Health Technology, Digital Healthcare
Article | July 14, 2023
Discover the potential of EHR implementation in revolutionizing clinical processes. Uncover strategies for addressing EHR ethical issues, ensuring integration that prioritizes patient-centered care.
Amidst the fusion of healthcare and technology, integrating electronic health records (EHRs) has emerged as a transformative element in modern medical practice. As a digital repository for a patient's medical journey, EHRs present unprecedented prospects for elevated care quality, improved data accessibility, and cost-effectiveness. Nevertheless, these advancements bring forth an array of EHR ethical issues that demand meticulous attention. In this context, establishing and adhering to the best practices for the ethical training of EHRs assumes paramount importance and a moral obligation. By skillfully navigating the intricate convergence of technology, patient confidentiality, and conscientious healthcare, these ethical EHR best practices illuminate the path toward a future where innovation and ethical principles harmoniously coexist.
1. Upholding Privacy and Confidentiality
Revealing a patient's information to external parties should strictly happen with the patient's explicit consent or within the parameters defined by legal regulations. Data stemming from clinical interactions is confidential and requires rigorous protection. The effective operation of EHRs requires authorized access by healthcare institutions, insurers, and related entities. Access by users is contingent upon predefined role-based privileges. The administrator identifies users, specifies the extent of information accessibility, and allocates exclusive usernames and passwords. Users must be conscientious about responsibly utilizing the information they access within their designated roles. Therefore, assigning user privileges plays a pivotal role in securing medical records. However, while regulating data access remains crucial, it doesn’t completely ensure confidentiality. Strengthening security through comprehensive privacy and security protocols remains essential for reinforcing patient data's inviolabilit.
2. Safeguarding Against Data Breaches
Ensuring patient privacy and safeguarding sensitive medical data is paramount in EHR ethical training. The imperatives of inadequate data security, encompassing compromised medical information, unauthorized access due to weak password safeguards, and the lack of encryption, accentuate the immediate need for a holistic approach. Employing strategies such as secure cloud storage, robust password protocols, two-factor authentication, and encryption is pivotal in enhancing data security, preventing the mishandling of patient records, and abiding by ethical standards. The potential legal and financial consequences of breaches underscore the criticality of these practices in maintaining patient trust and confidentiality within the digital healthcare domain.
3. EHR System Implementation
The integration of EHRs within healthcare organizations poses significant challenges, including resource waste, provider dissatisfaction, diminished patient trust, and potential safety risks. Successful EHR development, implementation, and upkeep demand substantial investment and collaboration among stakeholders, including clinicians, IT experts, educators, and consultants. Clinicians' active engagement is often underestimated, leading to the failure of EHR projects; therefore, clinician-led guidance is crucial in tasks such as EHR selection, workflow design, and quality improvement. Thoroughly mapping workflows before selecting an EHR is crucial, while maintaining user-friendly interfaces remains essential for success. Neglecting these aspects can reduce efficiency, compromise care, and increase safety threats. By prioritizing comprehensive planning, engaging clinicians, and optimizing user interfaces, healthcare institutions can ensure ethical and efficient EHR integration, ultimately enhancing patient care and safety.
4. Maintaining Data Accuracy
Upholding data accuracy stands as a fundamental principle in the ethical EHR domain. The integrity of information guarantees its unaltered and precise nature, contributing significantly to the enhancement of patient safety, reduction of healthcare errors, mitigation of health disparities, and betterment of public health. Nevertheless, concerns have been voiced regarding the reliability of data input into electronic records. The improper utilization of functionalities such as 'cut and paste' can lead to misleading portrayals of a patient's condition and treatment, breaching ethical standards. This practice poses elevated risks to patients and increases the liability of clinicians and institutions. Challenges also arise from drop-down menus that limit a clinician's choices, potentially giving rise to substantial errors, especially under time constraints. The collaborative efforts of clinicians and vendors can address software concerns, promoting user-friendly, reliable EHRs while tackling EHR ethical issues. Furthermore, data loss during transfers raises pertinent concerns about the accuracy of the database, a critical aspect as patient care decisions hinge on this data.
