Adolescent health care, confidentiality . There are many ways to define confidentiality, and how we conceptualize it affects how it functions in our everyday lives. WebThe Pros And Cons Of Confidentiality Soapstone Formal Analysis. The capacity of an adolescent to consent for health care as a mature minor is influenced by the minors developmental maturity, previous experience with illness, the gravity of the current illness, and the risks of proposed therapy. An EHR makes it much easier for a medical practice to track a charge for each procedure performed. p. 82810, for complete requirements.) When providing care for neurotypical (ie, without a defined neurologic difference) adolescents, obstetriciangynecologists and other health care providers should consider issues of parental access to the adolescents login information. Recently, however, there have been some concerns raised about such databases, especially when the information can be linked to individuals (in other words, it is not completely anonymous) or it is stored electronically without adequate security. Pros and Cons of US Healthcare Additionally, they should be informed of any restrictions to the confidential nature of the relationship. As adolescents navigate this important developmental period, obstetriciangynecologists should engage with them and promote best practices that protect adolescents vulnerability and assist them in developing autonomy. Require a parent or guardian code word to access an adolescents patient portal. Do not include specific laboratory data or counseling in after-visit summaries. All rights reserved. Parents are often too quick to give medications to lower a fever and make a child more comfortable. Available at: Esch T, Mejilla R, Anselmo M, Podtschaske B, Delbanco T, Walker J. However, there is concern that it may result in important confidentiality breaches for adolescent patients. Ethics Of Confidentiality In Health Care Can be especially important for children. Confidentiality laws regarding medical information are currently undergoing changes at both the state and federal levels. During this era of socialized medicine, there are both pros and cons of confidentiality, rights, safety, and the security of the patients. This is because; if an What you tell your doctor, lawyer, or psychologist is supposedly protected information that cannot be shared with others, no matter how intimate, gory, or revealing it may be. Cons: Physicians have less autonomy and less continuity with patients. Telehealth refers to providing healthcare services outside the bounds of a The following are examples of how some institutions have provided protection to adolescents; they are not applicable to all institutions or systems: For patients ages 1217-years old, manage or restrict parental or guardian access to provider notes. BMJ Open 2016;6:e010034. For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations. If the EHR system does not allow for procedures to maintain adolescent confidentiality, the obstetriciangynecologist or staff should inform the patient that parents or guardians will have access to the records, and the patient should be given the option of referral to a health care provider who is required to provide confidential care. Quality healthcare services: The US has modern medical equipment and ensures citizens are able to get quality medical care. Universal health care may encourage entrepreneurship. The network of participating doctors and hospitals. of Ethics and HIV Disclosure Available at: Confidentiality in Adolescent Health Care, Addressing Patients and Parents or Guardians About Confidentiality, Provision of Health Care to Adolescent Patients, Suggestions for Protecting Adolescent Confidentiality Within Institutions, https://www.guttmacher.org/state-policy/explore/overview-minors-consent-law, https://www.aafp.org/about/policies/all/adolescent-confidentiality.html, https://www.nihcm.org/component/content/article/5-issue-brief/1287-protecting-confidential-health-services-for-adolescents-young-adults, https://www.opennotes.org/tools-resources/for-health-care-providers/implementation-toolkit/, https://www.cahl.org/state-minor-consent-laws-a-summary-third-edition, Alliance for Innovation on Women's Health, Postpartum Contraceptive Access Initiative. Many Definitions of Patient Confidentiality, When You Cannot Expect Medical Information to Remain Confidential. We may have to disclose private information to protect a patients safety. Often her small private room was crowded with family, friends, and loved ones. The right of a mature minor to consent to medical care without previous parental or guardian consent has been recognized in many states.