The information provided in the case can be grouped around several important concepts: privacy, security, accountability, confidentiality, integrity and availability. Confidentiality implies that information can be accessed by authorized users only (Lehmann, Abbott & Roderer 2006). Integrity guarantees that information is complete and was not modified by unauthorized users (Lehmann, Abbott & Roderer 2006). Accountability attributes access and usage of confidential information to unique individuals (Lehmann, Abbott & Roderer 2006).
Ultimately, availability of the system means that users can easily access and use information they need to meet their goals (Lehmann, Abbott & Roderer 2006). The main stakeholders are healthcare consumers (patients), healthcare providers/ hospitals, and IT organizations like Google. Other stakeholders include private medical professionals, insurance companies, and government agencies. 2. America’s Current Recordkeeping System: Problems and Solutions The Google Health case study helps to evaluate the current state of recordkeeping systems in U.
S. healthcare. Today, the majority of medical record systems are paper-based; as a result, effective communication and access to the records are difficult or impossible (Anonymous n. d. ). Every year, American citizens make over one billion visits to doctors, and there are virtually “millions of paper medical records lining the corridors of thousands of local medical practices, and for the most part, they cannot be systematically examined, and they are difficult to share” (Anonymous n. d. ).
Duplication and loss of patient medical records make the provision of healthcare difficult, problematic, and costly. As a result, a new system of recordkeeping is needed to enhance the efficiency of recordkeeping operations in healthcare. Google Health can alleviate the inefficiency of the current record system by allowing consumers to enter and store their health data in an online repository (Anonymous n. d. ). Online repository makes it possible for doctors to send and share relevant health information electronically (Anonymous n.
d. ). The service is absolutely free for users, and the most advantageous features of the new system include: the so-called “health profile” for medications, allergies, and chronic health conditions; reminder messages for doctor visits or prescription refills; directories for nearby doctors, and even personalized health advice (Anonymous n. d. ). That the application can readily accept incoming information from other data storage systems is an important advantage (Anonymous n. d. ).
The development of the proposed system is justified by Google’s striving to make patient records more accessible and complete, and to streamline the basic recordkeeping processes (Anonymous n. d. ). 3. Electronic Medical Records: Management, Organization, and Technology Managing electronic recordkeeping systems in healthcare is not an easy task. In the context of management, the cost of implementing and maintaining an electronic medical record system is the issue of primary concern.
Google Health is free for its users, but hospitals and healthcare providers must be prepared to invest in organizational and technical changes that usually follow the implementation of such systems. For example, medical personnel will require additional training to successfully use and run Google Health. In their article, Baron et al. (2005) evaluate the cost-effectiveness of an electronic record system and confirm that the post-implementation annual budget for the new system increased almost 4 times.
Only due to the absence of the annual transcription costs and the elimination of 1 staff position was the hospital able to make $20,000 in annual savings (Baron et al. 2005). If properly implemented, Google Health has a potential to reduce future costs by an estimated $80-$240 billion dollars (Anonymous n. d. ). Here, managers should also pay attention to how information is used and monitor the risks of potential information misuse. From the viewpoint of organization factors, Google Health holds a promise to make patient health information more systematic and better organized.
Unfortunately, better organization and easy access alone cannot suffice to guarantee full security and protection of sensitive health information from the risks of intrusion. What matters is the implementation of sound regulatory frameworks, which will address the underlying privacy challenges and will give consumers higher degree of confidence that their records are protected from unauthorized access and use. Those who believe that HIPAA is a reliable regulatory mechanism will be disappointed, because HIPAA does not seem to fit in the current networking reality.
Greenberg, Ridgely and Hillestad (2009) assert that (a) HIPAA does not support the shift away from traditional bilateral relations between providers toward complex distributed network-based recordkeeping solutions; and (b) HIPAA fails to anticipate the development of broader interoperable national recordkeeping frameworks. As a result, the development and implementation of new privacy regulations are critical for the organizational success of Google Health. Finally, the most important technological factors include interoperability, privacy, and equal access to health records.
The new electronic health record system must not only accept incoming information from other recordkeeping systems, but be easy to integrate with the existing recordkeeping frameworks. An efficient health record system will have a complex barrier against the risks of unauthorized access to sensitive patient information. Here, Google Health must utilize complex user identification techniques and make consumers aware of the security practices it uses to protect their privacy and confidentiality. 4. Pros and Cons of Electronic Health Record Systems
That computer technologies enhance the efficiency of all business operations cannot be denied. The use of IT solutions in health care is of particular importance: information technologies have a potential to reduce the burden of paper-based records, to improve the organization and interoperability of various computer systems, and to enhance the quality, efficiency, and cost-effectiveness of healthcare provision. The benefits of using Google Health are many. EHR are the catalysts for the process of standardizing and digitizing the national system of medical records in an easy-to-use format (Anonymous n.
d. ). Easier access to patient records and the ability to share patient records with other doctors and medical care providers is another benefit of electronic health records. Myers et al. (2008) state that digitization of medical records benefits health care delivery, research, surveillance, and education. The number of forms used for effective recordkeeping can be reduced (Myers et al. 2008). Electronic transformation of healthcare data increases medical data reliability, reduces errors, and saves significant costs (Myers et al. 2008).
Electronic records speed up the process of collecting patient data and facilitate authentication, authorization, and auditing (Myers et al. 2008). The information in electronic health record systems can be easily organized around several different security levels, providing different access to users with different security clearance (Myers et al. 2008). Electronic health records let healthcare entities improve their public accountability and create precise audit trails (Myers et al. 2008). Unfortunately, security is still one of the most problematic aspects of any electronic health record system.
