutkat ◽  
James G. Hodge ◽  
Thomas Jeffry ◽  
Diana M. Bontá

Current economic conditions have coincided with the implementation of the Health Insurance Portability and Accountability Act (HIPAA) and forced public health officials to consider how to ethically incorporate compliance into their already strained budgets, while maintaining the integrity and intent of the legislation.As of April 14, 2003, the HIPAA Privacy Rule provides a new federal floor of protections for personal health information. The Privacy Rule establishes standards for the protection of health information held by many physicians’ offices, health plans, and health care clearinghouses. The Rule protects personal health information by establishing conditions regulating the use and disclosure of individually identifiable health information by these entities, also referred to as covered entities. The Rule does not prevent the daily operations of health care establishments (i.e., the treatment of patients and the collection of payment).


Author(s):  
Candace J. Gibson ◽  
Kelly J. Abrams

The introduction of information technologies and the electronic record in health care is thought to be a key means of improving efficiencies and effectiveness of the health care system; ensuring critical information is readily available at the point of care, decreasing unnecessary duplication of tests, increasing patient safety (particularly from adverse drug events), and linking providers and patients spatially and temporally across the continuum of care as health care moves out of the traditional hospital setting to the community and home. There is a steady movement in many countries towards eHealth and a fully implemented, in some cases, pan-regional or pan-national electronic heath record. A number of barriers and challenges exist in EHR implementation. These include lack of resources (both capital and human resources), resistance to change and adoption of new technologies, and lack of standards to ensure interoperability across separate applications and systems. From the public’s perspective, maintaining the security, privacy, and confidentiality of personal health information is a prominent concern and privacy of personal health information still looms as a potential stumbling block for the implementation of a omprehensive, shared electronic record. There are some steps that can be taken to increase the public’s comfort level and to ensure that these new systems are designed and used with security and privacy in mind.


2020 ◽  
Vol 153 (6) ◽  
pp. 378-398
Author(s):  
Teagan Rolf von den Baumen ◽  
Jennifer Lake ◽  
Amanda C. Everall ◽  
Katie Dainty ◽  
Zahava Rosenberg-Yunger ◽  
...  

Background: Ontario’s Health Links approach to care is an integrated care model designed to optimize care for patients with complex needs. Currently, community pharmacists have no formalized role. This study aimed to explore stakeholders’ perceptions about privacy and its impact on community pharmacists’ involvement with integrated care models. Methods: A qualitative study using semistructured telephone-based interviews was conducted. Participants worked in Ontario as pharmacists, providers in Health Links or team-based models or decision-makers in Health Links or health regions. Thematic analysis followed the Qualitative Analysis Guide of Leuven. Results: Twenty-two participants were interviewed, and all but one commented on privacy or information sharing in integrating community pharmacists with integrated care models. The 4 themes identified were as follows: 1) what does the circle of care look like? 2) value of sharing information, 3) uncertainty of what information to share and 4) perceptions on how to share information. Interpretation: The concerns surrounding privacy of personal health information and who is included in the circle of care represented an important barrier for integration. Enablers to mitigate privacy concerns included relationship building between community pharmacists, patients and other health care professionals and mutual access to information-sharing platforms such as electronic health records. Conclusion: Providers’ and decision-makers’ perceptions about community pharmacists and privacy affect information sharing and are incongruent with Ontario’s Personal Health Information Protection Act. Education is needed for health care professionals on legislation, especially as health systems move towards integrated care models to improve care. Can Pharm J (Ott) 2020;153:xx-xx.


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