pros and cons of confidentiality in healthcare pros and cons of confidentiality in healthcare

As citizens become more aware of the many issues involved in medical confidentiality, they can help shape the discussion and make their voices heard as lawmakers address the issues. Effective patientphysician communication. AI can be used for diagnostics, helping J Pediatr Adolesc Gynecol 2017;30:17683. Insurance companies may provide their policyholders discounted medical treatment by entering into agreements with doctors' offices and hospitals. 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. Any updates to this document can be found on acog.org or by calling the ACOG Resource Center.While ACOG makes every effort to present accurate and reliable information, this publication is provided as is without any warranty of accuracy, reliability, or otherwise, either express or implied. However, there is concern that it may result in important confidentiality breaches for adolescent patients. An EHR makes it much easier for a medical practice to track a charge for each procedure performed. Those who have good insurance Given the health concerns, at least one court has held that a physician may have a duty to disclose genetic information about a patient to immediate family members. The American College of Obstetricians and Gynecologists offers the following recommendations and conclusions: 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. Additionally, they should be informed of any restrictions to the confidential nature of the relationship. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Contradictory viewpoints. Adolescents are beginning to take responsibility for their health care, and this should be encouraged and supported as they transition to adult patients. Modern healthcare organizations have turned to electronic medical records (EMRs) in an Therefore, it is important to remember that there is difference between social health insurance. Obstetriciangynecologists and other health care providers should be active in educating their staff and patients regarding the confidentiality of services. The right of a mature minor to consent to medical care without previous parental or guardian consent has been recognized in many states.*. 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. Only a few states have comprehensive confidentiality laws, and many states control disclosure of health information through a combination of statutes addressing everything from particular disease information to autopsy records. There are some theorists that have pointed out that privacy is a basic human right or good that has got some intrinsic values. Society for Adolescent Health and Medicine, American Academy of Pediatrics. They argue that a right to health care would stop medical Available at: https://www.guttmacher.org/state-policy/explore/overview-minors-consent-law. Consequentialist theory suggests that without assurances of confidentiality, patients are less likely to disclose important medical information to their doctors. Rights-based theory states that patients have a right to control how their medical information is used. Legal protections for confidentiality are the result of our societys interest in privacy, but they can still be outweighed in cases where other society values (such as public health and safety) outweigh them. Not socialized medicinean Israeli view of health care reform. Similar caution should be assumed when releasing information to other health care providers. The rapid development of technology geared toward healthcare services has led to the creation of the term telehealth, which essentially means virtual care. 803. Therefore, a doctor is not under any obligation to reveal threats of minor harm, threats that the doctor does not believe are serious, or general threats where there is no identifiable individual at risk. But these safeguards must be designed to achieve a balance between protecting confidentiality and the need to share information in order to need to treat patients, assure quality health care, and conduct research that will lead to health advances. (2009). OpenNotes. American College of Obstetricians and Gynecologists Can be especially important for children. Marcell AV, Burstein GR. Pros: A single-payer system offers individuals greater control over their healthcare, providing the ability to choose their doctors based on approach or reputation. Read terms, Number 803 (Replaces Committee Opinion Number 599, May 2014). Reduction in Medical Errors: 5. The following are examples of how some institutions have provided protection to adolescents; they are not applicable to all institutions or systems: For patients ages 1217-years old, manage or restrict parental or guardian access to provider notes. ET). Lehrer JA, Pantell R, Tebb K, Shafer MA. Universal healthcare can increase overall life expectancy. There are many aspects of our lives that are available for anyone to access, and yet most people are either unaware of these possibilities, or unconcerned with this loss of confidentiality. There is little to no control over income distribution. Did you know that according to the Social Security Administration, 1 in 4 of todays 20-year-old Americans will become disabled before age 67?1 HealthMarkets can help you find a health plan should a serious condition leave you unable to work. This may mitigate the intimidation some patients may experience from parents or guardians. So there are a couple of questions that are up for debate. Once confidentiality is breeched, it is difficult to regain trust; so, obstetriciangynecologists should make efforts to avoid the violation of the trust between the health care provider and patient. J Adolesc Health 2012;51:40914. The second issue, which stems from the first, is under what circumstances confidentiality should be broken. For patients ages 18 and older, require a signed release of information for a parent or guardian to ask health questions about the adolescent by telephone. Advantages of Medical Technology in Healthcare: 1. Grilo SA, Catallozzi M, Santelli JS, Yan H, Song X, Heitel J, et al. Emancipation: A legal procedure whereby minors become legally responsible for themselves, and their parents or guardians are no longer responsible (financially or otherwise). 