Google Health is not an exception – privacy advocates and individuals are concerned that electronic health records will be stored in ways that facilitate privacy invasions (Anonymous n. d. ). The security threats are both physical and electronic, and include wireless email devices, tokens for remote network access, portable flash drives, the gaps in network management and information transfer, and extra-/ intra-institutional security challenges (Myers et al. 2008). Public health institutions are always at the increased risk of unauthorized intrusions (Myers et al. 2008).
Google Health proposes that patients and healthcare providers store patient health information in online repositories, and the latter may become an easy target of advertisers’ profiling intentions. Ultimately, the lack of technical/ technological training and staff awareness, as well as the lack of the necessary software and hardware infrastructures, can become a serious obstacle in the hospitals’ way to implementing advanced EHR solutions. 5. Google Health: Too New To Be Trusted The concept of Electronic Health Records reflects the progress and functionality of health information systems.
Google was one of the first to develop a sophisticated IT framework, which can be used by health care providers as the basic source of information about patients and serve as a reliable decision-making support at the point of care. Unfortunately, Google failed to equip its system with a reliable privacy protection mechanism; as of today, consumers should avoid using Google Health, until the company improves the system security and provides healthcare providers and patients with the details about its security practices.
As of today, customers should not entrust Google with the electronic medical records. The fact is in that Google failed to reassure the public that its “security is iron-tight and that businesses and individuals should have confidence in its ability to store and protect data” (Anonymous n. d. ). Consumers are not aware of the mechanisms Google uses and/ or is willing to use to protect sensitive patient health information from the risks of unauthorized intrusions.
Although Google Health could potentially alleviate the burden of unnecessary paperwork and provide hospitals with unique cost cutting opportunities, there is still much to do before Google Health becomes a trusted electronic health record solution. That the current state of regulation does not protect patient health information from the risks of unauthorized access adds its share of complexity to security issues. Current HIPAA privacy rules are not created to deal with the distributed network infrastructures (Greenberg, Ridgely & Hillestad 2009).
The larger these information networks grow, the weaker the local controls over sensitive patient information become (Greenberg, Ridgely & Hillestad 2009). The existing legal and regulatory ambiguities make customers absolutely unprotected in face of potential risk intrusions and failures. As a result, there is a risk of significant degradation of the current privacy safeguards; in this unregulated context, the development of health record frameworks may result in even greater privacy risks (Greenberg, Ridgely & Hillestad 2009).
Consumers should not entrust their records to Google Health, until the company develops sophisticated barriers against unauthorized access to sensitive health information and informs consumers about how these barriers work. Meanwhile, consumers should keep from using Google Health and similar EHR solutions. 6. Electronic Health Records: Some Features to Include Google Health is, probably, the first step toward creating an ideal electronic health record solution. Despite the multitude of benefits and technical options, there are features which Google Health must have to become a universal form of electronic recordkeeping in health care.
Based on what we currently know about electronic health records, the basic features I would include in such systems would be: (a) functional user interface; (b) the system of secure exchange of health information between providers; (c) a sophisticated system of security protection; and (d) a small education guide for consumers, who lack skills and knowledge needed to use a health record system. Primarily, a sophisticated security system must be developed, to guarantee that private consumer information is protected from the risks of unauthorized access.
Consumers who adopt electronic health record solutions require that the information be well protected and kept private (Kahn, Aulakh & Bosworth 2009). Bearing in mind, that more and more networks rely in wireless access to the Internet and local networks, some of the basic security mechanisms may include: changed Service ser identifiers, private IP addresses and subnetworks, complex account names and passwords, disabled SSID broadcasts, and media access control address filtering (Stream & Fletcher 2008).
Consumers must be aware of what these mechanisms are, how they protect their privacy, and what the company is doing to enhance the level of security protection for electronic health records. Functional user interface will facilitate the process of accessing and using the system even by non-experts. Should any problems occur, consumers will need professional advice, which will help them use the system more efficiently.
I cannot but agree to Kahn, Auklakh and Bosworth (2009) in that the value of even the idealized electronic record system will be enhanced by the development of tools that help consumers obtain advice and find information to determine their best health and technology options. A small educational guide will help users to learn the basic features of the electronic health record system and to meet their information needs. The system should be standardized to improve its interoperability and to guarantee effective transfer of medical data from other systems.
A mechanism of secure information exchange between providers should be developed, to improve the quality and productivity of health record networks. These networks will avoid using unencrypted transmissions, but will utilize multi-level access routes, to authorize the user and to reduce the risks of unauthorized intrusion. All these elements will lay the foundation for the development of a more sophisticated recordkeeping system, which will reduce costs, improve patient-hospital relations, and alleviate the burden of paperwork.
These elements will speed up the integration of electronic health record systems with the basic healthcare operations and will give healthcare providers a chance to improve the quality and efficiency of health care delivery. References Anonymous. (n. d. ). Should Google organize your medical records? Case study. Greenberg, MD, Ridgely, MS & Hillestad, RJ 2009, ‘Crossed wires: How yesterday’s privacy rules might undercut tomorrow’s nationwide health information framework’, Health Affairs, vol. 28, no. 2, pp450-452.
Kahn, JS, Aulakh, V & Bosworth, A 2009, ‘What it takes: Characteristics of the ideal personal health record’, Health Affairs, vol. 28, no. 2, pp369-376. Lehmann, HP, Abbott, PA & Roderer, NK 2006, Aspects of electronic health record systems, Birkhauser. Myers, J, Frieden, TR, Bherwani, KM & Henning, KJ 2008, ‘Privacy and public health at risk: Public health confidentiality in the digital age’, American Journal of Public Health, vol. 98, no. 5, pp793-801. Stream, G & Fletcher, J 2008, ‘Demystifying computer networks for small practices’, Family Practice Management, January, pp24-28.
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