May 23, 2024

After studying Module 3: Lecture Materials & Resources, discuss at least two potential ethical issues that could be of concern with nursing use of social media. ? Submission Ins

After studying Module 3: Lecture Materials & Resources, discuss at least two potential ethical issues that could be of concern with nursing use of social media.

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 3 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.

Chapter_0141.pptx

Chapter 14

Personal Health Records (PHRs)

What Is a Personal Health Record?

Paper

Persistent data storage that is portable and shareable

Electronic

Persistent data storage that is portable and shareable plus additional functions that include access to electronic health records (EHRs), secure messaging, and scheduling

Paper still most common form of record.

Trends Related to Personal Health Records

Rise of personal computing devices and the internet

Development of EHRs

Governmental policies (Health Insurance Portability and Accountability Act [HIPAA], Health Information Technology for Economic and Clinical Health [HITECH])

Person’s desire for functions

Mobile devices changing how PHRs will be delivered and what they can offer.

Blue ButtonSM for Patient Access to Electronic Health Records

Developed in 2010 to allow patients to access their records with the click of a button

Records available in either human-readable or machine-readable format

Features clinical, demographic, financial/health benefits and invoices, and other information related to the health and medical care of patients

Mobile devices changing how PHRs will be delivered and what they can offer.

Attributes of an Ideal Personal Health Record

Comprehensive, longitudinal data

Data ownership, control, and privacy

Portability

Data sharing

Access

Unique and desired services

Customization

Benefits of an Ideal Personal Health Record

Improved care coordination and patient safety

Improved care by informal caregivers and self-management

Improved self-care

Provide examples of reduced duplication between providers, improved adherence and satisfaction when informal caregiver is able to follow up electronically, and improved self-care through goal setting, planning, and reminders.

Types of Personal Health Records

Stand-alone

Untethered

Tethered

Networked

Systems are determined by what they are linked to; a stand-alone system is linked to nothing else,

a networked system is a linked to all sources of data for the given patient.

Benefits of Current Personal Health Records

Experience of care

Quality of care

Utilization and costs

Limitations of data are that experience is measured as satisfaction with care, quality is based on short-term outcomes, and cost is based on utilization.

Barriers to Adoption

Awareness

Usability

Privacy concerns

The digital divide

Provider engagement

Interoperability

Law and policy

Most people are not aware of PHRs; poor people and minorities less likely to adopt PHRs; about 2/3 of people say they are concerned about privacy of PHRs; both PHRs and EHRs suffer from usability problems.

Awareness

2010 survey:

More than 50% of people are unaware of PHRs.

Up to 76% of people are unaware of telephone applications for tracking health information.

2008 survey of rural physicians:

More than 25% are unaware of PHRs.

Up to 59% are unaware whether patients had or used PHRs.

Usability

Users are disappointed in the:

Amount of data available

Type of data available

Need to enter all the data themselves

Limited options for sharing data with clinicians

Privacy Concerns

Although studies show that PHRs can securely exchange health information, users are still concerned with security.

The Digital Divide

Individuals of lower socioeconomic status, ethnic minorities, and older individuals are less likely to adopt a PHR.

Interoperability

PHR data and functions are constrained by the systems to which the PHR is linked.

Several data representation exchange standards have been developed and proposed to mitigate this concern.

Continuity of care record (CCR)

Clinical document architecture (CDA)

Continuity of care document (CCD)

Law and Policy

State laws sometimes interfere with PHRs:

In California, certain results may not be electronically released for any reason.

Current laws prohibit healthcare providers from delivering care across state lines.

Barriers to Ideal Personal Health Records

Technical

Policy

Current records are not interoperable.

In some states current laws prevent full sharing of EHR data and prevent practice of medicine across state lines, limiting the use of PHRs for e-Visits.

Future of Personal Health Records

Generalizability of current evidence

Improvements:

Expand the scope of data in the PHR.

Expand the functionality of the PHR.

Current evidence limited to early adopters and integrated healthcare systems.

Data could be comprehensive and integrated with national health information exchange.

PHR functions could be personalized and motivational to facilitate health behaviors.

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After studying Module 3: Lecture Materials & Resources, discuss at least two potential ethical issues that could be of concern with nursing use of social media. ? Submission Ins

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