DETROIT – New technology has changed how we communicate, shop, find entertainment, and share information. One industry that has completely embraced the vast capabilities of technology in the storage, access, and protection of data in healthcare.

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With so much information, and privacy issues that keep pressuring how this data is kept and used, many challenges have surfaced. How web development has been able to protect patient privacy in healthcare is the focus of this article. We will look at how to use this sensitive data, how Health Insurance Portability and Accountability Act (HIPAA) guidelines are maintained, and how this data is accessible for patients regardless of their knowledge of new technology.

The Importance of Health Information Privacy in Healthcare

There is one major factor that drives the need for health information privacy in healthcare. It can be said in a single word: trust. Patient confidentiality is a required element in healthcare as it builds trust between patients and doctors. Patients are far more open about their medical history when they trust who they share this information with. With a patient-doctor relationship built on trust, the interactions between the two parties are better and this leads to health visits that are higher in quality resulting in better health outcomes.

The Different Types of Privacy in Healthcare

  • Many types of patient privacy exist in the healthcare sector. They include the following:
  • Physical privacy – respecting personal space
  • Informational privacy – the protection of personal data
  • Decisional privacy – permitting personal choices that may include religious or cultural affiliations
  • Associational privacy – accepting personal relationships that include family members or other partners
  • This article, in particular, will center on the informational privacy element.
  • The Evolution of Health Information Systems

If you have been seeing medical professionals for any length of time, you may recall that your doctor used to keep paper records. These records would document your visit, the topic discussed, concerns expressed, solutions or remedies offered, and any follow-up information when it became available.

There was a time when paper records were just fine. They would be part of a vast collection of document files that could be retrieved when needed. These paper files were important for clinical, research, administrative, and financial purposes. Paper records were updated manually which could result in lengthy delays and were only available for one user at a time to reference. Plus, these records were not normally available for patients to see. 

The biggest issue to come from paper-based medical records, aside from the need for storage that took up walls of space to store the files, was security. Or, to be more accurate, the lack of security. Sure, authorized personnel could go through files but had to first gain access through a variety of means that may have included one or more of the following forms of protection: locks, doors, identification cards or passes, and a detailed sign-out procedure. All of these were effective at the time. However, unauthorized access did not set off alarms or other security measures and there was no way of knowing exactly what information was seen.

Electronic health records (EHRs) are a completely different matter altogether. For starters, although the physical records belong to the doctor, practice, or organization that created them, the patient owns the information that the record contains. As the record is considered a business document, this is why it is said to be business property owned by the creator of the file.

Access to the EHR can come from multiple users through various information technology tools which permit patients to view their records at any time. There are patient portals that make this possible but will only allow viewing by patients. Medical professionals have additional access which gives them the ability to edit, correct and add to these files.

The office of the National Coordinator for Health Information Technology identifies electronic health records as “not just a collection of data that you are guarding – it’s a life.” This accurately describes an EHR based on the detailed medical and personal information it contains on an individual. This is also why three major ethical priorities are part of these records. There are:

  • Privacy and confidentiality
  • Security
  • Data integrity and availability

How These Files Are Kept Private and Confidential

Let’s first look at privacy. This is defined as “the right of individuals to keep information about themselves from being disclosed to others and is the claim of individuals to be let alone, from surveillance or interference from other individuals, organizations or the government.” This happens by allowing patient information to be released to others by only two methods:

  • With permission from the patient
  • Or as the law dictates

Medical professionals can access patient information because they own the files the information is stored within. This means that patient information can be used for payment, treatment, or administrative purposes without the requirement of authorization from the patient. It also means that the patient has the right to access their personal health record. But as has already been noted above, with trust in place between the doctor and patient, access to medical records between the two parties makes perfect sense to further that trusted relationship. 

As for confidentiality, restrictions must be in place to limit access to the information to just authorized individuals. Authorization is the most effective way to limit who can see what. With web development and new technology, levels of access are possible which places different restrictions based on what individual needs are concerning the personal medical records. For example, a doctor would require full access and the ability to edit the documentation. Patients would require full access but have restrictions on what they can do to their records regarding editing. The administrative staff at the clinic or hospital would require less access but enough to perform their duties and so on.

Plus, access given to the electronic medical records would include the requirement of specific tools to view those records. These tools would be the standard username and password system everyone is familiar with to enter certain online programs. This makes access easy for patients and all others who have the authorization to have access to the information. However, as an added layer of security, certain levels of access would need a further level of authenticity to allow entry to the files. This two-tier approach is becoming commonplace online but medical record access would include biometric scans of identifiable features that would be unique to the individual seeking access.

Audit Trails Assist In HIPAA Compliance

Organizations follow directions from the HIPAA Security Rule to conduct audit trails. An audit trail is a record of all system activity. This would include the date and time stamps associated with each entry made, a detailed list of files and pages left open, the duration of time that passed during the viewing, who did the viewing, and information on any changes made to the medical files. Other details that can be monitored and collected as part of an audit trail range from the printing of which pages, the number of screenshots, and the precise geographic location of the computer used to access the files.

Maintaining Integrity of the Records Is Also Vital

The final piece of the puzzle of the web development connection to electronic health records is integrity. Integrity essentially ensures that the data collected is correct and has not been altered. With data exchange becoming a frequent activity within the electronic environment, it is important to maintain the integrity of that information when it moves through systems. Practices that threaten the integrity of data include documentation integrity when recording a small detail incorrectly, copy and pasting data that increases the risk of data loss, and the limitations presented through the use of drop-down menus. Drop-down menus offer only so many options and in some cases, the options available are not relevant impacting the accuracy of the recording of the information.

Final Thoughts

New technology has made it a lot easier for us to accomplish many tasks that were tedious or far more labor-intensive. The healthcare industry adopted new technology early which quickly became a game-changer. Web development created innovative ways to access and collect patient data that made manual paper-based documentation obsolete. However, as great as digital data has become in the format of electronic medical records, it has also presented many new challenges. These include privacy, confidentiality, security, and the integrity of the data.

Fortunately, there are standards in place, resulting from the 1996 Health Insurance Portability and Accountability Act. The HIPAA spells out how to use the medical data, the storage of the data, who can access it, and how to access it. The system has a series of checks and balances to ensure the objectives are met and that the sensitive assets remain protected but accessible by only those who require access. It all boils down to trust. The quality of the data depends on the level of trust between a patient and a medical professional. Without a trusting relationship, the data collected will lack quality which may impact the level of care.

Marina Turea works as a content manager at Digital Authority Partners, a San Diego web development agency.