Discussion 3

1st page- Cover page

2nd page- Abstract (include what is the purpose of this project) 

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3rd page- Answering the following questions:

Health information is data related to medical history.Health information records include history, lab results, diagnostic information, and notes. It creates data sets that are used for individuals and populations.

Questions:

  1. 1. When thinking about Health Care information and HIT, autonomy is often an ethical issue. What concerns would patients have about their privacy with electronic health records.
  2. 2. How is beneficence and non-maleficence violated with ransomware?

4th page- References

Chapter Seven

1

Operational Definitions
Health information is data related to medical history.
Health information records include history, lab results, diagnostic information, and notes.
It creates data sets that are used for individuals and populations.

Operational Definitions
Health information management (H IM) includes obtaining, using, and protecting both digital and traditional patient information.
Professionals in each IM manage patient records.
They also are part of quality measurement including accreditation.

Operational Definitions
Health information technology (HIT) assists the exchange of health information through electronic systems.
HIT is used extensively in health care.
Privacy and security are important. HIT issues.

Operational Definitions
WHO defines the functions of HIT as data generation, compilation, analysis, synthesis, and communication.

Introduction
Health care is making progress in addressing DV.
Guidelines for treatment now exist.
Initiatives include awareness, guidelines, and strategies for response.
The ACA requires screening and counseling.

Introduction
Practitioners need to increase their awareness of diagnoses concerning DV.
They also must confront their own feelings and beliefs about domestic violence and its victims.

Ethical Dilemmas
Protection of privacy is a major ethical dilemma in HIM.
Access to medical records must balance privacy and equity.
Violation of privacy personal gain is a serious concern for health care.

Ethical Dilemmas
Conspiracy to commit PHI fraud for personal gain is both a legal and ethical issue.
These crimes harm individuals, organizations, and taxpayers.

Ethical Dilemmas
Failures to communicate about computers and their appropriate, use exists across generations.
Computers enable people to assume a different personality.
Computers also let people disregard their ethics foundations.

Ethical Dilemmas
Ethics professional societies encourage the development and use of codes of ethics.
However, those without a moral compass forget about ethics in their eat actions.
Individuals make decisions about their conduct in the cyber community.

Ethical Dilemmas
Examples of theft can also relate to the ethics and the Internet.
Ransomware is a type of computer software (malware) that infects computers, servers, and systems.
Ransomware makes files unreadable.

Ethical Dilemmas
Cyber attackers use extortion to receive a ransom for returning access to information.
Computer should not be in an environment for criminal attack.
Protection of information systems requires action including making it difficult for hackers to have access.

Smart Phone Networks
Smart phones collect and store large amounts of personal data.
From an ethics view, users agreed to this collection of data through apps.
The U.S. government does not vet health applications.
Many issues exist for the protection of privacy and health apps.

Ethics Decision-Making Models
The “3 rules of thumb” model is a foundation for decision-making.
Weber suggests that individual rights should be a priority.
The next consideration should be the good of the community and its interests.

Ethics Decision-Making Models
The Weber model than considers the good of the organization and its interests.
Lastly, individual good, and interests should be considered.
The Weber model helps to establish priorities in ethics decision-making.

Ethics Decision-Making Models
The “grandmother test” is also useful as a guide. Can you tell your grandmother about your decision?
Would she approve of this decision?
Decision-making models need to be part of education and healthcare organization ethics resources.

In Summary…

19

Chapter Eight

Technological Advances in Health Care: Blessing or Ethics Nightmare?

1

2

Medical and Health Information Technology
Medical technology involves products, equipment, and processes that help to make diagnoses.
Health information technology (HIT) includes computer hardware, software, and databases that assist the providers in giving quality care.
3

Medical and Health Information Technology
HIT can include the electronic medical record (EHR).
It can also include support systems like physician order entry (CPOE) and clinical decision-support systems (CDSS).
4

Ethics Obligations
The healthcare field is becoming more dependent on technology.
Innovation in technology requires due diligence.
Patient safety and effectiveness are being considered.
Attention needs to be paid to overall benefits.
5

Ethical Issues in Research
Technology research allows for a disassociation between the researcher and the research.
The lack of focus on the bigger picture can cause ethics violations that have major impact.
History demonstrates this issue.
6

Unethical Medical Research
Evaluation of research studies needs to consider the right to autonomy.
Autonomy is demonstrated by informed consent.
Informed consent includes competence, voluntariness, disclosure, and authorization.
7

Research Studies and Ethics
Tuskegee Syphilis Study (1932-1972)
This study failed to meet the criteria for true informed consent.
There was manipulation of subjects by researchers.
The researchers took advantage of a disadvantaged population, but they thought they were being ethical.
8

Research Studies and Ethics
The Willowbrook Study (1963-1966)
This study used children who had various mental disabilities for testing the progression of hepatitis virus.
The researchers assumed that these subjects were competent.
Researchers in this study took advantage of a vulnerable population.