*. How do we weigh the pros and cons of sharing personal health information with others in the medical community and with the government? For example, it is much easier to obtain a persons credit history (even legally) than it is to gain access to his/her medical history, even though both may be considered highly personal and private information. WebPros And Cons Of Sarbanes-Oxley Act Of 2002. Sarbanes-Oxley Act of 2002 is a law enacted by US congress in July 30, 2002. Employed physician in academic institution. The bill consists of 11 sections and was Obstetriciangynecologists who work with adolescent patients have a unique perspective and are encouraged to work with their institutions to protect patients confidentiality. It is important not only for health professionals to be aware of the many considerations of confidentiality laws, but it is also important for the individual. Implementation toolkit. However, during this era of socialized medicine, it would not be prudent to keep some of the health information about health (Klein,2011). WebHere are some Pros and Cons of personal health records: Pros: Correction of medical errors within the medical record was possible Patients had a broader knowledge base of their health concerns and decreased utilization of healthcare services Opportunities were provided for increased effective communication between patients and physicians Insurance companies may provide their policyholders discounted medical treatment by entering into agreements with doctors' offices and hospitals. In the latter situation, the laws usually provide protections against liability for disclosure. Second, we want to make sure that they have had the opportunity to learn to talk with a doctor by themselves so that when they are young adults, they are prepared to communicate and advocate for what they need. All Rights Reserved. After her murder, the family sued, claiming that the physician should have warned the victim. No part of this publication may be reproduced, stored in a retrieval system, posted on the internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.American College of Obstetricians and Gynecologists 409 12th Street SW, Washington, DC 20024-2188Confidentiality in adolescent health care. Another problem, however, is what to do regarding the patient who has discovered a breach of confidentiality. There are some problems with paper medical records. Technology Improving Healthcare in Hospitals: 4. The U.S. Supreme Court has stated that "disclosures of private medical information to doctors, to hospital personnel, to insurance companies, and to public health agencies are often an essential part of modern medical practice." As part of comprehensive health care, it is our practice to ask parents to wait outside for part of the interview and to encourage the adolescents to discuss their own interests and concerns. OpenNotes is a national initiative that encourages patient access to visit notes written by their health care providers 19. As your adolescents doctor and as the parent (or guardian), we have two roles here. WebData access limitations. What is Universal Health Care If protection of adolescent confidentiality is not possible within their electronic system, the information technology support within individual institutions should be employed to restrict parental access per HIPAA compliance. Patient Access to Health Records A number of states have adopted this principle, and some have extended it to all physicians or mental health professionals. High quality handovers are essential for safe healthcare and are used in many clinical situations. Therefore, they State confidentiality protections vary widely. Lehrer JA, Pantell R, Tebb K, Shafer MA. Challenges In order to ensure the privacy of the adolescent is not violated under HIPAA, obstetriciangynecologists and other health care providers should educate their patients about what information is released when a request or release of records is sent to a health care provider, including if a parent or guardian requests a release of information or a patient requests a release to the parent or guardian. Still, they are horrified by the potential that their insurance company may need access for reimbursement purposes. The obvious solution is to go to court, but this means making public the information they did not want anyone to know in the first place! People take this matter While gaining the adolescents trust, we still encourage them to discuss issues with their parents or guardians. While it is generally accepted that patients must consent before being entered into a research study, some state laws explicitly carve out an exception to confidentiality restrictions, allowing access to medical records for research purposes. Chernichovsky, D. (2009). Only individuals who are legally authorized to have access to patient data for a legally permissible purpose should be given access to patient These registries are usually kept confidential, and in many cases the information is kept separately from any individually identifying information. Sharing medical information for research purposes is more controversial. This can actually slow their recovery. Another problem, however, Obstetriciangynecologists and other health care providers should be active in educating their staff and patients regarding the confidentiality of services. Confidentiality in Adolescent Health Care | ACOG There is little to no control over income distribution. See Box 1 and ACOG Committee Opinion No. WebPeople may get a higher feeling of security. American Academy of Family Physicians. Breaking Confidentiality in Clients with The immediate occasion is 2009, which is shown through the copyright year or the year of Ererere. Annals of internal medicine, 158(8), 620-627. Ethical Dilemmas: Breaking Confidentiality Every patient has got the right to privacy and therefore has got