Health Informatics and Technology:

Professional Responsibilities

An Online Self-Paced Learning Module for Nursing Students

Objectives:

 Describe the role and benefits of health informatics in the delivery of quality patient-
centered care.

 Discuss professional health care provider responsibilities for safeguarding confidential

client information, including HIPAA regulations.

 Explain possible consequences for breaches in privacy and confidentiality.

 Discuss professional responsibilities in the use of social health care technology or media as
it relates to relationships with patients, colleagues and employers.
Health Informatics

 Is the “use of information and

technology to communicate,
manage knowledge, mitigate
error, and support decision
making.”
(QSEN, 2003)
 Benefits of Healthcare Informatics….

 Healthcare informatics is seen as a

potential method for improving the
delivery of quality health care by:
 Providing up-to-the-minute, real time
information about a patient’s condition
necessary for decision making
 Benefits of Healthcare Informatics….

 Minimizing errors with an

electronic health record (EHR)
that uses computerized
functions such as:
 Barcoding
 EHR Medication Reconciliation
 Computerized health care
provider order entry
 Patient care alerts/reminders
 Benefits of Healthcare Informatics….

 Promoting “meaningful” use of

electronic health record (EHR)
technology to:
 Improve the quality of health care thru
the electronic exchange of health
information
 Provide and engage patients and families
via access to personal health information
via “portals”
 Improve care coordination
 Improve population and public health
 Issues surrounding electronic health records…

 While the use of EHRs can greatly

enhance patient care decisions and
safety, the portability of health
information and sharing of electronic
data create potential risks to privacy
and confidentiality.
 Benefits of Healthcare informatics…

 Likewise, the use of social media

technology creates possible
opportunities for patient-provider
exchanges (thru texting, email, or
other venues) but raises new
concerns regarding documentation
and confidentiality
Privacy & Confidentiality are not the Same!

 PRIVACY: relates to the

patient’s right to dignity &
respect, and for personal info. to
be held private

 CONFIDENTIALITY: is
disclosure of information with
the patient’s consent for health
care purposes or when legally
required
 Historically…

 Issues of confidentiality and

privacy in nursing are not new…

 Florence Nightingale is
considered the founder of
modern day nursing…

npg.org.uk
 Nightingale pledge

 Beginning in 1893, nurses citing the

Nightingale Pledge promised to:

 “Hold in confidence all personal

matters committed to my keeping and
all family affairs coming to my
knowledge…”
 EHR: Electronic health records

 Professionally, nurses
have an ethical and legal
obligation to maintain
patient privacy and
confidentiality at all
times.
 HIPAA

 With the advent of electronic

health data, Congress in 1996
enacted HIPAA which stands for
the:
 Health
 Insurance
 Portability and
 Accountability
 Act
HIPAA
 HIPAA in short, is a set of rules for hospitals and health care
providers to ensure that medical records, medical billing, and
patient accounts meet certain consistent standards for handling,
documentation, and privacy.
HIPAA: Privacy rule

 The HIPAA “Privacy Rule” was enacted in 2003 to establish

standards for the protection and disclosure of patient health
information, and specifically:

 Defines identifiable protected health information (PHI), including patient

identifiers like a person’s name, birthdate, picture, medical diagnoses,
address, social security number, etc.

 Stipulates how this information may be used, by whom, and under what
circumstances.
HIPPA: Privacy rule

 There are 18 patient identifiers. Google “18 patient identifiers” to see the list
of identifiers that must be protected.

 Be aware that health information by itself without the identifiers is not considered
to be protected health information (PHI).

 For example, a set of vital signs by itself is not protected. However, when the
vital signs are accompanied by a name or medical record number, then it must be
protected.
HIPAA

 To better understand HIPPA, watch the following you tube video by the Nebraska
Medical Center (by Art Witkowski). (Copy and paste the web address below into
your browser and hit return).

 https://www.youtube.com/watch?v=d2Cw0ARJVDM
 Consequences
 Health care providers are required to
adhere to HIPAA regulations as well as
abide by employer policies which may
be more strict…
 Failure to do so can result in a
reprimand, sanction, fine, or loss of
licensure by the government or state
board of nursing and/or loss of
employment by the employer depending
on the circumstances…
Know the Facts vs. Myths

 Following are common myths about HIPAA:

 HIPAA prohibits discussions of a patient’s condition over the phone with a doctor or family member

 HIPAA prevents nurses and doctors from discussing a patient’s condition or treatment in a
semiprivate room with the curtain pulled

 HIPAA prohibits displaying patient care signs like “fall risk” or diabetic diet” at
the door of the hospital room or bedside
Know facts vs. Myths

 Common myths (continued):

 HIPAA does not allow leaving messages for patients at their homes, on an
answering machine, or with a family member

