3 Discussion Replies (100 Words Each)

Reply to 3 Discussions (100 Words each ). Give References to each And Use American Medical Association (AMA) style is accurately and consistently used for in-text citations and references

Discussion 1:

Part I:

In today’s world, technology is constantly evolving and shaping the way we live our lives. The technology that we use today could become outdated by tomorrow. Although we put our trust in the technology that we use, it is important to know that there are some ways that technology cannot protect privacy and maintain security.

As Harman states, “A coder reviewing an online medical record leaves her desk at noon for lunch without logging out of her work station.”1 This is one way technology could fail to protect privacy. When an employee leaves his or her work station open and unattended, a computer system cannot recognize if someone else hops on that user’s account. There are ways to prevent this such as auto logout, however there is still a time frame before auto logout is enacted, thus leaving time for someone else to hop on the open account. Ultimately, it is in the hands of employees and company policies to protect privacy in this aspect.

Similar to the first example, another way technology cannot help secure privacy is if a legitimate user logs into a system and then lets some of his or her colleagues us the system on their behalf to access information.1 The responsibility to protect privacy and data is entrusted in HIM professionals and if a HIM professional logs into a system to allow non-permitted staff to access information, they are not holding up to their standards to enforce security on private data. This is a situation in which we put trust into HIM professionals to protect data rather than technology.

Another example where we cannot rely on technology to protect private data is if preventative security measures conflict with operational efficiency and clinicians’ desire for convenient and timely access to data.1 As a result, security measures are ignored, thus leaving sensitive data exposed.

Part II:

Harman’s definition of a Chief Information Officer (CIO) is to “take on the responsibilities of coordinating the security policies and procedures of the organization, making staffing decisions, and producing routine reports for administration.”1

One of the most important responsibilities rested on the CIO is to lead risk management activites. According to the article “What makes a Great CIO,” it is said to “deploy tech only for playing defense.”2 Although this is a different perspective than we are used to, some might consider it an efficient strategy. It is also stated in this article that “Any success achieved will be quickly cloned by competitors.” Although it is good to lead innovation, one thing that a good CIO officer might want to consider when implementing new technology to grow their company is if they are the first to implement this technology. If so, they will be the first ones who will have to deal with new forms of information attacks and potential security breaches.

Another key element necessary to be an efficient and effective CIO is effective communication. This can be monitoring compliance with policies, maintaining state and federal law enforcement relationships, and coordinating the physical safety of employees.1 Communication is key to success and it’s the duty of the CIO to keep in touch with all technology based actions within their company.

According to Gerld Kane, it is important for any CIO to “Provide vision and purpose.”3 If a CIO displays clear aspirations, it can influence employees as they work and come across decision making that they will have to do themselves. Kane states that “Providing vision and purpose in a digital world does not require in-depth technical knowledge, but it does require basic digital literacy so that a leader can understand the environment sufficiently to develop that vision.”3 This means that CIOs must have an understanding of how different technology systems work and how they correlate to policies and standards to establish their vision and purpose. It isn’t until then that CIOs can inspire their employees to follow in their vision and purpose.

1) Harman LB, Cornelius FH. Ethical Health Informatics: Challenges and Opportunities. Burlington: Jones et Bartlett Learning; 2017.

2) What Makes a Great CIO? Forbes. https://www.forbes.com/forbes/2003/1124/043.html#7710bdd53e73. Published June 6, 2013. Accessed March 6, 2020.

3) Kane G C. Common Traits of the Best Digital Leaders. MIT Sloan Management Review. https://sloanreview.mit.edu/article/common-traits-of-the-best-digital-leaders/. Published July 9, 2018. Accessed March 6, 2020.

Discussion 2:

Computers have done a lot in the medical industry to increase security and confidentiality. The use of technology can filter the information that professionals receive such that they do not overstep their bounds of privacy to patients.1 They are not alone responsible for creating the perfect environment for ethical use of data with privacy and confidentiality in mind. People and policy play a larger factor in keeping privacy and confidentiality at priority, one commentator states that it’s about seventy percent education of policy and procedure and the rest about using the technology.1 Human error or lack of knowledge regarding rigorous policy is responsible for a large portion of disclosures.