every right to ensure that the information about his or her health is concealed. Even though ensuring the privacy of a patient is quite important during these days socialized medicine, but it has got some of its disadvantages. However, there may be substantial cost to these safeguards, and constant reevaluation of protection is imperative. All of the different ways of conceptualizing confidentiality include exceptions, allowing disclosure under certain circumstances or to particular agencies. All rights reserved. Only a few states have comprehensive confidentiality laws, and many states control disclosure of health information through a combination of statutes addressing everything from particular disease information to autopsy records. Emancipation: A legal procedure whereby minors become legally responsible for themselves, and their parents or guardians are no longer responsible (financially or otherwise). New York, NY: Guttmacher Institute; 2019. Although laws vary by state, all minors have a right to some confidential health care. The United States continues to move toward a nationwide health information network that will allow health care providers to obtain quick access to patient medical information through EHRs. Any updates to this document can be found on acog.org or by calling the ACOG Resource Center.While ACOG makes every effort to present accurate and reliable information, this publication is provided as is without any warranty of accuracy, reliability, or otherwise, either express or implied. In other words, socialized medicine is one of the many forms of social insurance. She had been admitted with HIV-related complications from pneumonia. Pros and Cons The most obvious benefit of utilizing AI technology is its ability to improve patient experiences. Although most Any concerns the patient has regarding the presence of a chaperone should be elicited and addressed if feasible. In addition, some states have statutes that require reporting of abuse of hospital patients or long-term care patients, elder abuse, spousal abuse, and domestic abuse. The Pros and Cons of Big Data in the Healthcare Industry Any updates to this document can be found on acog.org or by calling the ACOG Resource Center. A., & Arora, V. M. (2013). The bill consists of 11 sections and was created as a reaction to high numbers of fraud and business misbehavior in major US corporations. In Tarasoff, a patient informed his therapist of his intention to kill a young woman. The first three categories are circumstances in which physicians obligations to maintain health (usually of the public, or sometimes of a particular individual) outweigh the need to maintain patient confidentiality. With respect to children under 18, however, these protections are generally thought to be appropriate, particularly in cases when a physician may suspect a child's injury he or she has been called upon to treat may be the result of child abuse. Any concern for a HIPAA violation should be addressed by individual health care systems. Hospital rounds and kids' confidentiality, Why Do Politicians Weaponize Medicare? Identify the adolescents cell phone number at check-in (in addition to collecting the parent or guardians cell phone number). By reading this page you agree to ACOG's Terms and Conditions. This may mitigate the intimidation some patients may experience from parents or guardians. An overview of consent to reproductive health services by young people. WebHealth Care Providers: Any provider of medical or other health services, or supplies, who transmits any health information in electronic form in connection with a transaction for which standard requirements have been adopted. Obstetriciangynecologists and other health care providers who care for minors should be aware of federal and state laws that affect confidentiality. What Is Supplemental Disability Insurance? Ethical Issues in Nursing: The Impact of Smartphones on But genetic information does have implications for the health of blood relatives. Bright futures: guidelines for health supervision of infants, children, and adolescents . 1. Literature discussing confidentiality and AIDS patients supports the notion that health care professionals (including counselors) have a duty to warn and protect at-risk third parties. Pros And Cons Advantages of Medical Technology in Healthcare: 1. WebSafeguarding data confidentiality is not always easy as technological advances also provide means of easily accessing information from remote locations and making it Society for Adolescent Health and Medicine. American College of Obstetricians and Gynecologists Obstetriciangynecologists should make clear to the patient what limitations, if any, exist in the EHR system. Leaving out details when you post information or images does not protect client confidentiality. Patient Confidentiality: Privacy and Public Health - The Doctor Will Should a doctor disclose to a patients family members the fact that the patient carries a gene for cancer or Alzheimers disease? ACOG Committee Opinion No. