course material

1. Updated
With the increase of health information technology used to store and access patient
information, the likelihood of security breaches has also risen. In fact, according to
the Canadian Medical Association Journal (CMAJ):In the United States, there was a
whopping 97% increase in the number of health records breached from 2010 to 2011… The
number of patient records accessed in each breach has also increased substantially, from
26,968 (in 2010) to 49,394 (in 2011). Since August 2009, when the US government
regulated that any breach affecting more than 500 patients be publicly disclosed, a total of
385 breaches, involving more than 19 million records, have been reported to the
Department of Health and Human Services.A large portion of those breaches, 39%, occurred
because of a lost, stolen, or otherwise compromised portable electronic device—a problem
that will likely only get worse as iPads, smartphones, and other gadgets become more
common in hospitals. (CMAJ, 2012, p. E215).Consider your own experiences. Does your
organization use portable electronic devices? What safeguards are in place to ensure the
security of data and patient information? For this Discussion you consider ethical and
security issues surrounding the protection of digital health information.To prepare:Review
the Learning Resources dealing with the security of digital health care information. Reflect
on your own organization or one with which you are familiar, and think about how health
information stored electronically is protected.Consider the nurse’s responsibility to ensure
the protection of patient information. What strategies can you use?Reflect on ethical issues
that are likely to arise with the increased access to newer, smaller, and more powerful
technology tools.Consider strategies that can be implemented to ensure that the use of HIT
contributes to an overall culture of safety.Ask a probing question, substantiated with
additional background information, evidence or research.Share an insight from having read
your colleagues’ postings, synthesizing the information to provide new perspectives.Offer
and support an alternative perspective using readings from the classroom or from your own
research in the Walden Library.Validate an idea with your own experience and additional
research.Make a suggestion based on additional evidence drawn from readings or after
synthesizing multiple postings.Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence. Nursing
Responsibility to Protect Patient Information Office of the National Coordinator for Health
Information Technology (ONC) developed a framework to address privacy and security
challenges online related to health information (Brown, 2009). The eight principles are (1)
individual access; (2) correction; (3) openness and transparency; (4) individual choice; (5)

2. collection, use, and disclosure limitation; (6) data quality and integrity; (7) safeguards; and
(8) accountability (Brown, 2009). The first four principles describe an individual’s rights
regarding the accessibility, disclosure about how their information is collected and
treatment of their personal health information. The last four principles suggest measures
ensure an individual’s health information is protected. Data should be accurate and not
changed without authorization, information that is transmitted electronically should
implement reasonable administrative, technical, and physical safeguards to ensure
confidentiality, integrity, and availability and to prevent unauthorized or inappropriate
access, use or disclosure (Brown, 2009). There should also be auditing policies in place to
ensure the principles are being followed to prevent any breaches. HIT has made it more
difficult to protect patient privacy Protecting patient’s privacy is more difficult with HIT,
particularly with the utilization of the internet to ensure real-time information is available
to all departments, for example, in emergency medicine, orders need to be completed on an
emergent basis. The radiology department needs to be able to access orders and records in
real-time to know which procedure to perform. Through communication tools, electronic
ordering, decision support features, and data management, EHR systems will guide many
aspects of patient care. Treatment success will often depend on their proper functioning
(Hoffman & Podgurski, 2011). Security and ethical issues related to the use of smartphone
and tablets are related to the type of information that is shared in some instances by
healthcare workers. In my organization, we are cautioned in orientation to be careful what
we post about patients at our facilities. McGonigle, & Mastrian, (2015, p. 70) as cited in
Englund, Chappy, Jambunathan, & Gohdes, (2012, p. 244), comment above all, nurses must
be mindful that once communication is written and posted on the internet, there is no way
to retract what was written; it is a permanent record that can be tracked, even if the post id
deleted. In my organization strategies to safeguard patient information that promotes a
culture of safety is by not only monitoring our computer workstations but holding
educational workshops on ways to protect patient privacy. In my facility since everything
we do is virtual, anyone who enters our building needs to sign a privacy and confidentially
statement. The strategies in place instill confidence by our patients that we take their
privacy seriously. An area of improvement in my facility is with the way our workstations
are configured. As I work for our Virtual Care Center, our workstations are just computers
and six screens, with what is called a “privacy sail” that we can move. This sail is okay for
some of the work that is done at our facility where nurses are monitoring ventilators or
monitors, however for my department which is Case Management; we are talking to
patients all day long, and conversations carry. Those conversations are heard by everyone
in the department. One strategy to address this issue would be to move our department to
the third floor, which has not yet been completed, with more of a cubical arrangement
instead of open workstations. Reference Brown, B. (2009). Improving the Privacy and
Security of Personal Health Records. Journal Of Health Care Compliance, 11(2), 39-
68.Brown, S. M., Aboumatar, H. J., Francis, L., Halamka, J., Rozenblum, R., Rubin, E., & …
Sarnoff Lee, B. (2016). Balancing digital information-sharing and patient privacy when
engaging families in the intensive care unit. Journal Of The American Medical Informatics
Association, 23(5), 995-1000. doi:10.1093/jamia/ocv182Hoffman, S., & Podgurski, A.

3. (2011). Meaningful Use and Certification of Health Information Technology: What about
Safety?. Journal Of Law, Medicine & Ethics, 3977-80. doi:10.1111/j.1748-
720X.2011.00572.xMcGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the
foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.