Explain the impact of electronic medical records on compliance with HIPPA. How will HIPPA affect the role of the advanced trained nurse, e.g., the...


Electronic medical records are here to stay, I'm sure, and while they represent a significant advance in medical record-keeping, there are some areas of concern under HIPPA and in other ways, as well. 

One area of concern is the security of electronic records.  We are all aware that even governmental records have been hacked, and there is no reason to think that medical records are any less vulnerable to this problem.  Since one of the primary thrusts of HIPPA is confidentiality, this is a serious concern.

On other levels, confidentiality problems surface in the office or the hospital.  One is that information is being entered on a screen that might be visible to others.  I have noticed in the hospital, for example, that as I walk through a corridor, many computer screens containing confidential patient information are in plain view.  Another is that within an organization, be it an office, clinic, or hospital, unless levels of permission are built into the system, people have access to all the records.  Some places have built in access in such a way that one can only get to the records of one's patient.  I do not know if that is the case everywhere.  But access should always be on a "need to know" basis, since to do otherwise is asking for breach of confidentiality risks.

In recent weeks, there have been some articles in the New York Times about the potential for fraud and abuse in electronic medical record-keeping, with some institutions being under investigation, apparently.  One can now "copy and paste" from one medical record to another, which is problematic since hardly any two patients are treated precisely the same, even if they present with the same symptoms.  So, this is something that everyone who must enter records must be careful about.  Similarly, some of the software symptoms make it very easy to click on a button when presented with a menu of treatment options, even if all of the treatments were not provided. 

In general, this way of keeping records has tremendous benefits, but I am not so sure we have thought through all of the disadvantages and how to solve the new problems surfacing. 

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