The Future of Health Information Technology

Impact of Trust, Privacy, Security, Governance, and Standards on the Future of Health Information Technology Abstract The significance of health information technology in decision-making and improvement of quality services is highly acknowledged. However, ethical concerns have also been raised from the use of this technology. In the provision of quality care, health care systems are faced with challenges such as processing complicated client information, great demand, and a wide variety of treatment options and interventions. To address these challenges and increase access to basic care, most systems have recognized the value of information technology. While there is much to be gained from this technology, there are unintended ethical consequences that come about.

Therefore, ethical issues such as confidentiality, trust, privacy, governance and standards must also be considered when employing this technology.

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Impact of Trust, Privacy, Security, Governance, and Standards on the Future of Health Information Technology Introduction Information technology in the healthcare sector provides a viable tool for enhancing delivery of quality service with great efficiency. The increased application of information technology in the health care system is driven by the potential gains that could be obtained from provision of quality and efficient services. However, challenges such as costs involved and complexity of implementing it demand much adjustment. Efficient delivery of patient information is essential in cutting down the costs of health care and promoting better healthcare.

This is because the information will be available as required to the relevant parties in the healthcare system. The technology therefore promotes quality of care by enabling the healthcare providers and the clients to be more informed. However, security, privacy, standards and governance issues have a huge influence on the outcome of information technology on healthcare.

Security is achieved by preventing tampering with an individual’s health information without authorization; privacy is guaranteed if there is controlled access. Security and privacy of patient information is often compromised as the healthcare stakeholders share information. Most healthcare institutions try to uphold security and privacy of their clients by limiting access to this through isolating the information. However, this also hinders effective utilization of this information to benefit the patient. Proper use of health information according to established standards and governance regulations will lead to earlier identification of health issues and enhance health results of the clients through improved access to relevant patient information (Rylance, 1999). It will also enhance sharing of health information among the healthcare

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providers while giving the clients a role control and access to their health information, thus enhancing quality.

Literature Review Health information technology continues to modernize, becoming ever more present in the day-to-day functions of healthcare organizations. Updated health IT has already helped many hospitals realize added value in providing health care services. Computerized Physician Order Entries (CPOEs) create computerized pop-ups to prevent doctors from prescribing harmful drugs (Ground & UW, 2008). Electronic Health Records (EHRs) and Electronic Medical Records (EMRs) allow doctors within the same health service organization (HSO) or the same health system (HS) to electronically share patients’ medical information (Hamilton, 2010). But the uncertainty of positive outcomes will not be the only issue for the future of health IT. Similar to any IT system, the creation, implementation, and utilization of health IT must be closely monitored. For example, EHRs often contain immensely private information. If HSOs are not careful, security breaches could lead to patients’ information ending up in the wrong hands. For this reason, HSOs and HSs must consider issues pertaining to trust, privacy, security, governance, and standards when driving health IT in their facilities.

Trust Health IT projects entails rigorous preparation because of their complexities. In order for these projects to be successful, trust amongst all parties involved in the health delivery process must be established. If even one party lacks trust in a health IT system, the project will fail and the benefits of the system will never be fully realized. In one study, Renee Shield and her associates monitored patients and medical staff at a facility during an experimental EHR implementation. Trust was a major component of the researchers’ evaluations. Nurses were

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worried that some physicians would have a difficult time learning how to use the EHRs. Physicians wondered whether their opinions would be considered during the EHR transition and whether the EHRs would prove more burdensome than effective. The administrations concerns dealt with whether they would have enough time, money, and resources to successfully implement the system. Interviews with patients revealed anxieties about the security and privacy of their health information. This experimental EHR project was ultimately successful because physicians were entrusted to utilize EHRs in delivering services to patients (Shield, et al, 2010).

If other health organizations hope to experience successful incorporation of health IT, they will need to value the trust of all stakeholders.