5. Guaranteeing Data Authenticity
The assurance of documentation integrity pertains to the accurate and precise nature of the comprehensive health record. This includes principles of information governance, identifying patients, validating authorship, handling amendments and corrections in records, and auditing documentation validity while submitting reimbursement claims. EHR tools offer flexible documentation options through the utilization of templates and smart phrases, assisting in precise record-keeping. However, if these tools are misused, doubts about data integrity can arise, making information unreliable and possibly raising concerns about fraudulent activity. Established policies and procedures, including audit functions, must be in place to ensure proper billing. With adequate safeguards, records may accurately represent the patient's condition at admission and over time. Providers must understand the importance of reviewing and refining default data to ensure that only patient-specific information for that visit is recorded. In contrast, irrelevant data from default templates is removed.
6. Validating Dictation to Prevent Errors
Voice recognition systems lacking a validation step pose considerable challenges in maintaining data accuracy and preventing documentation errors within organizations, particularly when it comes to ethical issues with electronic health records. EHR companies need to implement a protocol requiring providers to promptly assess, modify, and validate dictated information. Given these documents' frequent use and sharing, precise and high-quality documentation in EHR systems is of utmost significance. The adoption of EHRs has led to substantial shifts in provider workflows and documentation processes. However, providers still need to clearly outline or fully understand comprehensive best practices for maintaining high-quality documentation in EHRs. Advancements are necessary to enhance documentation tools and methods, with a renewed emphasis on the essential aspects of data accuracy and quality. This should precede the widespread implementation of interoperable health information exchange initiatives.
7. Ensuring Accurate Documentation
Maintaining the integrity of documentation is compromised when incorrect information finds its way onto the wrong patient's health record. Patient identification errors can influence clinical decisions, endanger patient safety, violate privacy and security, and lead to redundant testing and escalated expenses for patients as well as providers. The propagation of patient identification mistakes can rapidly expand within EHR, personal health records, and Health Information Exchange (HIE) networks as information disseminates. Failing to implement advanced front-end solutions that incorporate robust matching algorithms or innovative techniques like biometrics or fingerprinting can expose organizations to risk. EHRs can incorporate targeted alerts to anticipate safety problems, like blood type inconsistencies or allergies, during treatment, addressing EHR issues. Organizations must institute a patient identity integrity program, integrating performance improvement metrics to monitor error rates and duplicate records in their electronic master patient index. Policies and procedures must ensure the accuracy of critical demographic data, facilitating the linkage of records within and across systems. Addressing the initial point of data capture as a primary front-end verification is also vital within policies.
8. Preserving the Authenticity of Audit Trails
Effective audits are crucial to ensuring that the health record documentation aligns with the reported level of service, fulfills reimbursement requirements set by payers, and guarantees that only authorized personnel access patient medical records and make entries. The audit trail must encompass the user's name, the triggering application, workstation details, the specific document, a description of the audited event (such as amendments, corrections, or deletions), and the timestamp. This audit trail outlines modifications (including deletions) within the health record and provides auditors with a foundation for compliance audits. Inadequate audit trail functionality within EHRs raises concerns about the integrity of health record documentation, potentially exposing organizations to legal liabilities and inadvertently fostering or shielding criminal activities. It may become challenging to ascertain if corrections or amendments were executed, who authorized the changes, or the nature of the modifications. In addition to the inherent unintentional errors that documentation might encounter, audit trail functionality can aid in detecting instances where records are altered to obstruct the disclosure of detrimental information. Organizations can utilize EHR trends to leverage audit trail features for identifying and analyzing patterns in health record usage. Typically, users can generate reports over specific time frames categorized by provider or provider type, with results directed to a compliance committee or the organization's governing body.
9. Fostering Compliance Awareness
Enhancing ethical EHR training involves a strategic focus on ensuring providers are well-versed in compliance and legal risks, starting from the EHR training phase. To address EHR problems, organizations should implement educational initiatives aimed at mitigating compliance issues. Staff education must emphasize the integrity of health record documentation, with a continuous program monitored and provided quarterly or annually. Addressing the 'who, what, why, and how' ensures a solid grasp of organizational practices that uphold individual best practices, encompassing identifying potential fraud, universal and administrative security measures, data validity, authorship, continual education's significance, and strategies for daily fraud prevention.
