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Ethical issues

HIPAA   (3,869 Views 7 Comments)
by Jlo531 Jlo531 (New) New

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  1. i am a nurse new to clinical informatics. our ED dept wants to flag any patient who has a history of a report placed to CPS/ APS on their behalf, onto their trackers. some of our administration thinks this is unethical, but I am arguing this is in the patients chart already...any opinions? Any advice on where to find legal implications?

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Esme12 is a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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Why do they want these charts flagged?

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LoveMyBugs is a BSN, CNA, RN and specializes in Pediatrics.

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My guess is to catch a trend. In my state too many kids fall through the cracks. We will call and report, but many times it goes univestigated.

If there is a pattern with multiple calls placed for the pt, it might make someone look closer the next ED visit. Just my guess

What are their reasons and why is it considered unethical?

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Jory has 10 years experience as a MSN, APRN, CNM.

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  1. i am a nurse new to clinical informatics. our ED dept wants to flag any patient who has a history of a report placed to CPS/ APS on their behalf, onto their trackers. some of our administration thinks this is unethical, but I am arguing this is in the patients chart already...any opinions? Any advice on where to find legal implications?

So, the ASSumption, is that nobody is allowed to change their lives? Once reported, always suspected?

Do they flag the drug-seekers, known addicts the same way?

I think that this could be seen as discrimination if it ever got out. Yes, it is unethical. Every evaluation needs to be with an unbiased eye. I don't agree with the "if it's flagged you will take a closer look" argument. You should be looking closely anyway.

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Esme12 is a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

5 Followers; 4 Articles; 20,896 Posts; 147,051 Profile Views

My guess is to catch a trend. In my state too many kids fall through the cracks. We will call and report, but many times it goes univestigated.

If there is a pattern with multiple calls placed for the pt, it might make someone look closer the next ED visit. Just my guess

What are their reasons and why is it considered unethical?

I know why they probably want them flagged but it is the wording that is important. YEARS ago we used to keep a frequent flyer list and would check other frequent flyer lists in the area for your ER hoppers. That is really no longer acceptable ......it never was acceptable but was a common practice.

In a department I worked we developed something called "Care plan on file". If the patient had a seeking history, violence history, abuse history, complicated medical care for rare diseases etc. We would involve the PCP and psych etc to develop thier "plan of care".

It kept valuable information for their care and safety. It flagged at registration.

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So, the ASSumption, is that nobody is allowed to change their lives? Once reported, always suspected?

Do they flag the drug-seekers, known addicts the same way?

I think that this could be seen as discrimination if it ever got out. Yes, it is unethical. Every evaluation needs to be with an unbiased eye. I don't agree with the "if it's flagged you will take a closer look" argument. You should be looking closely anyway.

Agree with everything Jory said in this post.

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Esme12 is a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

5 Followers; 4 Articles; 20,896 Posts; 147,051 Profile Views

So, the ASSumption, is that nobody is allowed to change their lives? Once reported, always suspected?

Do they flag the drug-seekers, known addicts the same way?

I think that this could be seen as discrimination if it ever got out. Yes, it is unethical. Every evaluation needs to be with an unbiased eye. I don't agree with the "if it's flagged you will take a closer look" argument. You should be looking closely anyway.

Again it is proof of intent. If you many flagged charts for different reason it isn't singling out any one population. We would actually have plans of consistent treatment so that they received the consistent care. We had complicated pregnancies listed. Several children with rare metabolic disorders or seizures that required unusual life saving treatments. Patient with a violent history we would have psych recommended meds and treatment. Seekers we would have specific plans for meds that were approved through their PCP.

So no it isn't discriminatory.

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