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Susan
Ethics Applied to HMIS/HIT
The principles of the American Health Information Management Association (AHIMA) code of ethics are to provide guidelines for HIM professionals to handle private and sensitive information. The purpose of the AHIMA code of ethics is to improve the quality of healthcare (AHIMA House of Delegates, 2019). Private and sensitive information can include private health information (PHI), genetics, behavioral issues, adoption, substance abuse, and sexual health (AHIMA House of Delegates, 2019). AHIMA principles stand for the protection of private/sensitive information through the support of people's rights to privacy, the ethical and appropriate use of information, education, and collaboration (AHIMA House of Delegates, 2019). HIT involves entering, storing, sharing, and accessing private and sensitive information and is therefore subject to the AHIMA code of ethics. Violators of the AHIMA code of ethics are subject to a peer review process leading up to legal implications when applicable (AHIMA House of Delegates, 2019).
The principles of the American Medical Informatics Association (AMIA) code of ethics are to establish measurable guidelines for HIM professionals to facilitate ethical behavior. Ethical behavior should be used when interacting with patients, healthcare organizations, government agencies, insurance companies, and administration (International Medical Informatics Association, n.d.). The AMIA code of ethics is geared toward healthcare professionals who use HIT systems such as the Electronic Health Record (EHR) (International Medical Informatics Association, n.d.). The AMIA code of ethics is designed to extend ethical behavior beyond that of governmental rules and regulations (International Medical Informatics Association, n.d.).
Health Management Information Systems (HMIS) are like HIT systems in that they manage data and aid in the decision-making process. However, HMIS differs from HIT because they are administratively driven instead of clinically driven. HMIS are used in human resources, resource planning, finance, supply chain, and project management (Glandon et al., 2020). Still, HMIS are also subjected to ethical considerations. For example, HR systems contain personal information from employees, such as salaries, raises, vacation time, health benefits, additional compensation, attendance, and disciplinary actions (Glandon et al., 2020). The privacy and security of employees’ personal information must be held to the same standards as PHI. Also, both the hiring and firing of employees are subject to ethical issues. These ethical issues can be better managed by HMIS because it can be used to document credentials, background checks, and disciplinary actions facilitating termination (Glandon et al., 2020). In addition, other operations, such as supply chain management, must also be handled ethically (Glandon et al., 2020). For example, administrators must select the most beneficial vendors to the organization without allowing personal biases or benefits to interfere with their decisions. HMIS can pull data and generate reports to help make these decisions and remove personal feelings from the decision-making process (Glandon et al., 2020). Lastly, HMIS can improve project management because it strategically assesses the feasibility of a project and manages change to promote better decision-making (Glandon et al., 2020). These are just a few examples of how HMIS can be used to overcome ethical dilemmas.
References
AHIMA House of Delegates. (2019). AHIMA code of ethics. AHIMA House of Delegates. https://library.ahima.org/doc?oid=105098#.Yt_pSVfMK3B
Glandon, G., Slovensky, D., & Smaltz.D. (2020). Information technology for healthcare managers. (9th ed.). AUPHA/HAP Book.
International Medical Informatics Association. (n.d.). The IMIA code of ethics for health information professionals. International Medical Informatics Association. https://www.imia-medinfo.org/new2/pubdocs/Ethics_Eng.pdf
Denise
AHIMA HMIS/HIT Relevant Code of Ethics:
AHIMA is the American Health Information Management Association. They are an international association that has a set of ethical principles. Many of these principles apply to HMIS/HIT. The principles include (AHIMA, 2019):
1. Consumer right to privacy and confidentiality
2. Place service and health of others above self-interests
3. Protect secure health information in the highest regard per statutes and regulations
4. Refuse to participate in unethical practices and ensure to report any participation in unethical practices
5. Use data, information and technology in the manner intended
6. Advocate for appropriate use of information across the system
7. Mentor and recruit students, colleagues, and peers to strengthen the workforce
8. Represent the profession in a positive manner
9. Advance the field through evidenced based practice and publication
10. Perform honorably and keep intended information confidential
11. State accurately and truthfully experiences, credentials, and education
12. Facilitate multidisciplinary collaboration and support ethical health information principles
13. Respect the dignity and worth of every person.
Review ACHE Code of Ethics (ACHE Code of Ethics | American College of Healthcare Executives) and Ethical Decision Making for Healthcare Executives ( https://www.ache.org/about-ache/our-story/our-commitments/ethics/ache-code-of-ethics/ethical-decision-making-for-healthcare-executives).
Analyze which of the ACHE ethical guidelines and Healthcare Executive's policy position statements are applicable HMIS?
ACHE Relevant Code of Ethics:
The American College of Healthcare Executives (ACHE) has a code of ethical decision making for healthcare executives. These healthcare principles can guide interdisciplinary ethical requirements for HIM/HMIS. The principles relevant to HIM/HCIS include (ACHE, 2016):
· Create an ethically grounded culture through mission, values, policies, procedures, and guidelines
· Communicate the commitment to ethical mission and values
· Model ethical professional behavior and decision-making processes
· Offer educational programs to all employees in an organization in house and through outside vendors that place an emphasis on ethical guidelines including respect, cultural sensitivity, and implicit bias.
· Ensure organizational ethical resources are available to all staff. Committees should be built to address both clinical and organizational ethical challenges. These committees should be a diverse multidisciplinary group and contribute to policy recommendations and directives.
· Ensure ethics groups/resources have ongoing training and address a broad range of ethical concerns.
· Seek assistance from subject matter experts and ethics resources when uncertain. An ethics consult may be a valuable resource to address clinical issues. Bring questionable ethical dilemmas to leadership.
· Evaluate and refine processes for addressing ethical issues
· Promote decision-making safeguarded against biases that ensure equity that balance the scales for societal, organizational, and individual issues.
Evaluate the role of HMIS in helping healthcare executives in ethical decision-making?
Healthcare Management Information Systems help the healthcare executives in ethical decision making by providing a standardized documentation process that staff must follow for all patients. Data collection within an HMIS does not look at individuals based on any biases. It collects relevant data and sorts the information based upon the data alone. Quality care can be ensured in an equitable fashion to all individuals based upon race or social standings.
Assess if personal, professional, or cultural biases can affect decision-making suggested by HMIS.
Ethical decision making can be impacted based upon our morals. One must look past their own biases and moral ideations when considering an ethical situation. What is ethical right may not always be morally right. This can cause inner conflict for the caregiver when addressing the ethical challenge. When someone has a moral dilemma with an ethical decision, it is best to remove yourself from that situation and consult a provider and committee that can review the case and make an informed ethical decision that is in the best interest of the patient.
Determine what other healthcare ethical dilemmas can impact the use of HMIS or health information contained in them.
One example of how HMIS and health information contained in the medical record can create an ethical dilemma is the patient portal. When a patient has a portal account and we provide the patient with the portal login in writing and leave it in the room, visitors and families may have access to the record based upon the printed instruction. This could provide information to visitors in the room that the patient did not want to see their information. If a screen is left open by mistake within a room, this can also be a breach of confidentiality and privacy.
Denise Harless
ACHE. (2016). Ethical Decision-Making for Healthcare Executives. Retrieved: https://www.ache.org/about-ache/our-story/our-commitments/ethics/ache-code-of-ethics/ethical-decision-making-for-healthcare-executives
AHIMA. (2019). AHIMA Code of Ethics. Retrieved: https://bok.ahima.org/doc?oid=105098#.Yt7qI3bMKUk