10. Conducting Feedback Sessions
Contrary to common assumptions, ongoing training is essential post-EHR implementation. After installing the EHR and initiating patient interactions, challenges inevitably emerge—be it staff unfamiliarity with functions or the need to revamp workflow processes. Promptly identifying these concerns to prevent errors and swiftly resolving them involves collecting feedback from EHR users among the staff, particularly in relation to EHR ethical issues. During the weeks after the system's launch, contemplate arranging routine meetings to gather insights. Ensuring diverse representation, including clinical staff, physicians, administrators, billing, and front desk personnel, is crucial. Seek input on their adaptation to changes and areas requiring improvement. Determine if specific training concepts need reinforcement. Surveys can be used in place of frequent meetings. Subsequently, prioritizing problem areas aids focused resolution by promptly addressing critical matters. The introduction of incremental changes helps staff adapt to the EHR seamlessly, safeguarding patient care continuity during the transition.
The Path Ahead
Following these ethical EHR training best practices ensures the accuracy and reliability of patient data, leading to improved clinical decision-making and patient safety. By maintaining documentation integrity, professionals can confidently provide quality care and reduce the risk of errors. Ethical EHR training further strengthens compliance with legal regulations, safeguarding both the organization as well as the healthcare provider from potential legal liabilities. Moreover, adhering to best practices promotes efficient workflows, enhancing productivity, and streamlining operations. Patient trust and confidence are strengthened as professionals demonstrate their commitment to data security, confidentiality, and ethical conduct. Ultimately, by upholding ethical EHR training standards, professionals contribute to a robust healthcare system by fostering positive patient outcomes, maintaining trust, and supporting the principles of ethical healthcare delivery.
Read More
Health Technology, Digital Healthcare
Article | August 16, 2023
Global efforts to tackle gender inequality have grown in recent years. But there is still so much to be done. Figures from the United Nations show that outcomes for women and girls continue to lag across a range of issues, including poverty, education, work and health. And according to the World Economic Forum, at the current rate, it will take 108 years to close the gender gap.
Although healthcare is founded in objectivity and science, gender bias is still remarkably common. We wanted to understand more about female perceptions of healthcare, so we undertook consumer research that delved into the experiences of women compared to men. The results pointed to a clear disparity, finding that women are less likely to visit the doctor when they have symptoms of ill health and, in some cases, are taken less seriously when they do seek medical advice.
Women being left behind
According to our research, a significant proportion of British women feel disappointed in the healthcare they receive, with one in five reporting they weren’t taken seriously when presenting symptoms to a healthcare provider. What’s more, a staggering one in four said they are reluctant to seek medical advice at all for fear of wasting a GP’s time. These statistics suggest that, not only are female experiences of healthcare damaging their relationship with clinicians, but they could be eroding confidence in recognising and acting on warning signs and symptoms too.
This sentiment is particularly evident when focusing on cardiac care. One in eight women (13%) feel ignored when presenting symptoms of heart disease to healthcare professionals, compared to just 4% of men. And of UK adults who have received a coronary heart disease (CHD) diagnosis, women experiencing symptoms were 55% more likely than men to visit the doctor multiple times before receiving a referral for further investigation. On top of this, women are five times more likely to receive a false finding from the cardiac stress tests that are traditionally used to assess heart health.
“There does appear to be a gender bias in onward referral to secondary care and for diagnostics in the local area, which is influenced by the attending healthcare professionals’ risk assessment. Traditional teaching has led to gender bias, as we are programmed to attribute a lower level of pre-test probability and risk to females. This may have contributed to a general lack of awareness around cardiovascular health in women. For example, in a survey I carried out among more than 600 female employees working within North West Anglia NHS Foundation Trust, 82% said they didn’t feel informed about their cardiovascular health. Considering participants included some of the most medically informed women in the UK, the results speak volumes about how we view cardiac health among women.”
- Dr Rebecca Schofield, consultant cardiologist at North West Anglia NHS Foundation Trust
These widespread misconceptions around heart disease and heart attacks are often exacerbated by what we see in the media – think of the countless TV stereotypes of male characters clutching their chests and falling to the floor.