One of the core components of the electronic medical record system is the availability of information that it presents to the medical personnel. With lack of proper policy and educated staff the information secured on the systems becomes vulnerable from each of the available access points. These access points can lead to an unauthorized disclosure of information which can be common and are particularly harmful.2 Security of information that is held within the confines of a healthcare network is essential; given that if information is disclosed then harm is done to the patient. To abide by the ethical property of non-maleficence data security and confidentiality must be maintained.2

Email had been discussed before as a target vector by which information is disclosed unknowingly by phishing attack. Email attacks have become popular and have not been able to be stopped completely as they rely on human error. In October of 2019, email breaches had been summed to 2.7 million individuals’ information being released.3 Computers do not have the ability to stop all phishing or email based attacks. Email is a particularly poor choice for medical practice because it is usually unencrypted.4

Automation software and technology for the implementation of security practice will always be fallible and need constant change and guidance from experts. The Chief Information Officer (CIO) with support of advisors fills the necessary role of creation of new and editing of old policy and administrative tasks that are associated with such policy deviations. For this, an in depth understanding of the problem space of a given organization is crucial. The healthcare problem space for information is multi-domain problem space encompassing; physical security, cyber security, information technology needs, laws and implementation of regulations regarding HIPAA and HITECH, administrative and management tasks, oversight and implementation of policy.4 CIO is also crucial in maintaining relationships with law enforcement and staff within the healthcare organization.4 Staff in particular are important to maintain a relationship with given that the education of staff is most important factor in technological implementation that supports staff while maintaining privacy and security.

Reference List

1. Hanken MA, Murphy G. Chapter 12: Electronic health records. In Laurinda Beebe Harman and Frances H. Cornelius. Ethical challenges in the management of health information, 3rd edition (pp.317-346). Burlington, MA: Jones & Bartlett Learning. 2017.
2. Lee LM. Ethics and subsequent use of electronic health record data. Journal of Biomedical Informatics, 2017; 71:143–146.
3. McGee MK. Email Breaches: A Growing Healthcare Challenge. Email Breaches: A Growing Healthcare Challenge. https://www.careersinfosecurity.com/blogs/email-breaches-growing-healthcare-challenge-p-2807. Published October 17, 2019. Accessed March 6, 2020.
4. Czirr K, West E. Chapter 13: Information security. In Laurinda Beebe Harman and Frances H. Cornelius. Ethical challenges in the management of health information, 3rd edition (pp.347-370). Burlington, MA: Jones & Bartlett Learning. 2017.

Discussion 3:

Discuss at least three (3) ways that computers cannot protect privacy and maintain confidentiality and security.

• It is difficult to argue against the use of computers in healthcare. These machines are overwhelmingly helpful for accessing and storing patient data. As opposed to the outdated method of paper-based filing systems that come with a plethora of time-consuming processes and problems. That being said, there are limitations in computers abilities to protect privacy and maintain confidentiality and security of patient data. One of computer’s main advantages over a paper-based system is the ability to create a network, where one computer can share information with another computer. This in turn makes accessing patient data more accessible and results in faster and potentially better healthcare. However, this is real double-edged sword because is also one of its biggest drawbacks. The more places that the data is stored or able to be accessed results in a much higher risk of the patient confidentiality being compromised. Computers also have short coming in that they have no ability to know how the data will be used once it is accessed by someone who is authorized to view the data. This authorized individual could potentially share that information with someone who is not authorized, and the security standards of the computer would be useless. This problem could be avoided by implementing policies and procedures for how to use the confidential data. The computer also has no regard for how someone would go about transferring data to another machine that is not in the secure network. For example, someone could access the computer and put data on an un-encrypted or secured portable hard drive. The data would then be unprotected from the security standards of the original computer or network and put the confidential data at risk. This is another example that would need to be resolved by way of laws and policies about how to transfer data. There is also an enormous amount of additional security risks if the computer containing the confidential information is connected to the internet. This is exemplified in the following quote from an article on cyber security, “The Internet provides much greater access to data, and to more valuable data, not only to legitimate users, but also to hackers, disgruntled employees, criminals, and corporate spies.” 2

Understanding the limitations of computers, describe and expand on a minimum of three (3) key elements necessary to be effective in the role of a chief information officer (CIO).

• There are several different elements that are necessary to be and effective CIO (chief information officer). One is something that I mentioned in the first question, and that is creating the SOP (standard operating procedures) and protocols for how data is to be transferred, stored, or shared. This is an incredibly important element, because this could potentially be the weakest link in the security of the data if a solid SOP is not established. Another crucial element is to ensure that the security of the data does not hinder to the ability for authorized users to access the data. If access to the data becomes overwhelmingly cumbersome, then operational efficiency will suffer. Which is the whole reason that computers were implemented in the first place, to increase operational efficiency. The last element I want to discuss is the ethical regards to patient data. The security, and efficiency of the data access are worthless if there is no regard to ethics in the sharing of confidential data. The sharing of the data has many benefits in the way of research and new innovative treatments. However, there is a fine line between restricting individuals “need to know” clearance on data to protect it, without losing the benefits of sharing the data. This decision of granting this clearance would fall upon the CIO.

Citations

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1. Harman L, Cornelius F. Ethical challenges in the Management of Health Information, 3rd Edition. 2017: 317-370.
2. Oracle. Data Security Challenges in the Internet Age. https://docs.oracle.com/cd/A91202_01/901_doc/network.901/a90148/overview.htm#1004705. Accessed March 6, 2020.