DETROIT – New technologies have changed the way we communicate, shop, find entertainment and share information. Healthcare is an industry that has fully embraced technology’s vast capabilities to store, access and protect data.
With so much information and privacy issues that continue to put pressure on how that data is stored and used, many challenges have arisen. This article is about how web development has been able to protect patient privacy in healthcare. We will see how to use this sensitive data, how the Health Insurance Portability and Accountability Act (HIPAA) guidelines are maintained and how this data is accessible to patients, regardless of their knowledge of new technologies.
The Importance of Health Information Privacy in Healthcare
There is a major factor driving the need for confidentiality of health information in health care. It boils down to one word: trust. Patient confidentiality is a required element in healthcare as it builds trust between patients and doctors. Patients are much more open about their medical history when they trust who they share this information with. With a patient-physician relationship built on trust, interactions between the two parties are better and this leads to higher quality healthcare visits, which leads to better health outcomes.
The Different Types of Confidentiality in Healthcare
- Many types of patient confidentiality exist in the healthcare industry. They include the following:
- Physical confidentiality – respect for personal space
- Informational confidentiality – the protection of personal data
- Decision-making privacy – allowing for personal choices which may include religious or cultural affiliations
- Associative confidentiality – accepting personal relationships that include family members or other partners
- This article, in particular, will focus on the information privacy element.
- The evolution of health information systems
If you’ve been seeing medical professionals for a while, you might remember that your doctor kept paper records. These records will document your visit, the topic discussed, concerns expressed, solutions or remedies offered, and any follow-up information when it becomes available.
There was a time when paper records were fine. They would be part of a large collection of document files that could be retrieved when needed. These paper records were important for clinical, research, administrative and financial purposes. Paper files were updated manually, which could lead to long delays, and were only accessible to one user at a time. In addition, these files were not normally accessible to patients.
The biggest issue with paper medical records, aside from the need for storage that took up walls of space to store the files, was security. Or, to be more precise, the lack of security. Of course, authorized personnel could browse the records, but first had to access them through various means that could include one or more of the following forms of protection: locks, doors, ID cards or passes, and an exit procedure. detailed. All of this was effective at the time. However, the unauthorized access did not trigger any alarms or other security measures and there was no way of knowing exactly what information had been seen.
Electronic health records (DSE) are an entirely different matter. For starters, although physical records belong to the physician, practice, or organization that created them, the patient owns the information in the record. Since the record is considered a commercial document, that is why it is said to be commercial property belonging to the creator of the record.
Access to the EHR can come from multiple users through various information technology tools that allow patients to view their records at any time. There are patient portals that make this possible, but only allow viewing by patients. Healthcare professionals have additional access that gives them the ability to edit, correct and add to these files.
The Office of the National Coordinator of Health Information Technology identifies electronic health records as “not just a collection of data that you keep – it’s a life.” This accurately describes an EHR based on the detailed medical and personal information it contains about an individual. This is also why three major ethical priorities are part of these dossiers. There are:
- Privacy and Confidentiality
- Data integrity and availability
How these files are kept private and confidential
Let’s look at privacy first. This is defined as “the right of individuals to prevent information about them from being disclosed to others and is the claim of individuals to be left alone, from the surveillance or interference of other individuals, organizations or of the government”. This happens by allowing patient information to be disclosed to others through only two methods:
- With the patient’s permission
- Or as the law dictates
Healthcare professionals can access patient information because they own the files in which the information is stored. This means that patient information may be used for payment, processing, or administrative purposes without the patient’s prior permission. It also means that the patient has the right to access their personal health record. But as already noted above, with trust in place between doctor and patient, access to medical records between the two parties makes perfect sense to strengthen that relationship of trust.
As for confidentiality, restrictions must be put in place to limit access to information to authorized persons only. Permission is the most effective way to limit who can see what. With web development and new technologies, levels of access are possible which impose different restrictions depending on individual needs regarding personal medical records. For example, a doctor would need full access and the ability to edit documentation. Patients would need full access, but would have restrictions on what they can do to their records regarding editing. Clinic or hospital administrative staff would need less but sufficient access to perform their duties, etc.
In addition, the access granted to electronic medical records would include the requirement for specific tools to view these records. These tools would be the standard username and password system that everyone knows for accessing certain online programs. This makes access easy for patients and all others who have permission to access the information. However, as an additional layer of security, some access levels would require an additional level of authenticity to allow file access. This two-tiered approach is becoming commonplace online, but access to medical records would include biometric scans of identifiable characteristics that would be unique to the person requesting access.
Audit trails help with HIPAA compliance
Organizations follow the guidelines of the HIPAA security rule to perform audit trails. An audit trail is a record of all system activity. This would include timestamps associated with each entry made, a detailed list of files and pages left open, the length of time that elapsed during the consultation, who performed the consultation, and information about any changes made to medical records. Other details that can be monitored and collected as part of an audit trail range from printing which pages, the number of screenshots taken, and the precise geographic location of the computer used to access to files.
Maintaining integrity of records is also vital
The final piece of the puzzle in connecting web development to electronic health records is integrity. Integrity basically ensures that the collected data is correct and has not been tampered with. As the exchange of data becomes a frequent activity in the electronic environment, it is important to maintain the integrity of this information as it moves through systems. Practices that threaten data integrity include documentation integrity when recording a small detail incorrectly, copying and pasting data that increases the risk of data loss, and limitations presented by use drop-down menus. The drop-down menus only offer a certain number of options and in some cases the available options are not relevant impacting the accuracy of the recording of information.
New technology has made it much easier for us to accomplish many tedious or much more labor-intensive tasks. The healthcare industry was an early adopter of new technologies that quickly changed the game. Web development has created innovative ways to access and collect patient data, which has rendered manual, paper-based documentation obsolete. However, while digital data has become important in the form of electronic medical records, it has also presented many new challenges. These include privacy, confidentiality, security and data integrity.
Fortunately, there are standards in place, resulting from the Health Insurance Portability and Accountability Act 1996. HIPAA explains how to use medical data, data storage, who can access it, and how to access it. The system has a series of checks and balances to ensure that objectives are met and that sensitive assets remain protected but accessible only to those who need them. It all comes down to trust. The quality of data depends on the level of trust between a patient and a healthcare professional. Without a relationship of trust, the data collected will lack quality, which can impact the level of care.
Marina Turea works as a content manager at Digital Authority Partners, a web development agency in San Diego.