pros and cons of confidentiality in healthcare
In fact, quite a lot of personal information is not protected at all. Potential for disclosure of laboratory results, prescriptions, and diagnoses may occur with itemized explanation of benefits statements. This article will explore how confidentiality should be conceived and if and when it should be broken. 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. WebConfidentiality covers all medical records (including x-rays, lab-reports, etc. Published online on March 26, 2020.Copyright 2020 by the American College of Obstetricians and Gynecologists. It builds trust: Experimenting with a range of behavior is common among adolescents and young adults. This will allow patients to create their own direct access to their record, rather than through a parent or guardian. Limiting parental or guardian access to information about certain personal issues such as sexuality, substance abuse, and mental health concerns allows adolescent patients to be more comfortable talking with their health care providers about these issues. American College of Obstetricians and Gynecologists. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. Technology Improving Healthcare in Hospitals: 4. Farnan, J. M., Sulmasy, L. S., Worster, B. K., Chaudhry, H. J., Rhyne, J. In the former situation, liability may be imposed for failing to disclose. Over time, however, regulations have been developed to protect the privacy and security of certain health information. The rapid development of technology geared toward healthcare services has led to the creation of the term telehealth, which essentially means virtual care. 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. In some states, physicians may experience serious disciplinary action for revealing a minors confidential sexual information. Advantages of Medical Technology in Healthcare: 1. HIPAA are essential to review periodically to understand your rights as a patient under this legislation. American College of Obstetricians and Gynecologists Gostin, L. O., Levit, L. A., & Nass, S. J. 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. 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. This claim is endlessly repeated but deeply obscure. Statutes on the rights of minors to consent to health care services vary by state, and obstetriciangynecologists and other health care providers should be familiar with the regulations that apply to their practice. References Leawood, KS: AAFP; 2018. Hagan JF, Shaw JS, Duncan PM. If protection of adolescent confidentiality is not possible within their electronic system, the information technology support within individual institutions should be employed to restrict parental access per HIPAA compliance. WebSolution for Explain the pros and cons of multipurpose pins on microcontrollers. Universal health care may encourage entrepreneurship. Pros: A single-payer system offers individuals greater control over their healthcare, providing the ability to choose their doctors based on approach or reputation. *For more information, see Guttmacher Institute. Don't use plagiarized sources. All of the different ways of conceptualizing confidentiality include exceptions, allowing disclosure under certain circumstances or to particular agencies. Most EHRs were not designed to provide item-specific control over parental or guardian access and release of adolescent health care information. 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. Identify the adolescents cell phone number at check-in (in addition to collecting the parent or guardians cell phone number). 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 1. The OpenNotes toolkit 22 offers resources for institutions that choose to provide patient access to health care providers notes. Any concern for a HIPAA violation should be addressed by individual health care systems. The American College of Obstetricians and Gynecologists encourages obstetriciangynecologists and other health care providers to ensure that their existing EHR systems protect the confidentiality of minor patients, including any OpenNotes features. Additionally, they should be informed of any restrictions to the confidential nature of the relationship. | Terms and Conditions of Use. Pros: Salaries might be lower than in other practice settings, but there are often added benefits, including more time off and better retirement options. What is Confidentiality and When is It Not Protected? Confidentiality discussions and private time with a health-care provider for youth, United States, 2016. Often her small private room was crowded with family, friends, and loved ones. 2023 My Superior Paper. WebPro 2 Instituting a right to health care could lower the cost of health care in the United States. Cloudy confidentiality: clinical and legal implications of cloud computing in health care. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. There are some problems with paper medical records. For example, according to the medical ethics scholars Tom Beauchamp and James Childress, confidentiality protections can be justified using three types of arguments: Interestingly, none of these philosophical arguments suggests that confidentiality should not be breached under certain circumstances. One of the biggest problems in confidentiality protections is the lack of clarity about when patient confidentiality can be breached. Social media and health care professionals: benefits, risks, and best practices. Special requirements for electronic medical records in adolescent medicine. Report confidentiality breaches to collaborative relationship to better protect the public health, safety and welfare. Obstet Gynecol 2020;135:e4350. Literature discussing confidentiality and AIDS patients supports the notion that health care professionals (including counselors) have a duty to warn and protect at-risk third parties. Copyright document.getElementById("dte").innerHTML = new Date().getFullYear(); interMDnet Corporation. (2009). First, we want to make sure that adolescent patients have access to health care to make sure that they are healthy and safe. All states and the District of Columbia allow minors to consent to sexually transmitted infection (STI) testing and treatment without parental permission 14. (Eds.). This section outlines the mandatory reporting situations (those that require disclosure to specific authorities) as well as the permissive exceptions (those that allow a physician to use his or her own discretion in deciding whether to disclose a patients information). Often, the behavior is not disclosed to parents