Privacy Protecting a patient’s privacy has and will continue to be a crucial aspect of driving health information technology. IT products, such as EHRs, make accessing patient information easier for physicians. But patients are increasingly concerned about who can view their health records and what these people are doing with their information. A study by George Rylance explains that maintaining a patient’s privacy and confidentiality is a long established principle of medical practice (Rylance, 1999). A patient’s health record can contain highly sensitive and potentially damaging information should it be shared with the wrong individuals. Rylance’s article clarifies that making sure only those who need to access a patient’s health information is crucial to maintaining the patient’s privacy and dignity. Further studies have tracked how hospitals have attempted to control who has access to patient health records. A computerized system in one hospital was set up and monitored by privacy officers, in order to delegate who can access patient records (Bodina, et al, 2012). Health organizations must protect patients’ privacy because failure to do so would have dire consequences for the institution’s credibility.

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Patients would then choose other providers with better reputations. Providers must do all they can to reinforce patients that their privacy will be maintained when implementing new health IT projects.

Security The purpose of health IT security is to ensure that the direct and indirect users find the system both trustworthy and private. In order to create a state in which health IT is “free” from prominent danger or threats of criminal activity, healthcare organizations must create systems of security. Legal requirements have been created to ensure there are common standards and expectations of security among all health IT users. Many of these mandates pertain to patient information and can be recognized in publically notable mandates, such as the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (Rinehart-Thompson,Hjort & Cassidy, 2009). While this law has been successfully established in most organizations since 2003, many common misinterpretations of the law’s provisions and limitations exist. These misinterpretations deal with authorization, consent, patient right of access, and professional health information management. As a result, there has been push for further legislation to enforce and strengthen the original law. Security has also been required at the industry level.

This comes with the support and growth of health IT, including interoperability capabilities and health exchanges at state levels.

Governance The federal and state government, industry and organizational sponsors, main users (i.e. doctors and nurses), and administration shares governance of Health IT. Having proper management or administration of health IT will greatly support its capabilities and security.

Health information technology is governed at all levels of management from the federal

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government to local practice managers. However, the HIPAA law at first only impacted federal organizations and few others. Since this time, the law has been enhanced to cover additional practice types and most health services in the country. Laws, such as HIPAA, have been enforced to create stronger regulations. Other laws, including ARRA, have also been created to support the growth and future of health IT. In addition to the laws, federal agencies, such as the Office of Inspector General, have worked with others to close the loopholes of health IT management. The constant additions and changes of legal requirements have made governance a challenge for health IT professionals.

As more health service organization move “through the process of identifying variations, creating solutions, and beginning implementation” (Dimotrropoulos, 2007) it will become essential to identify governance of privacy, security, and standards for health IT. By acknowledging this principle, leaders will be able to take ownership of the implementation process and oversee success for the future. Governance support of health IT must be addressed through education and the understanding of sought implications and standards.

Standards Standards are defined differently depending on the stakeholder’s point of view.

Stakeholders vary between the government, system builders, consumers (including organizations and practices), and patients. Each stakeholder group has a set of standards necessary to complete their duties of governance and health IT use. The government must have quality regulations that are supported by all types of health IT. In addition, it is necessary to have financial backing to support the growth of health IT among all health services, regardless of size. There is an immense complexity to being an informatician who designs, implements, and monitors health information systems. When an organization is in this process it is important to include the most

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influential and knowledgeable person to ensure patient safety and staff compliance (McLane & Turley, 2011). Consumers of the products have the largest amount of standards, since they have separate standards in addition to sharing those of the government and patients. The use and capabilities of health IT is of the utmost importance for the consumer stakeholders. Patients require a standard of security of their personal health information. This constitutes the trust and privacy of the use of health IT and its overall governance.

There are also agreed levels of quality on behalf of all the stakeholders. In order to achieve these quality levels, there must be collaboration on standards of education and engagement, policy adoption, outcomes and best practices, and interoperability. In simpler terms, the desired standards require providing better information of medicine to improve care and decrease expenses (Lohr, 2011). It is the aspiration of anyone in healthcare to pursue the best means to great healthcare. With trust and privacy healthcare and become more secure.

Nevertheless, this security will only sustain with proper governance that acknowledges and meets expected standards.

