Dinh, M. & Chu, M. (2006). Evolution of health information management and information technology in emergency medicine.

In response, Adel lets us know about

Your article mentioned how the recent technologies such as health informatics presents new ethical challenges. This relates to an article that I read that discussed how the ED physicians play an important role in information technology and their roles in developing and implementing a national health information technology strategy (Dinh & Chu, 2006). The authors further stated that inspite of the barriers to implementation such as cost, disruption in workplace practices, data security, and lack of evidence, there are also potential benefits. These are process optimization, quality control, and interconnectivity (Dinh & Chu, 2006).

Dinh, M. & Chu, M. (2006). Evolution of health information management and information technology in emergency medicine. Emergency Medicine Australasia, 18, 289-294.

Forsyth, L. (2009). What you need to know about social networking.

Tiffanie shares


In an article written by Forsyth (2009) the author identifies the continuing struggle for areas overseeing law making to develop what is and is not appropriate behavior between employers and employees in social networking. We all know that employees being fired from the place of employment over what they said, did, or posted on a social networking site is becoming a "norm" now. It happens everyday and is on the news every evening. One item that Forsyth (2009) pointed out is that 45% of employers were screening social networking sites of potential employees. That is crazy! Next thing you know you have to do a background check for criminal offenses and social networking sites. There is a part of the article that listed "rules" for nurses using social networking sites. This was the best part because most of these seem common knowlege... guess not! Some examples: don't fake a sick day and then post it on your site and don't post photos or comments engaging in ocnduct in the workplace which you know would be inappropriate (Forsyth, 2009). One that I would add - do not update your status from work! The date and time is noted when you update and it can be traced back to see if you were at work!

Tiff

Forsyth, L. (2009). What you need to knw about social networking. Queensland Nurse, 28(5), 22-23.

Dienemann,J. & Van de Castle, B. (2003). The impact of healthcare informatics on an organization.

Nicole's insights...

Dienneman & Van de Castle (2003) discuss how informatics effects not just nursing but the healthcare field as a whole. There are nurses as well as physicians who are resistant to the implementation of any type of computer charting. What I found interesting is as nurses, we were not given a choice. We were required to learn the computer system. As for physicians, many have adapted to the system. Others continue to spat verbal orders or pull a busy nurse aside to put their orders in. In addition, hospitals hire scribes to do work for them. We have been told to write physicians up who are noncompliant with the putting their own orders in. I have started to do so.

Informatics is a great subject that is still controversial. Patient information, blogs, webpages should be used with caution. I just read this morning that a woman is being taken to court over what is displayed on her blog site. I take these matters very seriously. While doing my webpage, I typed out a consent for one of my co workers who is on my subject to sign, she laughed.I told her, 'Please read and sign.' She signed but thought I was crazy. Anyway, I enjoy discussing issues such as this.
...

Dienemann,J. & Van de Castle, B. (2003). The impact of healthcare informatics on an organization. Journal of Nursing Informatics, 33(11),557-562.

McBride, D. & Cohen, E. (2009). Misuse of social networking may have ethical implications for nurses.

Healthy lets us know...

McBride & Cohen (2009) briefly wrote about potential violations of professional nursing conduct through the use of social networking sites. Many challenges mentioned in the article have been previously discussed, such as HIPAA violations. One slippery slope mentioned that I had not considered is the "friending" of patient & nurse relationships on these social sites. Participants may not be aware that employer boundaries extend to these sites, or these sites may blur these boundaries that were established to protect the privacy of both the patients as well as staff.

McBride, D. & Cohen, E. (2009). Misuse of social networking may have ethical implications for nurses. ONS Connect, July 2009, 17.

Black, L., & Anderson, E. E. (2007). Physicians, patients and confidentiality: The role of physicians in electronic health records.

On the other hand, James shares...

I agree with what you are saying that "ethics in technology and informatics is not different than ethics in health care and life" but one thing we must admit as Black and Anderson, (2007) states that electronic medical records presents new challenges to the continuing quest to maintain patient-physician confidentiality.