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Communication Systems in Healthcare Hospitals: 3. Its value also sabotages any effort to solve financing problems. WebThe uniqueness of HIEs-structures, relationships, funding, and authority-adds new complexities to the familiar issues of privacy, confidentiality, security, and information use. Top of Page However, it also has the potential to negatively influence patient care. Confidentiality, Privacy, and Unreliable Technology Keeping your personal information private is a major concern in psychotherapy, but online treatment adds a layer Health Insurance Portability and Accountability Act (HIPAA) of 1996: When Congress passed HIPAA in 1996, the law was known primarily for its provisions that provide stronger health insurance protection for people leaving jobs and people with preexisting medical conditions. We want to work with you to help your adolescent make the best choices for a healthy future. Retrieved November 15, 2019. Teens also have a right to confidential mental health and substance abuse treatment. Pros and Cons Measures to ensure protection will vary based on the EHR system capabilities and institution-specific policies. The minor can consent to medical, dental, or psychiatric care. BMJ Qual Saf 2017;26:26270. WebPros of Confidentiality in Healthcare: Encourages patients to seek care: Confidentiality helps build trust between patients and healthcare providers, which may encourage patients to According Chernichovsky (2009), the term Socialize medicine is defined as a health system where by which the government owns and operates both the financing of healthcare and also its delivery. The American College of Obstetricians and Gynecologists encourages obstetriciangynecologists and other health care providers to ensure that their existing EHR systems protect the confidentiality of minor patients, including any OpenNotes features. This article will explore how confidentiality should be conceived and if and when it should be broken. At the initial visit, the obstetriciangynecologist should discuss the following issues with the parent or guardian and the patient: 1) the meaning and importance of confidentiality; 2) the scope of confidentiality protection; and 3) the limitations of confidentiality. This will allow patients to create their own direct access to their record, rather than through a parent or guardian. New England Journal of Medicine, 361(21), e46. WebHealth care workers must respect patients confidences. Confidentiality discussions and private time with a health-care provider for youth, United States, 2016. J Adolesc Health 2007;40:21826. pros and cons Therefore, a doctor is not under any obligation to reveal threats of minor harm, threats that the doctor does not believe are serious, or general threats where there is no identifiable individual at risk. Optimally, obstetriciangynecologists should ensure that medical record information, including EHR information, for care provided under minor consent or mature minor provisions is considered confidential and should not be disclosed to parents or guardians without adolescent consent. Reduction in Medical Errors: 5. Additionally, it is costly for vendors to develop and maintain the levels of mandated confidentiality because the laws regarding confidentiality vary by state 4. The parent or guardian and patient should be aware that these discussions are considered private, not secret, and obstetriciangynecologists may disclose private information when concerned for the immediate danger of patients to themselves or others, or both, and when reporting is required by public health laws 6. Gray SH, Pasternak RH, Gooding HC, Woodward K, Hawkins K, Sawyer S, et al. Social Media Use Common Expectations for Nurses Obstetriciangynecologists should not misinterpret consent required to provide health care services with consent required to provide education and counseling; that is, even when consent is required by a parent or guardian for provision of contraception, an obstetriciangynecologist may still provide counseling about contraceptive options. Obstetriciangynecologists should be aware of how the process of the release of medical records of minors is addressed by their institution. Developments in technology have challenged our traditional understanding of "personal" information and privacy. Legal protections for confidentiality are the result of our societys interest in privacy, but they can still be outweighed in cases where other society values (such as public health and safety) outweigh them. (2011). Pros: A single-payer system offers individuals greater control over their healthcare, providing the ability to choose their doctors based on approach or reputation. Journal of Adolescent Health, 25: Available at: National Institute for Health Care Management. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. There if an individuals privacy is not protected or guaranteed, people find it hard to give complete and candid information about their health even to their own personal physicians leave alone to the insurer. The Cons of Patients Confidentiality, Security, Rights, and Privacy During this Era of Socialized Medicine Advantages & Disadvantages of an EHR Wearable Technology: Disadvantages of Medical Technology in Healthcare: 1. Explanation of benefits statements (health care billing and insurance claims sent by insurance carriers) are an additional challenge to confidentiality. Confidentiality protections for adolescents and young adults in the health care billing and insurance claims process. *For more information, see Guttmacher Institute. