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Medical ethics and confidentiality computers

1. Should corrections be date- and time- stamped?

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Yes, corrections of medical information of a patient should be date- and time-stamped; It is important that entry of medical information of a patient, which is supposed to be confidential should be done by an authorized personnel and the personnel who does the correction should also be identified. These recordings would maintain the validity of the information provided, and ease access to further details and personnel responsibility.

This particular procedure prevents denial of information, and is a good evidence for medico-legal cases when patient information is indiscriminately disclosed to a third party.

2. When should the patient be advised of the existence of computerized databases containing medical information about the patient?

Both patient and physician should be advised of the presence of computerized data base containing the confidential information of the patient; the patient should be informed of the personnel in charge of maintaining the database and other personnel that may have restricted access to the information. This information is made available before the physician passes the medical information down to the authorized personnel.

Depending on the degree of sensitivity of the case or person’s profile, there should be an appropriate security guard/code for such. I believe this is important so that there would be minimal access to the medical information, and the patient can accept or reject the authorized personnel for risk of irresponsible information dissemination. The patient must be kept abreast of everything happening to his/her profile on a regular basis. This helps to maintain trust in the physician, and also makes it easier to retrieve useful information from the patient.

Communication is cardinal to effective medical treatment; it is hinged on confidentiality and good patient-doctor relationship. By informing the patient of the existence of medical information in computer data base, this inevitable tool maintains its usefulness.

3. When should the patient be notified of purging of archaic or inaccurate information?

The patient should be notified of purging of archaic or inaccurate information before and after purging. The physician should also be aware of this. There should be systematic procedures that prevent mixing patients’ information. The essence of this is that the patient is fully aware of the status of the confidential medical information s[he] has provided for medical assistance, and s[he] is sure they are intact within a known period of time.

4. When should the computerized medical database be online to the computer terminal?

When appropriate computer programs are used, then the computer data base should be online to the computer terminal. Information should only be made available to individuals who need them for specific purpose, and with full consent from the patient.

5. When the computer service bureau destroys or erases records, should the erasure be verified by the bureau to the physician?

Yes, the erasure should be verified by the bureau to the physician to ascertain the quality and quantity of information erased, and the remaining relevant medical data on record.
6. Should individuals and organizations with access to the databases be identified to the patient?

Yes, individuals and organizations with access to the databases should be identified to the patient. Full disclosure should be made to both patient and physician prior distribution of the information; this is necessary in obtaining informed consent to treatment.

7. Does the AMA ethics opinion mention encryption as a technique for security?

The importance of security to confidentiality computers can not be overemphasized. In this vein, The AMA mentions encryption as a technique for security; others include pass wording and scannable badges.

8. What does the ethics opinion say about disclosure by the recipients of authorized data to third parties?

It out rightly spells out, that this should be avoided. Approval by the patient and notification of the physician should be sought before the release of patient-identifiable clinical and administrative data to individuals or organizations outside the medical care environment. No information should be made available to a third party without prior notice of the physician and patient. In fact, only the required information should be made available to individuals and organizations that need them.

REFERENCE

Confidentiality Computers. Accessed from

http://www.ama-assn.org/ama/pub/category/8360.html

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