or guardians. When going for the socialized medicine, an individual is required to give his or her personal health records. However, during this era of socialized medicine, it would not be prudent to keep some of the health information about health (Klein,2011). It is unclear how this issue affects confidentiality, and, many states have been hesitant to extend such a duty to health professionals. Parents are often too quick to give medications to lower a fever and make a child more comfortable. While gaining the adolescents trust, we still encourage them to discuss issues with their parents or guardians. Second, we want to make sure that they have had the opportunity to learn to talk with a doctor by themselves so that when they are young adults, they are prepared to communicate and advocate for what they need. 758, Promoting Healthy Relationships in Adolescents, for potential talking points when discussing confidentiality with parents, guardians, and patients 10. Insurance companies may provide their policyholders discounted medical treatment by entering into agreements with doctors' offices and hospitals. WebSolution for Explain the pros and cons of multipurpose pins on microcontrollers. Teens also have a right to confidential mental health and substance abuse treatment. Ethical theories provide many different ways to view confidentiality laws. Every patient has got the right to privacy and therefore has got every right to ensure that the information about his or her health is concealed. The statutes and case law governing exceptions can be separated into a number of different areas, including public health, public safety, protection of vulnerable persons, and research. Sexual misconduct. 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. ACOG Committee Opinion No. 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. Obstet Gynecol 2020;135:e1717. 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. WebThe uniqueness of HIEs-structures, relationships, funding, and authority-adds new complexities to the familiar issues of privacy, confidentiality, security, and information use. Chapel Hill (NC): Center for Adolescent Health and the Law; 2010. The first is how to define confidentiality, since there are many different types, with different objectives at heart. Sexual and reproductive health care services in the pediatric setting. 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. Sarbanes-Oxley Act of 2002 is a law enacted by US congress in July 30, 2002. 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. Committee on Adolescence. HMOs often only cover 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. 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. WebPeople may get a higher feeling of security. Additionally, they should be informed of any restrictions to the confidential nature of the relationship. Sharing medical information for research purposes is more controversial. 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. 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. Elk Grove Village (IL): American Academy of Pediatrics; 2017. The Pros of Using AI. Available at: English A, Bass L, Boyle AD, Eshragh F. State minor consent laws: a summary . Similar issues apply to postmortem disclosure. 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. 803. In Tarasoff, a patient informed his therapist of his intention to kill a young woman. A wide assortment of hardware and software. When providing care for neurotypical (ie, without a defined neurologic difference) adolescents, obstetriciangynecologists and other health care providers should consider issues of parental access to the adolescents login information. National Academies Press. 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. ACOG Committee Opinion No. Retrieved November 15, 2019. We want to work with you to help your adolescent make the best choices for a healthy future. For example, it is much easier to obtain a persons credit history (even legally) than it is to gain access to his/her medical history, even though both may be considered highly personal and private information. However, there is concern that it may result in important confidentiality breaches for adolescent patients. American College of Obstetricians and Gynecologists. Available at: Esch T, Mejilla R, Anselmo M, Podtschaske B, Delbanco T, Walker J. Obstetriciangynecologists and other health care providers and institutions that establish an EHR system should consider systems with adolescent-specific modules that can be customized to accommodate the confidentiality needs related to minor adolescents and comply with the requirements of state and federal laws 16. Although most Obstetriciangynecologists and other health care providers and institutions that establish an electronic health record (EHR) system should consider systems with adolescent-specific modules that can be customized to accommodate the confidentiality needs related to minor adolescents and comply with the requirements of state and federal laws. Obstetriciangynecologists who work with adolescent patients have a unique perspective and are encouraged to work with their institutions to protect patients confidentiality. Flag a portion of the visit note as confidential in order for those sections to be omitted from access by a parent or guardian. Engaging patients through open notes: an evaluation using mixed methods. Committee on Adolescence, Council on Clinical and Information Technology. Another problem, however, is what to do regarding the patient who has discovered a breach of confidentiality. People could make long-term plans in a more profound manner. J Adolesc Health 2019;64:3118. Lehrer JA, Pantell R, Tebb K, Shafer MA. However, there are some circumstances when it is necessary for the obstetriciangynecologist to share private information with a parent or guardian or others. The Cons of Patients Confidentiality, Security, Rights, and Privacy During this Era of Socialized Medicine One of the biggest problems in confidentiality protections is the lack of clarity about when patient confidentiality can be breached. A number of states have adopted this principle, and some have extended it to all physicians or mental health professionals. Its value also sabotages any effort to solve financing problems. There are times when a parental or guardian proxy to the adolescents patient portal may be appropriate, such as when an adolescent lacks the capacity for decision making, including those adolescents with severe intellectual or development disabilities.
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