 HIPAA prohibits leaving patients’ charts at the bedside or outside patients’

rooms
 Patient Authorization:

 Patient authorization for disclosure is not needed in situations

where:

 Laws require reporting of abuse, neglect, or domestic violence

 Example: child abuse

 Disclosure of information is needed to facilitate organ donation

 Example: kidney donation
 Patient Authorization:

 Patient authorization for disclosure is not needed in

situations where:

 Laws require reporting of information for preventing or

controlling illnesses, communicable diseases, injury, or
disability
 Examples: HIV, Sexually Transmitted Diseases

 Disclosure may lessen a serious threat to a person or the

public
 Example: Workplace violence
Technology Explosion:

 In addition to safeguarding information on the electronic health

record (EHR), professional responsibilities include appropriate use
of health care technology via social media
 Know and Follow These Tips for Social Media
Use!

 Both the American Nurses’ Association (ANA) and the National Council
of State Boards of Nursing (NCSBN) have combined to publish principles
and tips for social networking.

 Additionally, know the Social Media Policy for your employer or nursing
program.
 Principles and Tips:

 In general, principles and tips from the ANA and NCSBN

include:

1. Don’t share or post information or photos of patients

2. Maintain professional boundaries with patients
3. Do not post comments about employers, co-workers even if names are
omitted
4. Do not take photos or videos of patients on cell
phones or devices
5. Report breaches in confidentiality or privacy
Principles and Tips:

 Principles and tips (cont’d):

1. Be mindful that posted content you believe is private and accessible can be
disseminated to others

2. Be aware that content deleted from a site may still be

accessible or recoverable
Consequences….

 To learn more about professional responsibilities and the possible

consequences for breaches in privacy or confidentiality…..

 Copy and paste the following link below into your browser and hit return.
Read the short article on “Social Media: Proceed with Caution”

 http://www.theamericannurse.org/index.php/2014/01/02/social-media-
proceed-with-caution/
 Professional Boundaries: What You Should Know

 Additionally, be mindful of boundary violations with

patients!

 Contact with patients and former patients (via electronic or

cellular contacts) outside of work settings blurs the
distinction between professional and personal relationships
and should be avoided.
Additional Considerations: Professional
Relationships

 Negative online posts about co-workers (such as bullying or

intimidation) can constitute lateral violence, are inappropriate, and
can have professional consequences

 Likewise, online posts about employers or work conditions has

raised issues over freedom of speech versus libel or defamation
 Promoting a Professional Image:

 Lastly, be aware that others (including nursing

employers) may use social media to screen potential
applicants for hiring…

 While many states are enacting laws to prevent

employers from demanding access (i.e. passwords) to
personal social media accounts, consider carefully
what you post and how it reflects
on your professional image!
Social media

 Knowing the benefits and

risks of associated with
electronic health records
and internet technology can
help you chart a course that
utilizes electronic resources
appropriately and
professionally!
references

 American Nurses Association (2011, September). Principles for social networking and the nurse. Silver

Spring, MD: Author.

 Coty, J., & Owns, I.T. (2016) Getting social media: What are the rules. Nursing Focus, 45,14,16.

 Duffy, M. (2011) Facebook, twitter, and linkedin, oh my! American Journal of Nursing, 111(4), 56-59.

 Duffy, M. (2011) Patient privacy and company policy in online life. American Journal of Nursing, 111(9),

65-69.

 Fraser, R. (2011). The nurse’s social media advantage. Indianapolis, IN: Sigma Theta Tau International.
 references

 George, D.R. (2011). Friending facebook? A minicourse on the use of social media by health

professionals. Journal of Continuing Education in the Health Professions, 31(3), 215-219.

 Jones, C. & Hayter, M. (2013). Social media use by nurses and midwives: a ‘recipe for disaster ‘

or a ‘force for good’? Journal of Clinical Nursing, 22(11/12), 1495-1496. doi: 10.1111/jocn.12239

 McWay, D.C., Smith, J.K. (2014). Status update: Social media exchanges are sometimes part of the

health record. Journal of the American Health Information Management Association, 85(3), 28-

32.

 National Council of State Boards of Nursing (2011, August). White Paper : A nurse’s guide to the use of

social media. Chicago, IL: Author.

 Quality and Safety Education for Nurses. (2003). Retrieved from: qsen.org
References

 Schmitt, T.L. (2012). Social media use in nursing education. Online Journal of Issues in Nursing, 17(3),

2-21.

 Skiba, D.J. (2011). The need for social media policies for schools of nursing. Nursing Education Perspectives,

32(2), 126-127.

 Spector, N. & Kappel, D.M. (2012). Guidelines for using electronic and social media: The regulatory perspective.

Online Journal of Issues in Nursing, 17(3), 1-16.