9

Research Studies and Ethics
Researchers can become so absorbed in the study that they fail to see the ethical implications.
Susan Reverby uncovered another example of this issue in the USPHS funded syphilis study in Guatemala.
Findings like this call for an ethics review and a third-party evaluation of research studies.
10

Recent Innovations
There are many innovations that involve technology that pose ethics concerns.
One example is synthetic biology.
Researchers can create non-genetic raw materials to substitute for genetic material.
11

Recent Innovations
Synthetic biology shows both promise and concern.
Ethics questions include concerns about usage and controls.
The Presidential Commission for the Study of Bioethical Issues was formed to study ethics principles as they relate to this field.
12

Ethics Principles
Public beneficence looks at gains or losses for the public populations affected by the new research.
Responsible stewardship asks researchers to consider those who cannot represent themselves in future studies and in the use of products of the studies.
13

Ethics Principles
Freedom of intellectual efforts balances total freedom for study with stopping research. It asks for ongoing accountability.
Justice and fairness asks researchers to not subject individual, groups, or communities to risks in an unfair manner.
14

Computer –Assisted Robotic Surgery
This area combines the use of computer imagery and robotic equipment to assist in surgical interventions.
It includes stereotatic radiosurgery, computer-aided maxillofacial surgery, and robotic-assisted visceral surgery.
15

Computer –Assisted Robotic Surgery
Ethics issues include the lack of resources for all facilities to have this level of technology, thereby affecting population beneficence.
In addition, the costs of the investment must be recovered and that cost is passed on to the patient.
Only patients with funds can benefit.
16

Magnetic Resonance Imaging
MRI now have increased field strength (signals).
MRI strengths may reach 7-9.4T; resulting in enhanced image quality.
Ethical issues arise with the increase in costs versus the overall increased patient benefit.
17

17

Magnetic Resonance Imaging
Marketing makes an investment in higher “T” for MRI machines.
Deontology is often used as an argument for purchasing the higher “T” machines.
However, the higher “T” machine can also generate lower “T” images.
18

Magnetic Resonance Imaging
Consideration is being given for reimbursement for MRIs by signal strength.
This action can increase ethics temptation to upcode.
There is also a temptation to order more 1.5T images on 3T machines.
19

IBM Watson an Cognitive Health Care
IBM Watson is a supercomputer that can change healthcare decision making.
There are ethics concerns including the replacement of physicians.
Autonomy issues need to be considered.
20

HIT and Medical Group Practice
HIT is expanding rapidly and there is a rush toward implementation.
The HITECH is an attempt to ensure adoption of the EHR.
Meaningful use is required including proof of application and certification.
21

HIT and Medical Group Practice
An ethical concern about beneficence can be found when looking at the need for speedy implementation of the EHR.
The quality of care for patients should be of concern regardless of the form of documentation. There is a moral obligation to act in their benefit.
22

HIT and Medical Group Practice
Providers may choose to opt-out of the incentive program for EHR adoption.
This decision may be based on excessive capital expense, costs of training, and other concerns.
Patient quality concerns are issues with this decision (nonmaleficence).
23

IT and Privacy
The benefits of the EHR can also be liabilities.
Patients are concerned that their medical records are not confidential.
HIPPA violations have occurred.
Security continues to be an issue in protecting patient information.
24

IT and Privacy
Ethics issues include the protection of confidentiality.
In addition, training needs to be ongoing.
Organizations have a fiduciary obligation to protect security.
25

Keeping Up with Regulations
Medical group practices also have increasing and changing funding issues and regulations.
There is a need to stay current with MACRA and other reimbursement changes.
Autonomy of medical providers and nonmaleficience are ethics issues.
26

In Summary…
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