Barriers of Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Barriers

Barriers of Electronic Medical Record Systems EHR System implementation are another issues that should be analyzed. They include technological and organizational barriers. The following are some of the barriers stated by Lewis and Mitchell.

Technological and Cost Barriers of Electronic Medical Record Systems EHR System

• Lack of sufficiently powered computer systems.
• Lack of affordable computer systems and/or workstations.
• Lack of adequate system security.
• Lack of data exchange standards.
• System inflexibility.

Organizational Barriers of Electronic Medical Record Systems EHR System

• Lack of a clear definition and objective of an Electronic Medical Record Systems EHR System should be.
• Lack of clear objectives for the development of the Electronic Medical Record Systems EHR System.
• Unclear legal ramifications of electronic data.
• Social concern regarding the patient's right to privacy.
• Lack of information system staff skills necessary to develop an Electronic Medical Record Systems EHR System, and
• Staff acceptance and implementation issues.

Laws and Legal Issues for Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Laws and Legal Issues

In order to implement and EHR system or Electronic Medical Record Systems EHR System in the country successfully, a number of laws need to be enacted to protect patient records. The laws should focus on two main issues: right of privacy and right of access to health records, as discussed below.

The Right of Privacy for Electronic Medical Record Systems EHR System

Growing demanded for information contained in patient records pose an ever increasing threat to patient privacy. When information from patient records or from Electronic Medical Record Systems EHR System is disclosed by a provider, it is extremely difficult to control re-disclosure of the information effectively. The lack of protection of patient privacy may hinder full development of computer-based patient record systems.

Thus, the government has to enact privacy legislation to assure that the patient information from the Electronic Medical Record Systems EHR System will not be disclosed to third parties without the patient's consent, except under defined circumstances.

Right of Access to Health Records for the Electronic Medical Record Systems EHR System

Rights of access to health records from Electronic Medical Record Systems EHR System maintained by physicians and other individual health care providers should be clear. According to a researcher, in the USA, several statutes contain special provisions concerning a patient's access to particular portions of his or her record, such as X-Rays. In the absence of regulation, some courts have recognized a provider's common-law duty to allow a patient limited access to his or her records in the Electronic Medical Record Systems EHR System. The government has to enact a regulation to clear the right of access to patient records.

Another information, in addition, in the United States, there are numerous laws governing the provacy of personal information, including medical records in Electronic Medical Record Systems EHR System. Many of these laws also mandate that the security of records is also ensured.

Privacy of The Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Privacy

Privacy is another major issues connected to the electronic medical record systems, such as the use of medical database, and the adequacy of current privacy protection law. This section will analyse impacts of the lack of privacy measures in the EHRs or Electronic Medical Record Systems EHR System, such as discrimination and damage to reputation. Recommendation for protection of Electronic Medical Record Systems EHR System privacy will also discussed.

Discrimination for Electronic Medical Record Systems EHR System

Discrimination by employers and insurers is a major concern. In 2000, a survey showed that more than 200 cases in which individuals with a genetic predisposition to certain diseases reported a range of discriminatory actions made by insurance companies, employers, and other on the basis of genetic information.

Damage to Reputation of Electronic Medical Record Systems EHR System

Release of patient's personal and sensitive information, such as mental health problems, HIV-positive status, a history of substance abuse, and existence of debilitating illness, can have a devastating impact on an individual's reputation, affecting all aspects of his or her life. In addition, medical records may be used to persecute patients, by allowing the perpetration of malicious pranks, fraud, or other unlawful activity.

Protecting Patient Privacy for Electronic Medical Record Systems EHR System

In order to protect patient's privacy, a number of policies as discussed below should be applied in the Electronic Medical Record Systems EHR System organization.