Tonya, I beg to disagree with your statement that "today’s technology and access to computers puts sensitive information in the hands of unprepared individuals." The reason why I disagree with this statement is because confidentiality is covered in the nurses Code of Ethics Provision 3.2 states "the nurses promotes, advocates for and strives to protect the health, safety and rights of patients."The physicians also have Code of Medical Ethics which address confidentiality Opinion E-5.07 which states"the utmost effort and care must be taken to protect the confidentiality of all medical records, including computerized medical records (Council on Ethical and Judicial Affairs 2006,155)."(Black and Anderson, 2007).

Black and Anderson, (2007) recommend patient education about electronic health records and disclosure of information because of the fear employment or insurance discrimination.

References
Black, L., & Anderson, E. E. (2007). Physicians, patients and confidentiality: The role of physicians in electronic health records. American Journal of Bioethics, 7(3), 50-51.

Jiang, W. W., Chen, W., & Chen, Y. C. (2004). Important computer competencies for the nursing profession. Journal of Nursing Research, 12(3), 213-225.

Adel shares...

I agree with what James shared about nurses needing some nursing informatics knowledge prior to entering the workforce. I would even suggest before going farther in one's degree plan. Jiang, Chen, and Chen (2004) conducted a research that discussed the use of competencies that will help nursing professionals to work efficiently and serve as the basis of life-long learning, enabling them to maintain up to date computer knowledge and skills. According to the research results, among the seven competency items,the domain "attitude" toward the computer, was chosen as the most important. These results can serve as a comprehensive list for nurses to check their computer competence and try to make up any shortcomings (Jiang et al., 2004).These can be used by schools in designing computer curricula and with the limited class hours, need to include the items that will be most beneficial to the students.

Relating this to our class, the competency checklist that we completed prior to starting the class determined what aspects in informatics needed improvement. Knowing what aspects needed work, with the help of the learning contract, I was able to work on such deficiencies. This will help me in keeping abreast with the ever changing technology. I also need to make sure that I keep up with further technological changes in the future.

Jiang, W. W., Chen, W., & Chen, Y. C. (2004). Important computer competencies for the nursing profession. Journal of Nursing Research, 12(3), 213-225.

Curtin, L.L., (2005) Ethics in informatics, the intersection of nursing, ethics, and information technology.

Insights through Tonya

Ethics in technology and informatics is not different than ethics in healthcare and life. This article explores how to bring healthcare, ethics and computing to intertwine with each other. Ethics is discussed as a choice between right and wrong. Humans since the 1940’s have be learning and changing computer ethics. Computer ethics is defined as a field that studies computers and the code of conduct for computer professional. In healthcare you can not be part of the computer profession due to easy access or sharing of patient information via computers with or without an electronic medical record. Today’s technology and access to computers puts sensitive information in the hands of unprepared individuals. Healthcare, ethics, and informatics and its users must be good ethically, legally, and morally for the greater good of human kind.
Curtin, L.L., (2005) Ethics in informatics, the intersection of nursing, ethics, and information technology. Nursing Administration Quarterly. 29 (4). 349-352.

Milton, C. (2007). Information and human freedom: Nursing implications and ethical decision-making in the 21st century.

Thanks Adel...

Milton (2007) discussed the ethical exploration and possible challenges associated with the information age in nursing research, practice, and education. He also focused on the disciplinary responsibilities for information giving and receiving. Since manual filing and storing of documents are no longer manageable in healthcare organizations, managing such information electronically brings about ethical considerations in the healthcare settings. Nurses and other members of the healthcare team have the special obligation to be ethical in handling patients' confidential information being guided by the premise that patients have the freedom to choose and access desired healthcare services (Milton, 2007). I believe that patient information though electronically accessible is manageable with the right processes in place. Educating staff of the serious implications in the misuse of such information plays an important part.In our facility, we have been trained not to look into any patient's electronic record, even your co-worker's or family's patient record, unless you are a direct caregiver or your primary role in the hospital supports it.