But given that CHD is responsible for one in 13 female deaths, it appears that public health efforts have failed to make people aware of the risks for women. It is, perhaps, not surprising then that 42% of women with CHD did not immediately recognise their symptoms as signs of heart disease. In short, women are missing out on time-critical diagnoses and treatment due to a lack of awareness and education among both healthcare providers and the public.
Technologies making a difference
Thankfully, progress is being made to improve healthcare outcomes for women. Innovative technologies are increasingly providing diagnostic solutions that can reduce incidences of human bias and give clinicians greater clarity on the presence or severity of different conditions in their female patients.
For example, AI is already being used to detect diseases such as cancer more accurately. Its adoption is facilitating reviews and translations of mammograms 30 times faster, with 99% accuracy, reducing the need for unnecessary biopsies.
There’s extraordinary potential for AI and healthcare, and it’s something the NHS continues to recognise, most recently with the launch of its Artificial Intelligence Laboratory (AI Lab) and NHS England’s (NHSE) MedTech Funding Mandate. The latter aims to accelerate the uptake of selected innovative medical devices, diagnostics, and digital products to patients.
As part of the NHS efforts, NHSE has mandated the HeartFlow Analysis for use in hospitals across England for patients, male or female, who might otherwise be sent for a cardiac stress test. The HeartFlow Analysis is a gender-neutral technology that takes data from a coronary CT scan of the heart and leverages deep learning (a form of AI) and highly trained analysts to create a personalised, digital 3D model of each patient’s coronary arteries. This then helps clinicians to quickly diagnose CHD and decide the appropriate treatment for patients of any gender. Time spent in hospital is minimised for patients and often layered testing and unnecessary invasive diagnostic procedures can be avoided.
Final thoughts
While AI is helping us tackle gender bias in certain areas such as oncologic and cardiac testing, healthcare professionals are not absolved of responsibility when it comes to confronting this problem. It remains incumbent upon clinicians to recognise unconscious bias that would deter them from referring women or minority patients for much-needed testing.
Outside of the hospital, public health education efforts must expand so that far more of us can recognise shortness of breath, nausea, vomiting, back or jaw pain, and other symptoms beyond chest pain to be indicators of a heart attack in a woman. Knowing what to look for and overcoming personal bias that might lead to these signs being disregarded, may allow us to help one of the more than 100 women who will experience a heart attack in the UK today.
Read More
Health Technology, AI
Article | July 18, 2023
The medical field has undergone a significant amount of change during the past few years, and it’s clear that healthcare consumers are seeking digital experiences. Meeting this need by providing virtual care options can not only remove barriers to quality healthcare but also reduce stress on the healthcare system.
At the same time, how can medical providers offer digital care options, and how can doing so drive revenue growth?
Allow online scheduling to increase appointment volume
If you have ever spent hours on hold, you know how frustrating it can be. In the same way, if patients are left on hold for too long, they will most likely disconnect before a member of the team can assist them. This is why it’s crucial to allow patients to schedule their care online. Patients expect to attend medical appointments at a time that is convenient for them, which means they want to schedule those appointments at a time that is convenient for them as well. They do not want to spend time waiting on hold, only for someone on the other end of the phone to offer them appointments that do not work for them.
The solution would be for medical providers to invest in a digital phone solution that can maintain a virtual waiting room. These virtual waiting rooms allow patients to maintain their place in line, such as receiving a callback, making it easier for them to schedule appointments. Of course, an online booking option can be helpful as well. Most patients want to schedule their appointments when they are not at work, and an online booking option allows them to do so regardless of their business hours.
Don’t forget to consider the type of booking software you use as well. If you select booking software that will automatically sync with your scheduling system in the office, you can take a significant amount of stress off your front office staff.
Digital communication options are crucial
Tebra’s recent Patient Perspectives report indicates that the majority of patients (55%) want to be able to reach their medical providers quickly to get answers to their questions, even when they do not have an appointment scheduled. If you have two-way messaging software, you can streamline the flow between your patients and providers, which may reduce the number of appointments your patients need to book.
