Available at: Esch T, Mejilla R, Anselmo M, Podtschaske B, Delbanco T, Walker J. Online Therapy: Security, Ethics, and Legal Issues. Insurance companies may provide their policyholders discounted medical treatment by entering into agreements with doctors' offices and hospitals. Ensure compliance by their workforce. Disclosing this information would prolong his or her life, but it might also prolong suffering. Cons: A single-payer system can be more costly, as it allows doctors and health care facilities to negotiate the terms of their contracts. Pros and Cons In fact, quite a lot of personal information is not protected at all. With appropriate safeguards, EHRs may offer more security than traditional paper-record systems. An EHR makes it much easier for a medical practice to track a charge for each procedure performed. In the next section, we will look at the circumstances under which confidentiality may be broken. A variety of organizational structures. The Pros and Cons of Online Therapy - Verywell Mind 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. Read terms, Number 803 (Replaces Committee Opinion Number 599, May 2014). The other advantage for concealing health information to the service provider may end up being detrimental to the patient. Pros: A single-payer system offers individuals greater control over their healthcare, providing the ability to choose their doctors based on approach or reputation. 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. American College of Obstetricians and Gynecologists. Forgone health care among U.S. adolescents: associations between risk characteristics and confidentiality concern. Hagan JF, Shaw JS, Duncan PM. Sharing Patient Information: Pros, Cons and Implications Advantages & Disadvantages of an EHR OpenNotes. The bottom line is that not all information, even medical information, is automatically granted legal protection from disclosure: only information that is particularly sensitive is protected (and even sensitive information may be disclosed under certain circumstances). Offering clinician note feedback. The use of telehealth continues to grow, reaching multiple medical specialties and providing care to a greater population of patients. Don't use plagiarized sources. Providing alone time, apart from a parent or guardian, for discussion between the adolescent patient and health care provider is an important aspect of the health care visit 5. BMJ Open 2016;6:e010034. Those who have good insurance After her murder, the family sued, claiming that the physician should have warned the victim. There are numerous reasons for ensuring that there is protection of the privacy, security, and confidentiality of the health information. Confidentiality in Adolescent Health Care | ACOG Whether or not to disclose personal medical information is often said to be a balancing act between the benefits of keeping confidentiality and the benefits of waiving it. The pros and cons of TriTerm Medical insurance The staff is always available to discuss health problems or answer questions. 4th ed. Given these parameters, duty to warn cases are not without controversy, and some people believe that they place the physician in the undesirable role of law enforcer, rather than healer. Statutes and regulations regarding medical record information should be updated to ensure this standard is achieved. Breaking Confidentiality in Clients with WebWhat is more, it suggests that breaches of confidentiality should be restricted to the circumstances under which there is sufficient evidence that the clients or other persons safety is in danger or the health, safety or welfare of children or vulnerable adults is (Health care providers should be cognizant of potential coercion by parent or guardian to maintain access.). When going for the socialized medicine, an individual is required to give his or her personal health records. 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. This essay examines the pros and cons of the confidentiality, safety, rights, and the security of patients in an era of increased socialized medicine. There is little to no control over income distribution. Ethical Dilemmas: Breaking Confidentiality These are the kinds of questions that are important to consider, and difficult to answer using legal theories of confidentiality. Security measures and enhanced EHR standards should be adopted at the systems level to prevent breaches of patient confidentiality. If, however, you plan to take detailed actions based on There should be private conversation time between the health care provider and adolescent patient. Lehrer JA, Pantell R, Tebb K, Shafer MA. J Adolesc Health 2007;40:21826. However, there may be substantial cost to these safeguards, and constant reevaluation of protection is imperative. But genetic information does have implications for the health of blood relatives. Adolescents face considerable potential harms to their health from mental health disorders, interpersonal violence, substance use, and unprotected sexual activity. 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. Journal of the American Academy of Psychiatry and the Law Online, 39(4), 571-578. It has increased paper work for health care professionals (Livestrong, 2015). Marcell AV, Burstein GR. Identify and protect against reasonably anticipated threats to the security or integrity of the information. 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. Ford C, English A, Sigman G. Confidential health care for adolescents: position paper for the Society for Adolescent Medicine. 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. Cons: Physicians have less autonomy and less continuity with patients. 803. The network of participating doctors and hospitals. Committee Opinion No. Confidentiality extends beyond reproductive health for minors. In Tarasoff, a patient informed his therapist of his intention to kill a young woman. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. The ACOG policies can be found on acog.org. The Cons of Patients Confidentiality, Security, Rights, and Privacy During this Era of Socialized Medicine My first patient living with HIV came to me when I was a new nurse in a Chicago hospital. However, the obstetriciangynecologist should exercise extreme caution when using a personal patient email address to relay medical information because email servers may not be secure 6. Ensure the confidentiality, integrity, and availability of all e-PHI they create, receive, maintain or transmit. Because It Works, Nature Documentaries Could Help Save the Planet, Use of this site is your Agreement to the Terms. American College of Obstetricians and Gynecologists 409 12th Street SW, Washington, DC 20024-2188. 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. 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. Obstetriciangynecologists should work with their health care organizations to be able to provide confidential billing. Available at: Promoting healthy relationships in adolescents. Any concerns the patient has regarding the presence of a chaperone should be elicited and addressed if feasible. WebHere are some Pros and Cons of personal health records: Pros: Correction of medical errors within the medical record was possible Patients had a broader knowledge base of their health concerns and decreased utilization of healthcare services Opportunities were provided for increased effective communication between patients and physicians Web2 Pros and Cons of Managed Care in America Introduction I. Technology Improving Healthcare in Hospitals: 4. Conclusion 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. This can actually slow their recovery. Confidentiality in child and adolescent Shared decision making between patient, parent or guardian, and health care provider, when possible, is the goal in order to optimize the adolescents medical care 13. Employed physician in academic institution. