Health records and their importance
Health records contain information such as compensation and medication information; they serve as the primary means of contact between clients and their health care providers. They serve as a valuable tool for clinicians in providing the best possible care. Paper, electronic, or hybrid records (a mix of paper and electronic records) are all choices. Each of these types of records has its own set of advantages and disadvantages that make it more appealing than other forms or completely avoidable; privacy issues and inefficiencies in accessing information, particularly with electronic records, are causing concern. As a result, they have legal and ethical mechanisms that guide medical data management. These legalities, on the other hand, do not provide the ultimate answer to the issues in the administration of medical information, in fact, as Arora contends, they are another source of additional conflicts in medical record management. (Arora et al., 2013)
Strengths and Weaknesses of using Hybrid Records
The combination of paper work and the electronic approaches present certain elements of management of the medical record that can be considered advantageous hence strengths of the hybrid records or some shortcomings that can be considered weaknesses in its usage. Some of the strengths include, quick access to medical information gives room for better response, quality health care and increase the productivity of health care professionals. Another advantage is the sharing of patient data with much ease. Hybrid record usage allows multiple people to access the patient records. According to Pham, it makes collaboration much easier as data on paper can be scanned and sent to medical professionals who are geographically far apart for analysis and professional contribution to enable doctors to make best possible decisions. Hybrid records can also be computed and analyzed much faster. (Pham et al., 2010). The nurses and doctors can turn to the hybrid files and make faster decisions based on the record due to minimized stages and procedure at the same time minimizing errors.
The major weaknesses of using hybrid records revolve around the security of the record and the vulnerability and other legal issues. First, converting the paper documents to electronic to fit in the hybrid category require that one has to create crosswalks or subheadings that are aligned with the paper chart for easy retrieval and forms the legal document. Secondly, the usage of hybrid records requires a digital signature that can sometimes be breached unwillingly due to hacking leading to legal confrontations and privacy abuse. Fourth, the using of hybrid record require that a massive scale of medical operations are computerized. As such, there is need to use computer network in accessing of this files and with it comes to some network security loop holes that can be exploited by mischievous individuals. (Rodrigues et al., 2012). It is beside the stringent compliance protocols that the system has to observe, occasionally without success.
Legal issues that may arise in the use of hybrid records
Using hybrid record appears to inherit the advantages of both paper and electronic records. However, few features leave it susceptible to legal complications (Goodman et al. 2010). For example, it entails mountains of data that practitioners may quickly consider an overload. Because of the impracticality involved in analyzing these chunks of data, they may act on limited interpretations which later on may be interpreted by victims as negligence and as a result pursue legal proceedings. Unlike paper work, which is difficult to tell who viewed the data, hybrid records often employ features that leaves signature trails of those who had access to certain information. Computer audits may reveal this log, including those with genuine intentions. Such cases may legally be interpreted as a breach of privacy. Also, unlike the paper record that can be easily stashed in office cabinets, hybrid record entails electronic records that are stored in computer servers. As Shini, Thomas, and Chittaranjan argue, they become directly under the threat of computer attacks that make hybrid record usage very vulnerable to fraud claims by patient's ones they have reason to believe that their personal medical information has been hacked. (Shini et al., 2012).
Willow Bend Policy
The policy encompasses guidelines on the protection of personal health information, how the data is stored and transmitted between the permitted parties or obliterated. The policy applies to all forms of data – paper, electronic or hybrid.
State Regulation
In the state of California, the health records management policies are very much in agreement with Willow Bend policy. According to Becerra, the personal health records (PHR) can only be obtained from the individuals with their consent. Electronic and hybrid data is stored and accessed online via individual's usernames and passwords. (Becerra, 2017). The strategy ensures that only the permitted people are given access to such information. Regarding the destruction of the information, the state government has the policy to delete such information on request by the individual. Besides, personal audit trails can be prompted by the individual to receive email alerts once unauthorized access to their data is made.
Medical Condition of Participant
The Willow Bend Policy provides guidelines to the participation of individuals. By the time individual take part, there is a general assumption that they know the terms like, similar to the Conditions of Participation. The policy provides that certain personal health information is retained whether in the paper, electronic or hybrid form for a given period. However, master patient index, birth, deaths and surgery records are permanently retained. Information fed into computers is stored in discs as part of the master repository. There also exist destruction guidelines to this information. Both electronic and paper information is destroyed. Further, the policy gives room for an annual review of the destruction guidelines for digital data with consideration to the new technologies. The Medicare condition of participation does not, however, has provisions for health record destruction.
Health Insurance Portable Accountability Act (HIPAA)
The HIPAA policy, just like the Willow Bend policy avails means to store and manage the patient's records in ways that are acceptable. The main difference is that it lacks guidelines that direct the retention of health records. Instead, it points out to the state laws to which it is applied to cover this gap. Like the Willow Bend policy, HIPAA stipulates that personal health records in the paper form are destroyed by shredding and burning to render them completely unreadable (Huang & Liu, 2011). In this regard – storage, management, and destruction of data, the Willow Bend Policy resonate quite well with the HIPAA.
In conclusion, it is my opinion that there is need to have well inclusive policies that cover both paper and electronic data management without leaving a loophole to maintain the privacy of protected health records. Medicare condition of participation, Willow Bend Policy and Health Insurance Accountability Act are very much in line to realize this.
References
Cushman, R., Froomkin, A. M., Cava, A., Abril, P., & Goodman, K. W. (2010). Ethical, legal and social issues for personal health records and applications. Journal of biomedical informatics, 43(5), S51-S55.
Farnan, J. M., Sulmasy, L. S., Worster, B. K., Chaudhry, H. J., Rhyne, J. A., & Arora, V. M. (2013). Online medical professionalism: patient and public relationships: a policy statement from the American College of Physicians and the Federation of State Medical Boards. Annals of internal medicine, 158(8), 620-627.
Fernández-Cardeñosa, G., de la Torre-Díez, I., López-Coronado, M., & Rodrigues, J. J. (2012). Analysis of cloud-based solutions on EHR systems in different scenarios. Journal of medical systems, 36(6), 3777-3782.
Huang, H. F., & Liu, K. C. (2011). Efficient key management for preserving HIPAA regulations. Journal of Systems and Software, 84(1), 113-119.
O’Malley, A. S., Grossman, J. M., Cohen, G. R., Kemper, N. M., & Pham, H. H. (2010). Are electronic medical records helpful for care coordination? Experiences of physician practices. Journal of general internal medicine, 25(3), 177-185.
Shini, S. G., Thomas, T., & Chithraranjan, K. (2012). Cloud based medical image exchange-security challenges. Procedia Engineering, 38, 3454-3461.
Xavier Becerra (2017). Is Personal Health Record Right for You? Retrieved from http: https://oag.ca.gov/privacy/facts/medical-privacy/health-record