In the pursuit for greater efficiency and quality in healthcare delivery, health IT modernization continues to be a pressing topic. Improved health IT can more rapidly deliver patient health information, cut down storage and administrative costs through electronic documentation, and avert potentially harmful clinical errors. Many studies have evaluated health IT systems, concluding that providers must consider several topics before, during, and after a system’s implementation. Topics that providers must value include trust of all stakeholders affected by health IT, patient privacy, health IT system security, the various levels of health IT governance, and the maintenance of organizational standards. Technology is a rapidly evolving field that affects many industries, specifically healthcare. Healthcare organizations that properly

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consider and integrate these five topics into health IT systems will significantly enhance the quality of health service delivery.

Observation Innovations and advances in health information systems have promoted effectiveness in diagnosis and management of diseases thus lessening suffering. The patients have greater autonomy in the use of their health information hence playing a key role in making decisions affecting their health. Since the physician and patient have access to this health information, much regulation is needed to ensure it is used appropriately. As the health information systems become increasingly in use, there is an increased risk of distorting information in various ways.

Ethical issues that underlie health information technology will continue to pose huge integrity challenges.

The patients need to trust healthcare organizations to keep their health information private and safe. This can be so if the health organizations and other relevant stakeholders define and create sustainable trust and properly regulate the movement and use of the data. Lack of trust widens the fear of the clients regarding the health information technology. Information provided by healthcare organizations should reflect the needs of the patient. Effective use of information to promote the quality of healthcare depends on the trust (National Research Council (U.S.), 2009). This is because trust confers responsibility for the usage of information according to best governance standards. Privacy and security issues will remain a big challenge to emerging fields like genetics and bioinformatics, and therefore the need to establish effective two-way communication. There are no established consistent standards within the health care system.

There is lack of universal understanding on security and privacy of health data through all the exchanging platforms; hence, clients are concerned about unintended people having access to

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their health information. Adequate communication between the health service providers and the patient is essential in safeguarding privacy. This can be achieved if the physicians clearly indicate to their clients whatever they are doing and the reason for doing it.

Conclusion Efficient flow of health information over the different environments involved in healthcare require infrastructure that caters for the security, privacy, governance and trust. It is the responsibility of the health care providers to ensure that the privacy and security of client data is safeguarded. These can be done by enhancing the capacity of the information system professionals. There is need to establish guidelines and policies that will guarantee uniform collection and sharing of data to evaluate its quality. Effective utilization of information technology requires removal of barriers to information flow within the stakeholders. This demands an infrastructure founded on trust. Therefore, all stakeholders must be engaged with key focus being on protecting client’s health data thus enhancing trust. Privacy and security should be the main area of concern whenever the infrastructure for health information is being developed. In addition, information management professionals should play a role of enlightening the clients on the correct way to retrieve their health records without compromising their confidentiality.

Lack of adequate governance in the design and development of health information infrastructure creates a conflict between different systems and stakeholders. Since the health information infrastructure must be used in diverse environments, the security and privacy of health records cannot be assured in the different institutions that use it, and this creates concerns regarding to adherence to governance laws. Health information management need to ensure that

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use of health information technology does not infringe governance structures established by the federal and state laws.

Standards must be developed and implemented to improve information flow across the healthcare givers. Developing standards for the diverse health information areas, including privacy and security issues will establish a platform for ensuring universality of health information broadly. Developing these standards requires participation of all stakeholders. The standards developed will be beneficial in ensuring appropriate and safe exchange of information amongst the right stakeholders thus improving health care.

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Hamilton B., (2010). Electronic health records. McGraw-Hill Lohr, S. (2011, July 16). Assessing the effect of standards in digital health records on innovation - NYTimes.com. The New York Times - Technology. Retrieved April 21, 2012, from http://www.nyti McLane, S. P., & Turley, J. P. (2011). Informaticians: How they may benefit your healthcare organization. JONA: The Journal of Nursing Administration, 41(1), 29-35. Retrieved January 26, 2012, from http://ehis.ebscohost.com/edu/detail? vid=3&hid=124&sid=df6787c5-2598-4ce3-a7e2-603b279571f6%40sessionmgr110& National Research Council (U.S.), (2009). Computational technology for effective health care: Immediate steps and strategic directions. Washington, DC: The National Academic Press.

Rinehart-Thompson, L. A., Hjort, B. M., & Cassidy, B. S. (2009). Redefining the health information management privacy and security role. Perspectives in Health Information

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