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. Obstet Gynecol 2020;135:e1717.This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. Top of Page Obstetriciangynecologists who work with adolescent patients have a unique perspective and are encouraged to work with their institutions to protect patients confidentiality. Neither of these survey types is best for every use case your organization has its own specific needs.For analysis of, say, a rapid one-off poll to help you identify and improve an aspect of a product or service, an anonymous survey is sometimes all you need.. The consequences of undermining this duty of confidence would be damaging to the individuals health and treatment. The U.S. Supreme Court has stated that "disclosures of private medical information to doctors, to hospital personnel, to insurance companies, and to public health agencies are often an essential part of modern medical practice." Additionally, it is costly for vendors to develop and maintain the levels of mandated confidentiality because the laws regarding confidentiality vary by state 4. In order to ensure the privacy of the adolescent is not violated under HIPAA, obstetriciangynecologists and other health care providers should educate their patients about what information is released when a request or release of records is sent to a health care provider, including if a parent or guardian requests a release of information or a patient requests a release to the parent or guardian. The obvious solution is to go to court, but this means making public the information they did not want anyone to know in the first place! If, however, you plan to take detailed actions based on Standards for health information technology to ensure adolescent privacy. Quality healthcare services: The US has modern medical equipment and ensures citizens are able to get quality medical care. 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 parent or guardian and patient should be aware that these discussions are considered private, not secret, and obstetriciangynecologists may disclose private information when concerned for the immediate danger of patients to themselves or others, or both, and when reporting is required by public health laws 6. All of the different ways of conceptualizing confidentiality include exceptions, allowing disclosure under certain circumstances or to particular agencies. WebPeople may get a higher feeling of security. Bulk pricing was not found for item. WebData access limitations. Often her small private room was crowded with family, friends, and loved ones. Journal of the American Academy of Psychiatry and the Law Online, 39(4), 571-578. Do not include specific laboratory data or counseling in after-visit summaries. Since its much easier and faster to access patient details and history through an electronic health record, its also much easier to immediately place imaging and laboratory work orders. Don't use plagiarized sources. Because online therapy involves communication via computers or mobile devices, it has security issues 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. Confidentiality laws regarding medical information are currently undergoing changes at both the state and federal levels. All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Although laws vary by state, all minors have a right to some confidential health care. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. Over time, however, regulations have been developed to protect the privacy and security of certain health information. People would have to worry less about their future. Identify and protect against reasonably anticipated threats to the security or integrity of the information. WebIn general, [a] covered health care provider [with a direct treatment relationship] must obtain the individuals consent,prior to using or disclosing protected health information to carry out treatment, payment, or health care operations. (See section [] 164.506, 65 Federal Register [F.R.] These unique issues include: The diversity of stakeholders. Any updates to this document can be found on acog.org or by calling the ACOG Resource Center. Implementation toolkit. By reading this page you agree to ACOG's Terms and Conditions. The most obvious examples of public health concerns outweighing individual rights to confidentiality are from contagious disease cases. The staff is always available to discuss health problems or answer questions. Recommendations for electronic health record use for delivery of adolescent health care. With appropriate safeguards, EHRs may offer more security than traditional paper-record systems. Some states have