pros and cons of confidentiality in healthcare10 marca 2023
Forgone health care among U.S. adolescents: associations between risk characteristics and confidentiality concern. Available at: National Institute for Health Care Management. Douglas and colleagues article discusses the wider health effects of the pandemic response.1 There is, however, one matter that hasnt been discussed in any media at allthe frequent breach in confidentiality. Knowing what confidentiality laws in your area cover can help you make informed decisions about how your information is shared. Confidentiality, Privacy, and Unreliable Technology Keeping your personal information private is a major concern in psychotherapy, but online treatment adds a layer A wide assortment of hardware and software. Grilo SA, Catallozzi M, Santelli JS, Yan H, Song X, Heitel J, et al. Almost all states have child abuse reporting statutes. Only individuals who are legally authorized to have access to patient data for a legally permissible purpose should be given access to patient The other advantage for concealing health information to the service provider may end up being detrimental to the patient. 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. New York, NY: Guttmacher Institute; 2019. Confidentiality is a fundamental right and is of paramount importance in our healthcare system. Confidentiality discussions and private time with a health-care provider for youth, United States, 2016. Fidelity-based confidentiality suggests that physicians have an obligation not to disclosure information shared with them in their medical role. Require a parent or guardian code word to access an adolescents patient portal. Quicker access to test results. Statutes vary by state, but minors may become emancipated when they marry, serve in active duty in the U.S. military, or obtain a declaration from the court. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented. Many Definitions of Patient Confidentiality, When You Cannot Expect Medical Information to Remain Confidential. In the next section, we will look at the circumstances under which confidentiality may be broken. They are required to keep information about patients health private unless the patient give permission to release his/her health information (De Bord et al, 2013). Sharing medical information for research purposes is more controversial. 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. Contradictory viewpoints. Get Your Custom Essay on, The Pros and Cons of the Confidentiality of Patients in an Era of Increased Socialized Medicine. Ventola, C. L. (2014). ), as well as communications between patient and doctor, and generally includes communications between the patient and other professional staff working with the doctor. Socialized medicine programs are mostly being financed by the tax payers and therefore if one conceals this information may jeopardize the kind of services that are being provided. All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. How do we weigh the pros and cons of sharing personal health information with others in the medical community and with the government? WebPros And Cons Of Sarbanes-Oxley Act Of 2002. This can actually slow their recovery. Did you know that according to the Social Security Administration, 1 in 4 of todays 20-year-old Americans People would have to worry less about their future. Rules regarding privacy and confidentiality apply to a telehealth setting as much as they do to one that's face to face. The maintenance of patient confidentiality may be affected by the widespread adoption and integration of electronic health records (EHRs) in clinical care, which may necessitate a closer evaluation of the unique challenge this presents for providers of adolescent health care. Pros of the Confidentiality, Safety, Rights, and the Security of Patients in an Era of Increased Socialized Medicine Cons: Physicians have less autonomy and less continuity with patients. 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. 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 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. Big data definitely Cons: Physicians have less autonomy and less continuity with patients. For example, if the physicians primary role is to prolong life, confidentiality should be breached when the disclosure would serve to prolong life, or the failure to disclose would shorten life. This Committee Opinion was developed by the American College of Obstetricians and Gynecologists Committee on Adolescent Health Care in collaboration with committee member Kimberly Hoover, MD and liaison member Stephanie Crewe, MD, MHS. Allow parental or guardian access to the EHR to expire at the age state law requires confidentiality. Gray SH, Pasternak RH, Gooding HC, Woodward K, Hawkins K, Sawyer S, et al. Obstetriciangynecologists should emphasize to the parent or guardian that confidentiality is important to foster a safe and trusting environment for adolescents to discuss their concerns and health care. There are many ways to define confidentiality, and how we conceptualize it affects how it functions in our everyday lives. Available at: Anoshiravani A, Gaskin GL, Groshek MR, Kuelbs C, Longhurst CA. They are of the argument that privacy is in itself objectively valuable, as an important component of human well-being. Journal of Adolescent Health, 25: The Health Insurance Portability and Accountability Act (HIPAA) privacy rule, however, defers to state and other federal applicable laws about disclosure of protected health information for unemancipated minors that may allow health care providers discretion regarding parental or guardian access to a minors protected health information 15. The capacity of an adolescent to consent for health care as a mature minor is influenced by the minors developmental maturity, previous experience with illness, the gravity of the current illness, and the risks of proposed therapy. Sarbanes-Oxley Act of 2002 is a law enacted by US congress in July 30, 2002. Flag a portion of the visit note as confidential in order for those sections to be omitted from access by a parent or guardian. For additional quantities, please contact [emailprotected] A 2016 study demonstrated that, when given the opportunity, adolescents use of EHRs afforded enhanced medical care and, although they accessed the portal less for laboratory results, appointments, or prescriptions, adolescents did engage