Confidentiality and Telehealth Essay

In a healthcare system, confidentiality refers to staff or practitioners safeguarding the privacy of the medical information that the patient provides according to his own preferences. Every patient who comes into contact with the healthcare system has a right to privacy, security, and anonymity. The health practitioners and staff should hold this information with the highest regards possible. Patients and practitioners enjoy a unique or special relationship (Quigley et al., 2017). Patients trust health practitioners by giving them their personal medical information. Therefore, this relationship should not be abused. The information should be shared with the third party or uninvolved persons, especially those who are not on the team treating the patient.

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The federal law - Health Insurance Portability and Accountability Act (HIPAA) safeguards the medical information of the patients against mismanagement. The disclosure, privacy, and access to patients' information are set as a confidential measure to make sure that the privacy of patients is guaranteed. With technological advances and its application in health has led to an ethical dilemma which demands for more responsibility as far as the relationship between the practitioner and the patient is concerned. According to Quashie & Green (2016), the provider must make sure, in this technological dispensation that he follows a protocol in telehealth communication to protect the medical information of patients from being accessed by unauthorized people. This approach will help in securing the patients' information and instilling integrity in the process as far as the electronic encounter is concerned.

It requires ethical responsibility when dealing with telehealth because one will be able to fulfill, to his patient, a fiduciary obligation. It will enhance the professional standards in healthcare service management. It is a huge responsibility on the part of healthcare providers to ensure the integrity and protection of electronic transmission of patients' medical information. According to Bernabe et al. (2014), it requires integrity when transmitting patients' medical information from one associate to another in the healthcare system. According to the Federal Law, a provider who is not able to protect and safeguard patients' information is liable for breaching Health Information Privacy Act. The HITECH Act provides for serious penalties to any provider who does not abide by these measures.

Unresolved legal and ethical concerns

Even though telehealth has the capability of transforming health care services and practices, health systems, and healthcare providers are reluctant in adopting it because of the existence of unresolved legal and ethical concerns. There is a concern as far as ethical issues on confidentiality, privacy, and security in telehealth consultations. Telehealth involves tele-assistance and telediagnosis issues. In the mentioned issues, it is incumbent upon healthcare providers to ensure that ethical and legal components and liability of the health institutions are satisfied (Dunne & Rawlins, 2015 pp.638).

The main risk lies with health telediagnosis. When damages occur, the providers are held responsible and should shoulder that responsibility. This observation may not sound so well with practitioners. For instance, from a legal perspective, there is no provision of spreading the liability once the damage is caused in telediagnosis. Therefore, this process must make sure that there is absolute transparency. The cost involved in the medical act is only based on the image records' cost. However, it is not very easy to estimate the image interpretation cost at the present. Therefore, it is prudent to come up with a contract.

In the contemporary health care practices and services, the contract that is considered by providers as the most convenient one is the one that is similar to laboratories' contracts. This phenomenon means that if the practitioner, who has received the sample, messes then he will be solely held responsible for the damage. As telediagnosis continues to develop, other legal and ethical obligation may continue appearing.

Certainly, the healthcare practitioners may opt to use the latest technology (telehealth) because of the increased reliability. On the other hand, it is dangerous to use tele-assistance when there is no medical isolation or emergency cases. It will increase the quality of the conventional medical act and jeopardize the integrity as well. Generally, it is against the medical ethics to engage in medical practices without any clinical examination of the case presented by a patient.

For healthcare providers who are involved in telehealth consultations, their medico-legal perspective is similar to the alternative use of a letter, email, fax, or telephone. It will still apply all the normal standards as far as skills and care are concerned regardless of the mode used or the distance of the patient (Karcher& Presser, 2018 pp.18). In telehealth consultations involving the hospital specialist and a general practitioner, it is incumbent upon the referring doctor to provide accurate information (history). However, a video record will retrospectively prove the case in point.

The permission of the patient is required if there is an extra activity by a healthcare provider that is beyond the purposes of treatment before recording is carried out (Mattison, 2018 pp.12). It is also important to note that there may some situations that may not demand the use of telehealth depending on the suitability of practice and the circumstance. According to Dart et al. (2016 pp.342), to affirm whether telehealth is an efficient practice, as far as healthcare practices are concerned, time is the best judge. However, the courts will be used to determine some of the medico-legal issues that are presented by the telehealth practices ultimately.