statutes that require reporting of abuse of hospital patients or long-term care patients, elder abuse, spousal abuse, and domestic abuse. WebConfidentiality covers all medical records (including x-rays, lab-reports, etc. What you tell your doctor, lawyer, or psychologist is supposedly protected information that cannot be shared with others, no matter how intimate, gory, or revealing it may be. 803. Committee Opinion No. This essay examines the pros and cons of the confidentiality, safety, rights, and the security of patients in an era of increased socialized medicine. Because research allows better treatments to be developed and in this way serves the general public, it seems reasonable that disclosure should be permissible under certain circumstances, provided that individuals have the option of remaining anonymous. Private information, especially if identifiable, should only be disclosed to the third party with the consent of the patient. In fact, quite a lot of personal information is not protected at all. What is Confidentiality and When is It Not Protected? 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. The privacy rule, which is based on requirements contained in HIPAA, provides protection against parents or guardians access to protected health information for the following circumstances: adolescents aged 18 years and older; emancipated minors; minors who can legally consent to services or receive services without parental or guardian consent or notification according to state or other applicable law; or when a parent or guardian assents to an agreement of confidentiality between the minor adolescent and health care provider. Pharmacy and Therapeutics, 39(7), 491. 1. WebSolution for Explain the pros and cons of multipurpose pins on microcontrollers. Adolescents should be aware that certain insurance carriers itemize explanation of benefits statements 7. The United States continues to move toward a nationwide health information network that will allow health care providers to obtain quick access to patient medical information through EHRs. (Monday through Friday, 8:30 a.m. to 5 p.m. My patient was a petite woman in her mid-forties with long dark hair. 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. The ACOG policies can be found on acog.org. Unlike electronic medical records stored on cloud servers, paper medical records need physical space for storage purposes. 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. Teens also have a right to confidential mental health and substance abuse treatment. The principle of bioethics of non-malefience require for the sage guarding of personal privacy. 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). All states allow disclosure to third party payers (insurance companies), although in most cases the patient will provide consent to this practice at the time of treatment (generally in a section of most hospital or physician office intake forms) or when one signs the initial coverage contract. But what if a patient threatens suicide? Useful sources of information on state laws include the Guttmacher Institute 14 and the Center for Adolescent Health & the Law 23. WebPros And Cons Of Sarbanes-Oxley Act Of 2002. J Adolesc Health 2014;54:48790. BMJ Qual Saf 2017;26:26270. It is helpful to conduct staff sensitivity training on the following topics: Comfort with issues regarding adolescent sexuality, Knowledge about confidentiality issues, including state and local laws, How to provide relevant information to parents or guardians and patients about private conversation time with the adolescent patient and obstetriciangynecologist, How to identify appropriate contact information for the adolescent patient (eg, personal cell phone) and parents or guardians for future follow-up, How to set up a code word to ensure the identity and security of the adolescent patient, Comfort with lesbian, gay, bisexual, transgender, or questioning (LGBTQ) issues and pronoun (she, he, they) usage. The overall goal of big data in healthcare is to use predictive analysis to find and address medical issues before they turn into larger problems. Obstetriciangynecologists who treat adolescent patients should provide resources for parents and caregivers and encourage continued parental involvement 10. The most obvious benefit of utilizing AI technology is its ability to improve patient experiences. Available at: Promoting healthy relationships in adolescents. Obstet Gynecol 2020;135:e4350. No part of this publication may be reproduced, stored in a retrieval system, posted on the internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. Copyright 2020 by the American College of Obstetricians and Gynecologists. It is not intended to substitute for the independent professional judgment of the treating clinician. ), as well as communications between patient and doctor, and generally includes communications between the patient and other professional staff working with the doctor. 1. Potential for disclosure of laboratory results, prescriptions, and diagnoses may occur with itemized explanation of benefits statements. 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. ACOG Committee Opinion No. An overview of consent to reproductive health services by young people. All rights reserved. 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. Explanation of benefits statements (health care billing and insurance claims sent by insurance carriers) are an additional challenge to confidentiality.