in frequent confidential communications with their health care providers through patient portals 4. The Importance of Supplemental Disability Insurance. In some research protocols, identifiers remain so that data can still be traced to particular individuals. If, after counseling, the patient refuses the chaperone, this decision should be respected and documented in the medical record 11. Bright futures: guidelines for health supervision of infants, children, and adolescents . Reduction in Medical Errors: 5. Wearable Technology: Disadvantages of Medical Technology in Healthcare: 1. Adolescent girls' and boys' preferences for provider gender and confidentiality in their health care. All states and the District of Columbia allow minors to consent to sexually transmitted infection (STI) testing and treatment without parental permission 14. consultation with a healthcare professional. Patient access varies widely across institutions and by the type of EHR used by the health care provider. 4. 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. 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. All of the different ways of conceptualizing confidentiality include exceptions, allowing disclosure under certain circumstances or to particular agencies. Adolescents also have rights to receive health care independently under legal principles such as mature minor and emancipated minor Box 2. Implementation toolkit. The staff is always available to discuss health problems or answer questions. When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient-doctor relationship. There are some problems with paper medical records. Add sensitive information into the prose of the visit note that is not included in billing or hospital searchable data. Adolescent health care, confidentiality . 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. Please try reloading page. 803. Employed physician in academic institution. Can be especially important for children. Sarbanes-Oxley Act of 2002 is a law enacted by US congress in July 30, 2002. Generally, parents or guardians and adolescents should be informed, both separately and together, that the information each of them shares with the health care provider will be treated as confidential. Another problem, however, 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. OpenNotes. As a last resort, the health care provider should consider referral if confidential care cannot be provided. Parent or guardian access to the patients visit notes through the electronic patient portal poses the potential that confidential and sensitive information may be accessed, resulting in a breach of confidentiality and potentially adverse outcomes for the adolescent patient. In practice, the major issue that faces health care providers and patients is the health care providers ability to provide confidential care using EHRs, such as when parents or guardians have the ability to access some of their adolescents health information when comprehensive health services are provided and billing systems generate statements that detail confidential services (eg, problem lists, laboratory tests, or prescriptions). A number of states have adopted this principle, and some have extended it to all physicians or mental health professionals. WebPros of Confidentiality in Healthcare: Encourages patients to seek care: Confidentiality helps build trust between patients and healthcare providers, which may encourage patients to 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. Finally, keeping private the information about the health of the patient, this will negatively affect his or her life. The Pros of Using AI. Teens also have a right to confidential mental health and substance abuse treatment. Health Insurance Portability and Accountability Act (HIPAA) of 1996: When Congress passed HIPAA in 1996, the law was known primarily for its provisions that provide stronger health insurance protection for people leaving jobs and people with preexisting medical conditions. Every patients file needs to be protected as it is stored in the network database. In such circumstances, it may be appropriate to restrict access to such sensitive information obtained during portions of the visit while allowing other portions to be viewable by parents or guardians. Improving patient It is not intended to substitute for the independent professional judgment of the treating clinician. We are a society strangely obsessed both with privacy and obtaining information. The bill consists of 11 sections and was created as a reaction to high numbers of fraud and business misbehavior in major US corporations. Unlike electronic medical records stored on cloud servers, paper medical records need physical space for storage purposes. Although most The minor can consent to medical, dental, or psychiatric care. Committee on Adolescence. While it is generally accepted that patients must consent before being entered into a research study, some state laws explicitly carve out an exception to confidentiality restrictions, allowing access to medical records for research purposes. Its just a matter of figuring out under what circumstances disclosures should occur. 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. Chapel Hill (NC): Center for Adolescent Health and the Law; 2010. BMJ Open 2016;6:e010034. This is due to the fact that if the doctor might not be able to offer the right care to the patient. Online Therapy: Security, Ethics, and Legal Issues. If the EHR system does not allow for procedures to maintain adolescent confidentiality, the obstetriciangynecologist or staff should inform the patient that parents or guardians will have access to the records, and the patient should be given the option of referral to a health care provider who is required to provide confidential care. All rights reserved. Patients should have autonomy regarding parent or guardian presence during examination, but a parent or guardian should not take the place of a chaperone 12. A survey of a large hospital corporation in London found that This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. By concealing the information about health, the patient may under cover through the socialized health cover. 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. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product. Recently, however, there have been some concerns raised about such databases, especially when the information can be linked to individuals (in other words, it is not completely anonymous) or it is stored electronically without adequate security. Jessica Wilen Berg is Professor of Law and Bioethics, Case Western Reserve University's School of Law and at the Department of Bioethics, Case Western Reserve School of Medicine, Cleveland, OH. Consequentialist theory suggests that without assurances of confidentiality, patients are less likely to disclose important medical information to their doctors. Employed physician in academic institution. Annals of internal medicine, 158(8), 620-627. 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 4. 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. Adolescents face considerable potential harms to their health from mental health disorders, interpersonal violence, substance use, and unprotected sexual activity. WebThe Cons Confidentiality and the institution of HIPAA hasnt been all positive. There is little to no control over income distribution. Another problem, however is what to do regarding the patient who has discovered a breach of confidentiality. WebConfidentiality covers all medical records (including x-rays, lab-reports, etc. 2023 My Superior Paper. Pharmacy and Therapeutics, 39(7), 491. WebThe uniqueness of HIEs-structures, relationships, funding, and authority-adds new complexities to the familiar issues of privacy, confidentiality, security, and information use. There are numerous reasons for ensuring that there is protection of the privacy, security, and confidentiality of the health information. According to Farnan et al (2013), privacy should always be guaranteed even if there will be no any form of embarrassment or any kind of harm. ACOG Committee Opinion No. In fact, quite a lot of personal information is not protected at all. However, there are some circumstances when it is necessary for the obstetriciangynecologist to share private information with a parent or guardian or others. There is little to no control over income distribution. Although much attention is currently focused on the federal privacy rule (HIPAA), there are a number of state confidentiality protections. According Chernichovsky (2009), the term Socialize medicine is defined as a health system where by which the government owns and operates both the financing of healthcare and also its delivery. Adolescents gain more ownership over their own health: We encourage adolescents to be active participants in their health care as a step toward becoming adults and to take on more responsibility. After her murder, the family sued, claiming that the physician should have warned the victim. Protection of privacy also ensures that the societal values are also protected. In some states, physicians may experience serious disciplinary action for revealing a minors confidential sexual information. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Although many genetic traits may be passed on to ones children, they clearly are not transmissible in the same way as contagious diseases and thus do not exactly fit under a discussion of public health concerns. Most EHRs were not designed to provide item-specific control over parental or guardian access and release of adolescent health care information. An EHR makes it much easier for a medical practice to track a charge for each procedure performed. WebThe Pros And Cons Of Confidentiality Soapstone Formal Analysis. Hospitals and office-based systems that currently use or are initiating OpenNotes should take steps to ensure that adolescent confidentiality is protected. WebPro 2 Instituting a right to health care could lower the cost of health care in the United States. So there are a couple of questions that are up for debate. Thirty-seven states require physicians to maintain confidentiality of medical records almost all states have placed some restrictions on the use of information contained in medical records that are held by state agencies. While gaining the adolescents trust, we still encourage them to discuss issues with their parents or guardians. National Academies Press. At the initial visit, the obstetriciangynecologist should discuss the following issues with the parent or guardian and the patient: 1) the meaning and importance of confidentiality; 2) the scope of confidentiality protection; and 3) the limitations of confidentiality. Parent or guardian access to the patients visit notes through the electronic patient portal poses the potential that confidential and sensitive information may be accessed, resulting in a breach of confidentiality and potentially adverse outcomes for the adolescent patient. One of the biggest problems in confidentiality protections is the lack of clarity about when patient confidentiality can be breached. Confidentiality extends beyond reproductive health for minors. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Adolescents often have questions or concerns that they may feel embarrassed to talk about in front of their parents or guardians. Universal health care may encourage entrepreneurship. (2009). Protect against reasonably anticipated, impermissible uses or disclosures. Insurance companies may provide their policyholders discounted medical treatment by entering into agreements with doctors' offices and hospitals. The Pros of Using AI. Effective patientphysician communication. Pediatrics 2012;130:98790. OpenNotes. In fact, quite a lot of personal information is not protected at all. Sarbanes-Oxley Act of 2002 is a law enacted by US congress in July 30, 2002. Not socialized medicinean Israeli view of health care reform. The sharing of medical information is one of the most complicated areas, and most patients are not even aware of the extent to which information about their care is shared within a hospital setting. In the former situation, liability may be imposed for failing to disclose. Obstetriciangynecologists are encouraged to know their individual systems and institutional policies regarding confidentiality, EHRs, patient portals, and the open access for visit notes. Many people are familiar with the idea of confidentiality as an integral part of the professional code of ethics in the legal, medical, and mental health fields. In other words, socialized medicine is one of the many forms of social insurance. (Health care providers should be cognizant of potential coercion by parent or guardian to maintain access.).
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