Milton, C. (2007). Information and human freedom: Nursing implications and ethical decision-making in the 21st century. Nursing Science Quarterly, 20(1), 33-36.

Layman, E. (2003). Health informatics: Ethical issues

Martha provides

Layman (2003) discussed how the recent technologies such as health informatics presents a new ethical challenges. These technologies are designed to increase access, improve quality, and decrease the cost of care. The author pointed out the positive aspects of health informatics such as can bridge distances, improve the quality of care, allow healthcare providers to explore new ways to increase efficacy of diagnosis and therapy. On the other hand, it creates conflicts with ethicals principles of autonomy, fidelity, and justice. The author proposed solutions including regulations, standard and guidelines, honor codes, and code of ethics. I believe that healthcare providers need to be accountable on ethical, moral, and legal responsibilities in order to mantain this technology productive and useful in the patient care.

Layman, E. (2003). Health informatics: Ethical issues. Health Care Manager. 22(1), 2-15.

Bolin, J. N.,Mechler, K.,Holcomb, J.,Williams, J.,(2008). An Alternative Strategy for Resolving Ethical Dilemmas in Rural Healthcare

James shares...

This particular article was very interesting because it talks about some of the ethical challenges in small rural healthcares. The authors acknowledge that some of the ethical dilemmas in small rural hospitals are hard to address mainly because some of the physicians in the rural areas play a double role for example, the same physician might be the private physician for hospital board members, administrators, and managers, this leads to a conflict of interest between organization loyalty and patient rights. Also because in small towns there is a tendency that majority of people knows each other therefore it is easy to excuse a conduct because of respect and relationship. This particular problem has lead to the creation of virtual peer review model and a virtual hospital ethics committee offered through the Texas A & M Health Science Center Rural Community Health Institute (R-CHI, College Station, Tx).
The virtual technology has allowed physicians from different locations to convene a meeting and discuss ethical issues. Therefore this new technology has allowed rural physicians to practice medicine without the fear of judging their peers. It has also allowed the hospital administrators in small rural towns to practice or conduct their duties without being infected by small town politics.

Reference

Bolin, J. N.,Mechler, K.,Holcomb, J.,Williams, J.,(2008). An Alternative Strategy for Resolving Ethical Dilemmas in Rural Healthcare, Ethics and Rural Healthcare, 8(4),63-65.

Cosco, T., Knopp, A., & Milke, D. (2007). Investigative first steps: appropriate identification and ethical review of research and quality improvement

From Toni


Cosco, T., Knopp, A., & Milke, D. (2007). Investigative first steps: appropriate identification and ethical review of research and quality improvement. Online Journal of Nursing Informatics, 11(3), .

Cosco, Knopp, and Milke (2007) discusses the research and quality improvement process used in research while making an attempt to combine nursing practice, information, and technology with evidence-based knowledge and improvements in patient care. The article is mainly differentiating research and quality improvement outcomes in a study based on care. There are concerns that ethical review of a study can be inaccurately identified as research or quality improvement methods. Generating information for nursing practice is the goal of nursing informatics in research. The article is mainly focused on the research methodology and how nursing informatics is used in this process.

I believe the authors give foundational information for those desiring to perform research while using healthcare informatics for data collection. This article is very good food for thought prior to research in nursing.

Ellaway, R. & Martin, R. D. (2008). What's mine is yours - open source as a new paradigm for sustainable healthcare education.

Melinda provides

Article:
Ellaway, R. & Martin, R. D. (2008). What's mine is yours - open source as a new paradigm for sustainable healthcare education. Medical Teacher 30, 175-179. DOI: 10.1080/01421590701874058.

Use of the internet as a resource sharing medium is invaluable. However allowing individuals to use your information or to use the information produced by others creates liability issues.