• Patients should be advised as to who has access to their Electronic Medical Record Systems EHR System and the level of access permitted should be specifically identified.
• Patients should be able to specify what information should not be disseminated via Electronic Medical Record Systems EHR System. Patients, however, will not have total control over their records. For example, public health and law enforcement may obtain patient's information without consent through means prescribed by law.
• Stringent security procedures should be in place to prevent unauthorized access to computer-based patient records and confidential data should be encrypted whenever patient information is transmitted electronically from on location to another.

Security Technologies for the Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Security Technologies

Today a number of security technologies have been developed to solve the security problem. The major security technologies will be discussed below.

Electronic / Digital Signatures - An electronic record or Electronic Medical Record Systems EHR System can be signed electronically to identify and individual person. Digital signatures employ powerful cryptographic techniques that not only make signatures unforgettable, but also explicitly bound to a particular document.

Firewalls - Firewalls are systems of computers and switches that restrict to approved locations the destination or source of data entering or leaving the hospital. Firewalls are a good option for improving both the confidentiality of communications and authentication users. According to Greenstein and Feinman, functionality of firewalls - such as packet filtering, application-level proxies, and real-time monitoring-have been employed.

Encryption - Encryption is the process of encoding or scrambling a message so that the meaning of the message is not clear to unauthorized persons. It is one of the strongest measures used to improve communications security, particularly for Electronic Medical Record Systems EHR System. Two types of cryptographic mechanisms can be used to provide and encryption capability: symmetric cryptography where entities share a common secret key; and asymmetric cryptography or public key cryptography where each communicating entity has a unique key pair.

Biometric Identifiers - Biometrics require some physically unique characteristics of the user be used for identification. Biometric identifiers include retinal scans or fingerprints that can identify authorized users. Lewis state that these techniques are rarely used in health care institutions or Electronic Medical Record Systems EHR System because currently they require very costly equipment.

Network Security of Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Network Security

Network data security relates to the security of data on a network. To ensure that the data of Electronic Medical Record Systems EHR System is useful and secure, systems must allow for interconnection between providers, such as hospitals, and interoperability.

Network Security Issues for the Electronic Medical Record Systems EHR System

• Interoperability - The ability of data to operate across networks under the same security arrangements.
• Integrity - The consistency and accuracy of the data stored and transmitted in computer-based systems over a given time period. The Electronic Medical Record Systems EHR System data should be received unchanged from when it was sent.
• Additions - The Electronic Medical Record Systems EHR System should have rigorous rules that allow information to be added as an addendum to the encounter buy will not allow the user to delete or alter the record.
• Authentication - The identify of the person accessing the record. The Electronic Medical Record Systems EHR System database should have a table with an encrypted password that the user must enter before accessing the Electronic Medical Record Systems EHR System.

Security Issue - International External Users

The Electronic Medical Record Systems EHR System's Security Issues for Users

To enhance security of patient's information within an organization, many policies should be applied. For internal users, for example, only authorized user should have access. The organization should define a hierarchy of users and create an authorization table to link users with the hierarchy. In addition, the organization should create security for the authorization table.

For external users, confidentiality agreements with external users should be signed. The organization has to implement hardware and software security systems, such as keys, passwords, and protocols. Special security to restrict mass copying or output of records should be used strictly as well.

Issue Analysis - Security of the Electronic Medical Record Systems EHR System

Electronic Medical Record Systems EHR System's Security

In implementing the Electronic Medical Record Systems EHR System, one of the major issues of concern is security of the Electronic Medical Record Systems EHR System and patient's information. The following are main concerns regarding the security:

• Access to patient's information by unauthorized users
• Inappropriate access to patient record information by authorized users
• Inadequate data security protection on the Internet
• Inadequate standards for data security
• Limited data security functionality in vendor systems

The suitable levels of privacy, confidentiality and security for achieving the Electronic Medical Record Systems EHR System may vary depending on the institutional environment and the use of the information. A balance between confidentiality and convenience must be achieved. This subsection will exam the security issues related to users, network, security technology, and strategies.