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. An Electronic Health Record, or EHR, is a resource growing more widely used in hospitals, clinics, and healthcare practices across the country.Rather than relying on paper-based documents, more healthcare professionals are transitioning to rely on digital collection of patient information in a format that can be stored of hard storage and The problem is that personal information (which is whats at stake with medical confidentiality) is not protected at law in the same way ones home or bodily integrity is protected. Implementation toolkit. Improving patient Breaching an individuals confidentiality and privacy do not only affect an individuals dignity, and might as well cause harm (Gostin, Levit & Nass, 2009). 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. The most obvious benefit of utilizing AI technology is its ability to improve patient experiences. Centers for Disease Control and Prevention Parents are often too quick to give medications to lower a fever and make a child more comfortable. Guttmacher Institute. Any concern for a HIPAA violation should be addressed by individual health care systems. 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. Therefore, it is important to develop "front-end" safeguards that prevent unauthorized breaches from occurring. Other states have consent laws that include substance misuse treatment, pregnancy prevention and care, and, sometimes, abortion services, mental health care, and emergency care. WebCharge capture refers to tracking each charge to a patient for medical services given. Its value also sabotages any effort to solve financing problems. ABSTRACT: 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. 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. 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. In the latter situation, the laws usually provide protections against liability for disclosure. They also should find out what is viewable in their institutions EHR system, such as what is visible in the after-visit summary. Con: Healthcare data security concerns Patient portals, generally speaking, are a health IT interface on which patients can view their own protected health information (PHI). As part of comprehensive health care, it is our practice to ask parents to wait outside for part of the interview and to encourage the adolescents to discuss their own interests and concerns. American College of Obstetricians and Gynecologists All states and the District of Columbia allow minors to consent to sexually transmitted infection (STI) testing and treatment without parental permission 14. The minor can consent to medical, dental, or psychiatric care. Obstetriciangynecologists and other health care providers should be active in educating their staff and patients regarding the confidentiality of services. Duty to warn cases focus on (1) the seriousness of the threat of harm and (2) the identifiability of the victim (whether there is a specific individual at risk). There if an individuals privacy is not protected or guaranteed, people find it hard to give complete and candid information about their health even to their own personal physicians leave alone to the insurer. Pros of the Confidentiality, Safety, Rights, and the Security of Patients in an Era of Increased Socialized Medicine 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. Cons: Physicians have less autonomy and less continuity with patients. 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. The Importance of Supplemental Disability Insurance. Please try reloading page. It provides a safe space to ask questions: Talking to adolescents one-on-one also gives adolescents a chance to ask questions or give information they may feel self-conscious about. She had been admitted with HIV-related complications from pneumonia. An EHR makes it much easier for a medical practice to track a charge for each procedure performed. WebProponents of the right to health care say that no one in one of the richest nations on earth should go without health care. It is unclear how this issue affects confidentiality, and, many states have been hesitant to extend such a duty to health professionals. First, we want to make sure that adolescent patients have access to health care to make sure that they are healthy and safe. 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. WebCharge capture refers to tracking each charge to a patient for medical services given. Potential for disclosure of laboratory results, prescriptions, and diagnoses may occur with itemized explanation of benefits statements. Universal health care may encourage entrepreneurship. As a last resort, the health care provider should consider referral if confidential care cannot be provided. WebConfidentiality. State confidentiality protections vary widely. Committee on Adolescence, Council on Clinical and Information Technology. These registries are usually kept confidential, and in many cases the information is kept separately from any individually identifying information. Mature minor: An adolescent younger than the age of majority who, even if living at home as a dependent, demonstrates the cognitive maturity to give informed consent. Pros And Cons Many Definitions of Patient Confidentiality, When You Cannot Expect Medical Information to Remain Confidential. 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. Cloudy confidentiality: clinical and legal implications of cloud computing in health care. In the event that an individuals personal health information is disclosed for example to the insurer, family members, or family members; this may lead to stigma, discrimination, and also embarrassment. 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. Measures to ensure protection will vary based on the EHR system capabilities and institution-specific policies. HIPAA are essential to review periodically to understand your rights as a patient under this legislation. A number of states have adopted this principle, and some have extended it to all physicians or mental health professionals. Big data definitely 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. Protect against reasonably anticipated, impermissible uses or disclosures. Any potential conflicts have been considered and managed in accordance with ACOGs Conflict of Interest Disclosure Policy. Employed physician in academic institution. Any updates to this document can be found on acog.org or by calling the ACOG Resource Center. WebHere are some pros and cons to think through before you discuss your HIV status. Published online on March 26, 2020.Copyright 2020 by the American College of Obstetricians and Gynecologists. New England Journal of Medicine, 361(21), e46. Another problem, however, is what to do regarding the patient who has discovered a breach of confidentiality. The first is how to define confidentiality, since there are many different types, with different objectives at heart. 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. Fidelity-based confidentiality suggests that physicians have an obligation not to disclosure information shared with them in their medical role. Special requirements for electronic medical records in adolescent medicine. Sexual misconduct. Patients should be informed that there are laws protecting their confidentiality in the health care setting. Pros and Cons In as much as it is the right of the patient to keep his or her health information private, it is prudential for the person to consider that this would interfere with his or her health (Ventola, 2014). Electronic Health Records of Patients in Hospitals: 2.
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