In this article, the authors discuss the creation of an open source website where educators can share the tools they have produced. Additionally, all sharing is free and revisions, adaptations, and reworking of the original programs are encouraged.
Sharing back and forth is a great way for educators to not only develop curriculum but also adapt lessons already produced, reducing prep-time and increasing educator to student time.

In an open-share environment the liability issue of copyright infringement is removed, as all submitters to the open share site agree to share openly their content.

HealthDay (2008. Medical Blogs may threaten patient privacy.

From hjmlpn

HealthDay (2008. Medical Blogs may threaten patient privacy. Retrieved on October 1, 2009 from http://health.usnews.com/articles/health/healthday/2008/08/07/medical-blogs-may-threaten-patient-privacy.html

The title of the article I chose is Medical Blogs may Threaten Patient Privacy. This article from the U.S. News & World Report examined 271 medical blogs and determined that they could identify the author's of these blogs 56.8% of the time. The blogs had not only medical information about patients but personal photos and details of patients. Sponsors and advertisements for medical equipment were displayed on the website. The author explains the importance of providing information to the public, but eithics should be part of this process. Blogging is new and guidelines and standards have not been set by professional organizations and until this happens patient identifiable information will remain on the net.

Simpson, R.L.(2005). Ethics: New delimmas emerge alongside new technologies.

And from Grammie

Simpson, R.L.(2005). Ethics: New delimmas emerge alongside new technologies. Nursing Administration Quarterly, 29(2). 179-182.

Reference found at Cinahl
This author clarifies the difference between regulations and ethics using simple terms. For instance, a regulation is a rule that an organization has adopted and must be followed. Ethics is more of a choice rather than a requirement. Ethics in informatics is challenging. Protecting one's priviacy is a rule or requirement in healthcare, however documenting electronically opens the door for potential threats to violating privacy of others. The author shared his concern of easy false or wrong documentation about a person could cause the person to loose their insurance or could cause them to be denied their insurance. Reading this article really made me think about what I read on internet and to not take what I read as the truth and to always keep an open mind.

Dainton, C. (2009, September). Physician-writers in the age of blogging.

Vickey shared...
Dainton, C. (2009, September). Physician-writers in the age of blogging. CMAJ: Canadian Medical Association Journal, 181(5), 348-348.

The article above was concise and interesting. It wrote about the slippery slope that healthcare providers (physicans in this case) have to worry about when blogging. It stated that professionals do have the right of freedom of speech but also have an obligation of the right of pts confidentiality. It concluded that one should err on the side of caution and be prudent until our professions evolved enough to include such technological matters (Dainton,
2009).

Curtin, L.L. (2005). Ethics in informatics: The intersection of nursing, ethics, and information technology

Amy said...
Curtin (2005) gave a very detailed explanation of the ways nursing, ethics, and information technology intersect. She cautioned that the revolution of informatics in healthcare gives tremedous power to anyone with access to a computer. There is ample opportunity for one to be careless, reckless, foolish, and even the gives one the ability to do harm such as the stealing of healthcare information or identities. The author stressed it was of the utmost importance that we as healthcare professionals be held accountable by strict, moral, legal, and ethical values.

Curtin, L.L. (2005). Ethics in informatics: The intersection of nursing, ethics, and information technology. Nursing Administration Quarterly, 29, 349-352.

Anderson, J.G. (2004). The role of ethics in information technology decisions: A case-based approach to biomedical informatics education.

Adrian said...
Anderson (2004) described the need for ethical and social course content in Informatics and Medical technology courses offered by medical schools and graduate nursing programs alike. He describes how a large majority of programs do not offer social and ethical coursework alongside the Informatics education. He feels that each program must offer these topics in their coursework so that future Informatics leaders will be prepared to face dilemmas in the future practice, regardless of the work setting. After reading this article, I firmly believe that ethical and liability issues are faced by informatics leaders and professionals every single day in their work setting.

Anderson, J.G. (2004). The role of ethics in information technology decisions: A case-based approach to biomedical informatics education. International Journal of Medical Informatics, 73, 145-150.