Ehthical concerns regarding EPIC and confidentiality

guest2210 · Feb 20, 2014

I have been training Epic for 8 years. The biggest ethical concern I have encountered is repeatedly re-enforcing the need to sign off of the computer before leaving the workstation. Physicians are the worse at this. It is stressed in training, for all of the usual reasons: i.e. HIPAA; and the possibility of someone else documenting in a patient's record and the person who forgot to log off being held liable for anything documented or ordered. Depending on the facility, time out times vary. Some are under a minute, which is rare. Most are between 5-10 minutes, which most physicians don't like because they have to log in again and again. But when it is explained and re-enforced that it is imperative that they comply with this, most will comply. It is also re-enforced to the end users during the actual go live.

Another issue is having more than one patient record open at a time. Again, this is stressed during training and during the go live. Some facilities will allow up to 3 records to be open at a time. This is discouraged. I will tell them that they can have more than one record open, but will strongly advise them against that practice. All they have to do is do a big, long note, ON THE WRONG CHART, and that usually breaks them of opening more than one patient's record. Nurses, unfortunately, are the biggest culprits of this practice. Until they see the program in use, they often cannot comprehend how difficult it is having more than one chart open at a time. Again, all it takes is charting something on the wrong patient, and this practice is usually not continued.

Hope this helps. If you have any more questions, please PM me.

Good luck.

nursingsteph · Feb 21, 2014

Thank you so much for your response. I can definitely see how this is an issue. "Now think about an ethical dilemma you have encountered related to patient confidentiality." This is the topic we have to write a paper on would you feel that those ideas fit this topic.I would have to do more research because like i have said we are just beginning the exposure to epic

guest2210 · Feb 22, 2014

Do you look at a friend or relative's chart if you find out they are hospitalized? If you have no reason to be in the chart, you can be fired for it. The issue of looking at a patient's chart in which you are not a part of the medical team treating that patient, i.e. relatives, friends, celebrities, people in the news-OctoMom. Several people were fired when she was hospitalized because they went into her medical record and were not a part of the treatment team. EMRs track everything. Even things that, supposedly, are not a permanent part of the patient's chart, can always be found.