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. Once confidentiality is breeched, it is difficult to regain trust; so, obstetriciangynecologists should make efforts to avoid the violation of the trust between the health care provider and patient. Although there are multiple benefits of EHRs, these benefits may conflict with the protection of confidentiality. During this era of increased socialized medicine, it has come with its pros and cons on the confidentiality, rights, safety, and the security of patients. WebSolution for Explain the pros and cons of multipurpose pins on microcontrollers. Protect against reasonably anticipated, impermissible uses or disclosures. What's the Pros & Cons Of Digital Health? - The Healthcare Guys Sexual misconduct. Generally, parents or guardians and adolescents should be informed, both separately and together, that the information each of them shares with the health care provider will be treated as confidential. The ACOG policies can be found on acog.org. Get Your Custom Essay on, The Pros and Cons of the Confidentiality of Patients in an Era of Increased Socialized Medicine. Obstet Gynecol 2018;132:e21320. 3rd ed. J Adolesc Health 2016;58:3747. Sarbanes-Oxley Act of 2002 is a law enacted by US congress in July 30, 2002. 803. Patient Access to Health Records: Pros and Cons Committee on Practice and Ambulatory Medicine. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product. During this era of increased socialized medicine, it has come with its pros and cons on the confidentiality, rights, safety, and the security of patients. Protection of privacy also ensures that the societal values are also protected. There is little to no control over income distribution. Private information, especially if identifiable, should only be disclosed to the third party with the consent of the patient. The principle of bioethics of non-malefience require for the sage guarding of personal privacy. The Importance of Supplemental Disability Insurance. Often, the behavior is not disclosed to parents or guardians. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. Webthe confidentiality of adolescents health care in-formation are fundamentally necessary to allow health care professionals to provide appropriate health care to adolescents and Ventola, C. L. (2014). Confidentiality extends beyond reproductive health for minors. Ability to share health information with family members and other relevant clinicians. Pros and cons What is managed Care One form of medical coverage is the managed-care plan. Online medical professionalism: patient and public relationships: policy statement from the American College of Physicians and the Federation of State Medical Boards. In fact, quite a lot of personal information is not protected at all. State laws typically either address the type of information (usually based on disease or illness) or the entity holding the information (such as government agencies), or both. WebPros And Cons Of Sarbanes-Oxley Act Of 2002. In some research protocols, identifiers remain so that data can still be traced to particular individuals. There are some theorists that have pointed out that privacy is a basic human right or good that has got some intrinsic values. Almost all states have child abuse reporting statutes. National Academies Press. In such circumstances, it may be appropriate to restrict access to such sensitive information obtained during portions of the visit while allowing other portions to be viewable by parents or guardians. Employed physician in academic institution. Meaningful use of a confidential adolescent patient portal. If, after counseling, the patient refuses the chaperone, this decision should be respected and documented in the medical record 11. 758, Promoting Healthy Relationships in Adolescents, for potential talking points when discussing confidentiality with parents, guardians, and patients 10. It builds trust: Experimenting with a range of behavior is common among adolescents and young adults. In fact, quite a lot of personal information is not protected at all. The other advantage for concealing health information to the service provider may end up being detrimental to the patient. It is unclear how this issue affects confidentiality, and, many states have been hesitant to extend such a duty to health professionals. Other states have consent laws that include substance misuse treatment, pregnancy prevention and care, and, sometimes, abortion services, mental health care, and emergency care. We are a society strangely obsessed both with privacy and obtaining information. Whether or not to disclose personal medical information is often said to be a balancing act between the benefits of keeping confidentiality and the benefits of waiving it. HMOs often only cover So there are a couple of questions that are up for debate. American College of Obstetricians and Gynecologists. The use of telehealth continues to grow, reaching multiple medical specialties and providing care to a greater population of patients. Guttmacher Institute. Leawood, KS: AAFP; 2018. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence.
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