Ethical Implications

Posted: December 21st, 2022

Ethical Implications

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Ethical Implications

The Long Island Council on Alcoholism and Drug Dependence (LICADD) presently lacks an electronic record system and interns and staff have no alternative but to write all progress information and notes for patients and other clients manually. The problem became more evident at a time when the facility asked its workers to turn to remote working in an attempt to curb further spread of a COVID-19 case reported within the facility. While working remotely, interns could utilize google voice or *67 followed by dialing the patient’s number when conversing on the phone. A free package of doxy was utilized if a client preferred a video engagement. When staff and interns had to create a progress note, they were required to type them and keep them on their personal computers (PCs). However, it is apparent from this form of operation that clients could have the fear that their data is not adequately protected and could be violated. Every client should feel that their data is secure with the agency not violating privacy by having patients’ progress notes on PCs.

The lack of an electronic system to store and facilitate the retrieval of clients’ data is an ethical concern as opposed to an everyday organizational problem because it violates the nursing ethical principles. A nurses or intern who mishandles a client’s data could be breaching the principle of nonmaleficence, which calls for protection of the patient from all forms of harm (Agianto, 2016). The harm in this scenario could entail safeguarding them from the pain that their data is being mishandled. Moreover, confidentiality is a fundamental ethical principle that guides nursing practice (Agianto, 2016). It is a vital medical and legal obligation that all health practitioners are supposed to follow. The principle stipulates that matters pertaining to patients should not be revealed to others at any cost. Therefore, failing to take adequate measures to safeguard client’s data is an ethical issue and not an ordinary business problem.

A critical examination of the case further reveals that it could have ethical repercussions unlike other problems that occur at the health facility. The client in this case is confident that the facility handles the data in the most suitable and secure manner. However, that is not the case because the case reveals that interns and staff keep patients’ crucial progress notes on their PC’s without any backup. Such information could be lost in case of a hard drive crash, or in case one loses his or her computer. The management allows this to happen with the full knowledge that the practice could have far-reaching ethical implications should one or more of the clients raise complaints regarding how the organization handles clients’ data.

Consequently, it is necessary to consult various groups and individuals that could facilitate the ongoing attempts to foster change. The fundamental groups to engage in this case is staff and interns to find out how the current operational technique impact on their services. Consulting staff and interns will provide insight into what needs to change to enact safer and secure ways of handling clients’ data. The other group that will contribute significantly in this case are the organizational leaders who will hasten the plan that is already in place to adopt an electronic system. It would also be essential to consult patients and other clients to find their views on how they would want their data to be handled. More fundamentally, it is important to consult technological experts who will come up with an effective solution to the current ethical concern to improve how the organizational handles patient data.

It is imperative to consult various parties because the ethical matter impacts significantly on the stakeholders’ values, emotions, beliefs, and reactions. For instance, the health workers and organizational leaders believe that the facility will develop a bad reputation for failing to come up with an effective way for handling clients’ data. Moreover, staff, interns, and leaders could develop the fear that the facility could become a victim of cybercrime that is increasingly becoming rampant, especially among institutions that do not enact effective measures to safeguard their data. Clients, on their part, are likely to become less confident in the way the organization handles their data if the firm does not take steps to improve data handling. Thus, the matter could evoke emotional reactions from various parties relating with the firm in one way or the other.

Each of the stakeholders have underlying needs, goals, and interests regarding the issue at hand. Clients would want to relate with an organization that takes effective measures to safeguard their information rather than dealing with an institution that lacks the capacity to uphold confidentiality. The organizational leaders, on their part, would want to lead an organization that upholds the principle of confidentiality. The leaders would want to create trust and confidence with its clients because this would determine the firm’s reputation as well as revenue generation. Also concerned are staff and interns who would want to serve in an institution that has developed systems that improve how they gather, store, and retrieve clients’ information. Overall, all stakeholders aspire to have an organization that has developed structures for handling clients’ information.

All concerned parties need to work towards implementing the recommended plan because other than having ethical concerns, the deficiency could have legal implications as well. Health care providers while offering their services must abide by the Health Insurance Portability and Accountability Act (HIPAA) regulations (Cohen & Mello, 2018). HIPAA is a federal law that defines the basis of security for particular individually identifiable health data.However, breaching or mishandling patient information could also be a violation of the Breach Notification Rules, which was formed out of HIPAA and obliges covered firms to inform clients when their insecure protected heath information is used without consent (Cohen & Mello, 2018). Firms and individual practitioners are liable for punishment for breaching any of the stipulated guidelines.    

The group needs to consider the ethical and legal effects associated with the problem as having the capacity to cause adverse effects, thereby making it necessary to identify the area that needs more attention to enact effective mitigating measures. The team working on the matter should identify an issue that requires urgent attention as one that would have immediate effects on the organizations. In this case, it is essential to address the ethical concerns as the most urgent matter because this directly impacts on all stakeholders. Addressing the ethical concern and coming up with effective remedies will present a platform to handle the legal concerns more effectively.

