The Hippocratic Bargain and Health Information Technology

The shift to longitudinal, comprehensive electronic health records (EHRs) means that any health care provider (e.g., dentist, pharmacist, physical therapist) or third-party user of the EHR (e.g., employer, life insurer) will be able to access much health information of questionable clinical utility and possibly of great sensitivity. Genetic test results, reproductive health, mental health, substance abuse, and domestic violence are examples of sensitive information that many patients would not want routinely available. The likely policy response is to give patients the ability to segment information in their EHRs and to sequester certain types of sensitive information, thereby limiting routine access to the totality of a patient's health record. This article explores the likely effect on the physician-patient relationship of patient-directed sequestration of sensitive health information, including the ethical and legal consequences.     

Health Information Technology and the Idea of Informed Consent

During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent's proper role in a health care environment in which electronic information sharing holds primary importance. This article discusses current implementation of the doctrine within health information exchange networks; the relationship between informed consent and privacy; the variety of ways that the concept is referenced in discussions of information sharing; and challenges that surround incorporation of the doctrine into the evolving HIT environment. The article concludes by reviewing the purpose behind the traditional obligation to obtain informed consent and the possibility of maintaining its relevance in the new environment.     

The Physician-Patient Relationship and a National Health Information Network

The growing use of interoperable electronic health records is likely to have significant effects on the physician-patient relationship. This relationship involves two-way trust: of the physician in patients, and of the patients in their providers. Interoperable records opens up this relationship to further view, with consequences that may both enhance and undermine trust. On the one hand, physicians may learn (from additional records) that information from their patients is — or is not — to be trusted. On the other hand, patients may learn from the increased oversight made possible by electronic records that their trust in their physicians is — or is not — warranted. Release of information through new methods of surveillance may also undermine patient trust. The article concludes that because trust is fragile, attention to transparency and confidentiality in the use of interoperable electronic records is essential.     

Information Accessibility for Public Health Emergencies-A Case Study of Information Accessibility during the New Coronavirus Outbreak

Barrier-free information construction has not been included in the information disclosure system for public emergencies in China. This makes it difficult for obstacle groups to obtain government information timely. By contrast, social forces, sign language videos and online accessible mini programs all give quick responds, which to some extent, bridge the information gap during the pandemic. This phenomenon is caused by the insufficient construction of information accessibility within the legal system, and the lack of popularization of accessibility concepts. The corresponding departments should improve the legal system of information accessibility by incorporating it into the information disclosure system for public emergencies in China. This will speed up the construction of modern public cultural service systems, promote the development of TV sign language hosting, and improve awareness of accessibility in science and technology to promote the design standards and principles of network accessibility and improve the dissemination of barrier-free information, hence meeting the information needs of barrier-free groups for major public emergencies.     

Health Information Exchange in Memphis: Impact on the Physician-Patient Relationship

Health information exchanges represent one way of making medical information available to practitioners across institutional boundaries. One health information exchange in Memphis Tennessee has been operational since May of 2006 and provides information supporting care for over 1.2 million individuals. Creating such an exchange challenged traditional institutional boundaries, roles, and perceptions. Approaching these challenges required leadership, trust, sound policy, new forms of dialogue, and an incremental approach to technology. Early evidence suggests a positive impact on patient care and a change in the way providers interact with their patients and on another. Personal health records, consolidated EHR systems, and other alternative models promise to have similar impacts on the way in which providers and patients interact with one another.     

城市老年群体微信健康信息的接触与鉴别研究

老年意味着一定程度上自我角色的迁徙与再造。老去的过程是逐渐失去对身体控制的过程;同样也是既有社交圈趋向新社交圈转移的过程。因此,考察老年群体问题,离不开健康和社交这两大主题。近年来,老年群体的社交平台逐渐向新媒体迁移,且增率渐长。但面对网络良莠不齐的信息时,老年人依然难免陷入新媒体"难民"的困境,成为虚假信息的重灾区。本研究尝试以微信平台为例,探讨老年人微信健康信息的接触与鉴别特征,进而帮助老年群体在社交媒体中更多地増能获益。研究得出:老年群体的新媒体应用聚焦于熟人社交,其网络信息的接触与鉴别对社交网络依赖程度较高;老年群体微信健康信息传播中的高度社交依赖,容易引发信息认知的内卷化;老年群体数字媒介素养问题严峻,亟待量身定制式的信息干预。     

Ethics, Information Technology, and Public Health: New Challenges for the Clinician-Patient Relationship

Increasingly widespread adoption of health information technology tools in clinical care increases interest in ethical and legal issues related to the use of these tools for public health and the effects of these uses on the clinician-patient relationship. It is argued that patients, clinicians, and society have generally uncontroversial duties to support civil society's public health mission, information technology supports this mission, and the effects of automated and computerized public health surveillance are likely to have little if any effect on the clinician-patient relationship. It is also suggested, nevertheless, that electronic public health surveillance raises interesting and important ethical issues, some of which can be addressed if not resolved by empirical research, especially regarding patient preferences about secondary use of health data and their moral obligation to contribute to population- based health.     

National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners--PHS. Final regulations

This final rule amends the existing regulations governing the National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners (the Data Bank), codified at 45 CFR part 60, authorizing the reporting and release of information concerning: (1) Payments made for the benefit of physicians, dentists, and other health care practitioners as a result of medical malpractice actions or claims; and (2) certain adverse actions taken regarding the licenses and clinical privileges of physicians and dentists. This final rule revises section 60.12 to change the process for collecting user fees from eligible individuals and entities requesting disclosure of information from the Data Bank.     

National Practitioner Data Bank for Adverse Information on Physicians and other Health Care Practitioners: charge for self-queries. Health Resources and Services Administration, HHS. Final rule

This final rule amends the existing regulations implementing the Health Care Quality Improvement Act of 1986 (the Act), which established the National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners (the Data Bank). The final rule amends the existing fee structure so that the Data Bank can fully recover its costs, as required by law. This rule removes the prohibition against charging for self-queries and, therefore, allows the Data Bank to assess costs in an equitable manner. This is consistent with both the Freedom of Information Act and the Privacy Act which allow the Government to charge fees for the reproduction of records. The Data Bank will continue its current practice of sending to the practitioner in whose name it was submitted--automatically, without a request, and free of charge--a copy of every report received by the Data Bank for purposes of verification and dispute resolution.