For example, patients can ask for prescription refills, run specific numbers by their medical providers, and get quick answers to questions about symptoms they might be experiencing. Not only does this support patients and nurture their loyalty, but it also alleviates unnecessary appointments from inundating providers’ schedules.
Take advantage of telehealth for additional revenue
Before the start of the COVID-19 pandemic, very few patients took advantage of telehealth. Now, nearly a quarter (about 25%) of all patients indicate that they have used telehealth during the past year, and many patients prefer this option.
The reality is that telehealth can remove barriers that would otherwise make it hard for patients to access care. They don't have to worry about taking time off work, arranging for child care, or driving a long distance to meet with a doctor.
While telehealth will never fully replace in-person visits, it can be an excellent option for cold and flu symptoms, mental health issues, and routine check-ins. By offering telehealth to your patients, you can make it much easier for them to access the care they need.
Modernize your revenue channels by taking advantage of digital healthcare
It’s obvious that the medical world is changing quickly, and digital aspects of care are here to stay. To ensure your practice can adequately meet your patients’ needs, take full advantage of everything in this article and ensure you have reliable digital care options. You can develop multiple revenue streams for your medical practice or system while maintaining high patient satisfaction rates and without adding to your workload.
Read More
Health Technology
Article | July 5, 2023
Your patients have grown to trust your expertise and recommendations in matters regarding their healthcare. As the sector transitions into a more digital playing field, uninterrupted network connectivity is more than just a bonus; it’s a necessity.
While there are many different challenges to completely integrating your practice into the digital world, internet outages are the costliest. Downtime can be caused by various factors, which can compromise patient safety, the faith your team instills in you, and your practice’s reputation and revenue. However, investing in the means to maintain a resilient network lets you maximize your network uptime to optimize resources.
We'll look at four different strategies and their benefits for your infrastructure so you can focus on what you do best: providing healthcare excellence to your patients.
Strengthening Network Infrastructure
The traditional way of doing things may be great for your remedies and techniques. Still, with a growing number of patients and their contextually relevant demands, your network needs to be able to accommodate many different booking requests, increase user activity on your server, and store sensitive patient information.
High-speed internet connections enhance your network performance and let you, your team, and your patients make the most of your uninterrupted uptime. Fiber-optic networks, when combined with load balancing and proper segmentation, can diffuse and direct network traffic efficiency and prevent congestion, which prevents downtime due to overload.
Implementing Network Monitoring and Management Tools
Much like your patients visit your practice to ensure everything is all right with the current state of their health, your network must also receive the same treatment. Identifying and pre-emptively resolving potential issues and vulnerabilities will prevent much more destructive or expensive problems from occurring.
Use real-time tools to monitor your bandwidth usage and gain visibility of potential bottlenecks. Tools that offer risk monitoring deliver alerts about critical events that pose a threat to your business continuity. Your IT team will be better equipped to troubleshoot issues promptly and optimize performance.
Conducting Regular Network Assessments and Audits
Once you have the proper monitoring tools to manage your network topology better, proactive troubleshooting is a great way to spot-check whether your current solution is working as it should. A network audit is much like proactive troubleshooting; you are looking to see if anything could harm the overall system and catch it before it can develop.
When auditing a network, the primary focus should be security measures. If patient and confidential data is not secure, the smooth operations of your business are the least of your worries. When conducting an audit, consulting with a network service provider will help identify issues with your protocols, data encryption, and firewall configuration.
Establishing Redundancy and Disaster Recovery Plans
Backing up private and confidential data is crucial to ensuring that sensitive information is not lost or exposed. Minimizing network downtime can often be achieved by having backup systems that will keep running in the event of an attack or outage. For example, a dedicated Cloud Access Network, power supplies, and switches will go a long way.
When creating an internet contingency plan, outline steps and protocols with your team that you will take in the event of a complete failure, including things such as brand reputation management, customer service, and data loss prevention.
Looking Forward
As the lines between in-person and digital are blurred, navigating the complexities of implementing a robust network is paramount to your business.
Strengthening your infrastructure, integrating redundant systems, and conducting regular audits and assessments with the proper monitoring and management tools will help you maximize uptime usage and minimize network downtime.
Although overwhelming, working with a reputable network service provider can help you embrace your network topology to remain competitive.
Read More