This paper is based on the influence of medical ethics on the confidentiality of medical information, especially that involving confidentialty computers Medical information is confidential; and any transfer, alterations and storage should be done with the consent of the patient, physician. information about the procedure to be employed and personnel should be made available to them.
1. Should corrections be date- and time- stamped?
Yes, corrections of medical information of a patient should be date- and time-stamped; this is to keep the information current and easy to retrieve. The date shows the extent and progress of necessary corrections on the order. When corrections are date- and time- stamped, there is room for accountability and it is difficult to tamper with the information by any unauthorized person. Besides, this can be automatic. As soon as any information is changed, the computer immediately records the time and date without a manual entry by the person. What would also increase the veracity of the entry?
It is important that entry of medical information of a patient, which is supposed to be confidential, should be done by authorized personnel and the personnel who do the correction should also be identified [William, 97]. 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?
The world is changing rapidly, and these changes are widespread affecting all profession. As a result, the need to store medical information in computerized databases has become pertinent. when this is about to be done, 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.
Change is not an easy thing to adapt to, both for the physician and the patient. Therefore, there must be detailed explanation on the requirements, components and advantages of using this method of information storage. It makes it easy for the patient to believe the change, and adapt to it. Depending on the degree of sensitivity of the case or person’s profile, there should be an appropriate security guard/code for such [William, 97]. 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 informed of activities on 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. And the sanity of the profession is kept intact.
3. When should the patient be notified of purging of archaic or inaccurate information?
There could be need to purge the system of inaccurate information, a standard procedure should be in place for this. And only the authorized personnel should be allowed to do so. This can not be done without the client/patient’s authorized consent. The patient is notified of purging of archaic or inaccurate information before and after purging. The patient may have advice and some useful information regarding the correction. It is equally important to inform the physician. There should be systematic procedures that prevent mixing patients’ information [William, 97]. 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.
Indeed, there is no question about it: the need to maintain the trust and confidence of the patient makes it important to inform them of this kind of change, it can be sensitive [Annals].
4. When should the computerized medical database be online to the computer terminal?
When computerized medical database become available, it should be made available at the online terminal. When appropriate computer programs are used, then the computer data base should be online to the computer terminal as soon as possible. It should be reiterated that information should only be made available to individuals who need them for specific purpose, and with full consent from the patient [William, 97].
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. The bureau of the physician could also notify the patient about the status of heir medical records [William, 97].
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 [William, 97].
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. There are other methods: these include pass wording and scannable badges.
8. What does the ethics opinion say about disclosure by the recipients of authorized data to third parties?
Medical information is confidential; you can not tamper with it just anyhow. Therefore, the AMA ethics has a clear declaration on this: 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 [William, 97]. In fact, only the required information should be made available to individuals and organizations that need them. Any thing outside this could call for legal action.
REFERENCE
· William L. Manning Health Law Resource. AMA opinions and standards. Confidentiality Computers. Accessed from http://www.ama-assn.org/
· Medical Records,Privacy and confidentiality. http://www.netreach.net/~wmanning/ama507.htm. 1996-97
· Confidential computers. www.ama-assn.org/ama/pub/category/8360.html
· Privacy and confidentiality.www.earlham.edu/ecs/html/policies/privconf.html
· Maintaining the confidentiality of medical informatio. www.annals.org/cgi/content/full/127/2/138