An analysis of the matter using ethical theories suggest that the lack of an electronic system to handle patient data and allowing staff and interns to keep personal data are unethical. For instance, examining the case based on utilitarianism suggests that the current practice is unethical and inappropriate. The utilitarian ethical theory implies that an action is ethical is it gives a result that benefits most of the people (Barsky, 2010). However, that is not the case in this scenario where the way of handling data could instill fear and discomfort among patients should they become aware that the facility lacks effective mechanisms to maintain data safely. Furthermore, looking at the matter based on the argument in deontology. The theory urges individuals to play a role that would make their action to appear ethical towards others (Barsky, 2010). Therefore, the hospital leaders in this case act unethically by having failed to install a more effective system early enough. Fortunately, the team now understands the significance of having an electronic system and is working very fast to enact the change. Also important in this case is the NASW Code of Ethics that forbids all forms of misconduct of social workers, which urges all workers, including health practitioners to always act ethically (NASW, 2022). The ethical framework are essential and any violation could result in unpleasant outcomes.

The most suitable remedy in this case is to install an electronic health record (EHR) system at the facility. An EHR works as an all-inclusive system that health workers can utilize to monitor their clients’ health information (Johar & Patagundi, 2018). The system is often a computer program that stores a file of each single element or a client’s care records. Practitioners can rely on the EHR to store valuable information such as lab test outcomes, billing information, allergies, medical history among other information, and personal data such as name, age, sex, and race (Johar & Patagundi, 2018). It is encouraging that the organizational leaders already have plans to adopt an electronic system and it is expected the change will transform organizational practices as well. Proper implementation of the system will enable workers to access precise, updated, and sharable data, as well as offer improved, quality, and safer care (Johar & Patagundi, 2018). Moreover, installing the feature will improve patient privacy and security, and also increase efficiency and productivity (Johar & Patagundi, 2018). Therefore, the team should not relent in its current initiative to install an electronic system.

However, effective implementation of the electronic system would require the concerned parties to embrace an equally effective monitoring approach to ensure that the program achieves its goals. An effective assessment technique is to identify certain performance metrics and find out if the facility achieves them after the implementation of the electronic system. A possible metric in this case would be to assess the ease of accessing and retrieving patient data (Johar & Patagundi, 2018). Increased retrieval would mean that the EHR system has beneficial effects on the way the staff and interns handle fundamental data. Another metric that would show the installation is having positive effects is increased patient satisfaction (Johar & Patagundi, 2018). Otherwise, increased dissatisfaction would imply that more need to happen to improve the data handling process.

Nonetheless, the team spearheading the implementation of an electronic system should consider some of the potential constraints that could derail the process. A possible challenge would be to get enough funds to support the initiative. The group has plans to reach out to various financers but this is not a guarantee that the group will access the needed money to facilitate the installation. Another possible challenge is that not all workers will be willing to accept change with resistance expected from certain members. Hence, it would be necessary to embrace a suitable change model that would steer the process successfully. A suitable framework in this case is Lewin’s change management model, which requires users to follow three major steps – unfreeze, change, and refreeze (Hussain et al., 2016). The unfreezing phase is where members learn about the need for transformation, while the change phase is where the actual change happens (Hussain et al., 2016). The refreeze phase offers an opportunity to emphasize on the adopted change. Overcoming the potential challenges is the only way to be guaranteed that change will occur.   

It would be easier to enact the new way of handling data and dealing with emerging issues by training workers on how to use the system. The training should focus on key aspects of EHR, including how to achieve efficient patient scheduling as well as how to achieve effective patient workflows. Moreover, the training should offer tips and skills on how to access the system from other devices, as well as provide valuable tips on how to address some of the mechanical issues that could affect the use of the electronic system (Johar & Patagundi, 2018). However, it would be difficult to achieve the targeted goals without adequate training.

Conclusion

The study addresses the need to identify and deal with ethical issues that could affect how health organizations conduct their operations and relate with clients. Specifically, the analysis focuses on the need to install an effective system to handle clients’ data to avoid causing security concerns. Analyzing the ethical dilemma has influenced my professional thinking and development because I now know that inadequate ways of handling patients’ information could have both legal and ethical repercussions. I would rely on the information I gain from this case to encourage members in all stations where I serve to ensure that the system for handling patient data is effective enough and one that instills confidence to all clients.

References

Agianto, A. (2016). Understanding ethical principles in nursing research. Belitung Nursing Journal, 2(2), 22-24. doi:10.33546/bnj.10

Barsky, A. (2010). Ethics and values in social work: An integrated approach for a comprehensive curriculum. Oxford: Oxford University Press.

Cohen, G., & Mello, M. (2018). HIPAA and protecting health information in the 21st century. JAMA, 320(3), 231-232. doi:10.1001/jama.2018.5630

Hussain, S., Shen, L., Akram, T., & Haider, M. (2016). Kurt Lewin’s process model for organizational change: The role of leadership and employee involvement: A critical review. Journal of Innovation & Knowledge, 3, 123-127. doi:10.1016/j.jik.2016.07.002

Johar, S., & Patagundi, B. (2018). Electronic health record system – benefits and challenges: A literature review. International Journal of research in Computer Application & Management, 8(2), 1-3. https://www.researchgate.net/publication/343254459_Electronic_Health_Record_System_-_Benefits_And_Challenges_A_literature_Review

NASW. (2022). Read the code of ethics. Retrieved March 29, 2022, from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English