Since the rise of COVID, telehealth has played a major role in today’s care. In June of 2020, the State of California Office of Health Information Integrity updated its state laws for telehealth security. This was to ensure privacy and security was implemented. The main things that were added to this law was to ensure HIPAA and state security requirements were authorized for telehealth. Proper software licensing, vendor agreement, vendor’s responsibilities of patients protected health information, how is the PHI disclosed, patient security during video conference, ways to restrict access to only authorized users, and record retention laws for electronic recordings.
Because of these changes, companies have security programs that protect their patients health information, protect patients rights, and protect patients privacy. If companies are not up to date on their security, they will be fine and sanctioned for unauthorizing one’s health information. Computer programmers handle the security needed to keep patients information safe and promote privacy of one’s health care information. Although information is online, the Health Insurance Portability and Accountability Act, federal law requires there to be national standards to protect sensitive patient health information from being disclosed without the patient’s consent. The ethical dilemmas that have resulted from technology is knowing that someone’s information could possibly get out into the open for someone to gain access to due to not having proper security. This can be resolved by having IT developers that daily write new algorithms to ensure that data is not breached.
Statewide health information policy manual (SHIPM) documents version 6/2022 – california health and human services. California Health and Human Services – Updates on CHHS Data Initiatives. (2022, May 25). Retrieved June 6, 2022, from https://www.chhs.ca.gov/ohii/shipm/statewide-healt…
A state law that was implemented to help regulate patient safety during the Covid-19 pandemic was the Coronavirus Preparedness and Response Supplemental Appropriations Act and the Coronavirus Aid Relief and Economic Security (CARES) Act. These regulations prompted the Centers for Medicare and Medicaid Services (CMS) to allow the reimbursement of fees for telehealth to be equivalent to that of in-person visits, waive coverage restrictions, allow for services outside of rural areas and allow services via smartphones (Pessar, 2021). This was a major change in the way mental health and substance abuse disorder programs treated patients because in-person services were stopped due to the pandemic and high risk of close contact. Prior to the pandemic, telehealth was a service used for people outside rural communities and was not covered by Medicare or Medicaid. The regulations that came about because of the pandemic allowed for this service to become available for many more people so that they may continue getting the treatment and help they needed. People are now able to speak with mental health professionals via telephone or video call and can get prescribed medications, talk to psychiatrists and get the appointments they need much faster because they no longer have to wait for in-person visits. There was a huge jump in the number of people dealing with mental health problems and drug abuse from the sudden changes that occurred to their social and financial situations. This change in the way care was being provided and the availability of telehealth services allowed for more people to be seen and get the treatments they needed.
The technology associated with the new regulations for telehealth includes technology devices like cell phones and computers. One dilemma that has resulted from the use of telehealth is maintaining patient privacy. According to the AMA (n.d.), “all physicians who participate in telehealth/telemedicine must assure themselves that telemedicine services have appropriate protocols to prevent unauthorized access and to protect the security and integrity of patient information at the patient end of the electronic encounter, during transmission, and among all health care professionals and other personnel who participate.” It is not really an ethical dilemma, but still an important one because if the wrong person gets access to the telehealth appointment or information shared, it can lead to ethical issues and private patient information being shared with others who it does not pertain to. One way to resolve this is to ensure there are security steps in place to ensure the correct people are joining and creating a secure network that is reliable and has several lines of defense in the event that someone tries to hack into the system. Another dilemma is obtaining informed consents. When doing in-person visits, people are able to sign physical forms or electronic forms that are automatically uploaded into their electronic health record, but in telemedicine, these forms must be obtained differently and uploaded into their files. There is a risk in these forms getting lost or uploaded into the wrong files which becomes an ethical dilemma when services are being carried out without written or signed consent because it was lost or the wrong services are being provided based on the informed consents on file that belong to someone else. One way to resolve this is to always double check patient identifiers on all forms being signed and uploaded and double checking that you are uploading the correct information for the correct patient.
American Medical Association (AMA). (n.d). Ethical practice in Telemedicine. Retrieved from https://www.ama-assn.org/delivering-care/ethics/ethical-practice-telemedicine (Links to an external site.)
Pessar, S. C., Boustead, A., Ge, Y., Smart, R., & Pacula, R. L. (2021). Assessment of state and federal health policies for opioid use disorder treatment during the covid-19 pandemic and beyond. Jama Health Forum, 2(11). https://doi.org/10.1001/jamahealthforum.2021.3833
Medication errors can lead to serious patient harm in any healthcare setting. Even though health care workers want the best for patients, medication error rates remain high causing an alarming number of disabilities and deaths. Preventable errors also increase healthcare costs and can increase insurance rates. Health care workers must work together to ensure patient safety and decrease medication errors.
In my literature review I continued to find that healthcare workers are scared to report errors. They are worried about the punishment they may receive if they report themselves. It has been found that punishment for medication errors causes less errors to be reported. A learning and supportive environment is healthier and safer for patients. (Rodziewicz et all, 2022)
Another factor that stood out to me was the cost of medication errors. I found an article that stated, “in the USA hospitals in 1995, the annual spending on medication errors for each hospital was around 2.9 million dollars” (Nasr et al, 2021).
Hopefully as we all work together in the future and the electronic health record does become the national standard, medication errors can be reduced. Our patients want safe care, and we want to give them safe care. Reducing medication errors could also reduce cost to those who pay for health care services.
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common mental and developmental disorders in children that affects their ability to pay attention and control their behaviors. The two main forms of treatment include behavior therapy and medications. Many people disagree with giving children medications, but they have been found to help them concentrate and control their behaviors, sometimes in combination with other treatments. By helping children focus and perform better in school, they can reap the full benefits of their education and have a better quality of life.
The most important takeaways from the literature review resources I reviewed are that there are so many different styles of research and data presentation to consider. In regards to ADHD, I found a lot of resources that compared children with ADHD to those with normal behaviors and some that included children on medication versus no treatment. This helps support the idea of comparing children to see if medications actually make a difference for them. One thing to consider is that treating ADHD takes a team and a process to reach a place where the child is able to function at their best level. Some of these children in the studies may have been in an adjustment phase in their treatment and others may not have been compliant with treatments. The one topic I had more difficulty finding research on was the long-term effects of taking ADHD medications at such a young age. Many resources presented with inconclusive information or lacked the proper evidence and support to help defend the results found. This shows that more research needs to be done to show whether there are long lasting effects of taking medications, which may help put more parents at ease with this treatment as an option if they had better evidence showing that it was more beneficial than harmful. Overall, There was a lot of resources that presented general information about the benefits of treating ADHD with medications, but there is still room for more solid research and evidence to be presented on this topic because so many researchers are gearing towards excluding medications as a treatment option.
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