A study was conducted on 200 participants who were sampled from the general public. The topics under discussion in the survey were patient confidentiality and ethical issues in relation to telehealth between emergency department and accident. Nurse practitioners in the emergency wing were also involved, especially those dealing with the treatment of minor accidents in community health facilities (Tachakra et al., 2003). The study demonstrated that security and confidentiality of patients' medical information is not just a technological issue or problem, but it reflects a possible factor in human failings.

Before the advent of technology and the subsequent innovation of telehealth, the relationship between doctors and patients has been based on the characteristics of the duties of providers as far as the right of a patient to autonomy and privacy is concerned, risk disclosure, and confidentiality. The electronic mediation only expanded the services and also increased the responsibilities of healthcare providers and practitioners.

In a more complex scenario where telehealth is used, obligations are appropriately put both on the local site and the distance provider. With the use of a digital line, the service is provided in a private location or setting. According to Mort et al. (2015 pp.442), telehealth demands that the patient must be informed on the purpose and the nature of the equipment in use, the effects as well as the requirements to be fulfilled by the two parties in that location. The practitioner ensures that he does not breach the confidentiality measures as set in healthcare profession as well as in the federal law. This is the best approach to be used because when damage is done, the provider shoulders the responsibilities and liabilities. However, this approach may undermine the competency and skills of the provider for fear of making a mistake then paying for it.

Telehealth enhances responsibility. It demands that the credentials of the staff are important in making sure that the provider provides quality services while utilizing the equipment. In case of an emergency situation, in the local setting where the service is being administered, a local provider should be in the proximity to handle it in a timely manner. When the doctors use the equipment they are more responsible to avoid making mistakes. The patient is able to get quality services and total attention from the provider (Botrugno, 2017).

However, regardless of the four main areas involved in the telehealth (standards, reimbursement, cross-border licensure and malpractice, and the patient-doctor relationship) there is lack of clear or agreed international or interstate ethics and law standard manner which has forced telehealth in many parts of the country to struggle to be accepted and embraced by regulatory bodies, patients, and providers as a means that can be used in the delivery of health services. Therefore, no matter how efficient the approach may be, very few people benefit from it. Consequently, it has a long way to go. However, the widespread use of technology in the world shows that there is light at the end of the tunnel as far as its widespread acceptance and use is concerned.

Telehealth security and confidentiality

Traditional healthcare practices and services, especially of chronic illnesses, are expensive. For instance, it is estimated that diabetes cost in the United States of America is almost $93 billion every year. Telehealth, therefore, is an effort to make sure that this cost, among others, is lowered. Telehealth has proven promising in the initial stages of its application. However, it has not been very successful in the real life. it is important to state that it is not easy to analyze the existing gap between trail stages and real life because there is inadequate research done as far as trial stages are concerned.

According to Watzlaf et al. (2017 pp.39), confidentiality and security in telehealth include issues like recording, storing and transmitting of information of the patient; accounting; authentication; and authorization. These problems are also common with other organizations that use the applications of information technology. However, there are emanating challenges in the physical safety of the information, privacy, and security. In physical security, for instance, the provider must evaluate falls detections in the aging patients remotely.

Telehealth system is likely to be trusted by the patients, at least more than the traditional means. However, lack of human contact is not felt by patients. This phenomenon does not reduce reliability in as far as healthcare practices and services are concerned. It is important that the information of patients is safeguarded as well as their safety to establish a positive relationship between the providers and patients. This relationship will also allow successful implementation of telehealth approach.

Implications of telehealth

Telehealth has positively contributed to the health sector in terms of consultations and diagnosis, health and clinical services outcomes, patients' surveillance and monitoring, as well as technological advancement. Patients have safety and security concerns in all of these areas. Technologies in telehealth range from computing patients' information and telephone use. Even though its progress is slow, the future of telehealth seems bright (Johnson et al., 2017).

Additionally, technological evolution offers a broader and more capability for telehealth services and practices in the healthcare services, especially in delivery. With the adherence of patients to increases in care, telehealth has enhanced their access to care. It is possible to see healthcare providers networking with each other. Patients' safety is closely monitored in hospitals and alternative living facilities as well as homes.

To the telehealth approach that is based on the use of tele...