Security of Health Care Records

With the increase of health information technology used to store and access patient information, the likelihood of security breaches has also risen. In fact, according to the Canadian Medical Association Journal (CMAJ):

In the United States, there was a whopping 97% increase in the number of health records breached from 2010 to 2011... The number of patient records accessed in each breach has also increased substantially, from 26,968 (in 2010) to 49,394 (in 2011). Since August 2009, when the US government regulated that any breach affecting more than 500 patients be publicly disclosed, a total of 385 breaches, involving more than 19 million records, have been reported to the Department of Health and Human Services.

A large portion of those breaches, 39%, occurred because of a lost, stolen, or otherwise compromised portable electronic device-a problem that will likely only get worse as iPads, smartphones, and other gadgets become more common in hospitals. (CMAJ, 2012, p. E215).

Consider your own experiences. Does your organization use portable electronic devices? What safeguards are in place to ensure the security of data and patient information? For this Discussion you consider ethical and security issues surrounding the protection of digital health information.

To prepare:

· Review the Learning Resources dealing with the security of digital health care information. Reflect on your own organization or one with which you are familiar, and think about how health information stored electronically is protected.

· Consider the nurse's responsibility to ensure the protection of patient information. What strategies can you use?

· Reflect on ethical issues that are likely to arise with the increased access to newer, smaller, and more powerful technology tools.

· Consider strategies that can be implemented to ensure that the use of HIT contributes to an overall culture of safety.

1. an analysis of the nurse's responsibility to protect patient information and the extent that HIT has made it easier or more difficult to protect patient privacy.

2. Comment on any security or ethical issues related to the use of portable devices to store information.

3. Assess the strategies your organization uses to safeguard patient information and how these promote a culture of safety.

4. Describe an area where improvement is needed and one strategy that could address the situation.

Course Readings

· McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge(Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.

o Chapter 5, "Ethical Applications of Informatics"

This chapter examines the ethical dilemmas that arise in nursing informatics. The authors explore the responsibilities for the ethical use of health information technology.

o Chapter 15, "Information Copyright and Fair Use and Network Security"

In this chapter, the author explains information fair use and copyright restrictions. The chapter describes processes for ensuring the security of a computer network.

· Brown, B. (2009a). Improving the privacy and security of personal health records. Journal of Health Care Compliance, 11(2), 39-40, 68.

Retrieved from the Walden Library databases.

The author of this article examines the use of the document titled "Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identified Health Information." The article describes how the framework aims to construct an approach to address the privacy and security challenges that come with health information exchanges and personal health records.

· Dimitropoulos, L., Patel, V., Scheffler, S. A., & Posnack, S. (2011). Public attitudes toward health information exchange: Perceived benefits and concerns. American Journal of Managed Care, 17,SP111-SP116.

Retrieved from the Walden Library databases.

This article describes a study that sought to determine the attitude of consumers toward electronic health information exchanges (HIE), HIE privacy and security concerns, and the relationship between these concerns and the perceived benefits of HIE. The authors recommend solutions to some of the privacy challenges stimulated by HIE.

· Goodman, K. W. (2010). Ethics, information technology, and public health: New challenges for the clinician-patient relationship. Journal of Law, Medicine & Ethics, 38(1), 58-63.

Retrieved from the Walden Library databases.

This article focuses on the challenges generated by the increased level of adoption of health information technology tools. The author emphasizes the ethical issues raised by electronic public health surveillance and the secondary use of health data.

· Hoffman, S., & Podgurski, A. (2011). Meaningful use and certification of health information technology: What about safety? Journal of Law, Medicine & Ethics, 39(3), 425-436.

Retrieved from the Walden Library databases.

This article stresses the necessity of sufficient safeguards for EHR systems. The author explores current safety regulations for EHR system design and deployment. The author makes additional recommendations for protecting public health in the digital area.

· Rothstein, M. A. (2010). The Hippocratic bargain and health information technology. Journal of Law, Medicine & Ethics, 38(1), 7-13.

Retrieved from the Walden Library databases.

The increasing availability of sensitive patient information granted by electronic health records has generated significant debate about patient privacy. This article examines the potential ethical and legal consequences of patient-directed sequestering of sensitive health information.