Is EHR Tracking For Your Healthcare IT Clients Ethical?

By Megan Williams, contributing writer

Tracking former patients through EHRs can be helpful to the progressing medical students, but is it ethical?

According to Health IT Security, researchers from Northwestern University’s Feinberg School Of Medicine are debating that topic.

Academic Medicine published a study last month revealing that medical students are increasingly using EHRs to improve their training. Of course, this also yields a potential positive for patients, because students are able to view the real life impact of their decisions. Still though, the practice steps into a grey area of medical and technological ethics.

The Study
Lead study author, Dr. Gregory E. Brisson and his colleagues insist that it is critical that students get authorization from patients before they engage in any type of “EHR tracking.” They also emphasize the importance of proper training, and awareness of the responsibility that comes with the practice. Currently, there are no guidelines around EHR tracking, but Dr. Brisson believes that national guidelines would be beneficial, stating that they should be structured in a way that will optimize benefits while being mindful of privacy and patient choice.

Dr. Brisson and the other authors stated, “Both patients and students benefit from tracking. However, there is an inherent ethical conflict between medical education and patient privacy, and ambiguity regarding the appropriateness of tracking has likely hindered its evolution as a learning tool.”

Ethical Use
HIPAA currently allows access to patient records for healthcare operations including:

• assessing quality and improving activities
• assuring competency, including provider evaluation
• conducting or arranging audits, medical reviews, or legal services
• insurance functions including underwriting
• business planning, management, development, and administration
• general business management and administration

HIPAA has yet to meaningfully or directly address ethical concerns around EHR tracking, leaving physicians to make ethical decisions on their own.
One of the primary concerns is respect for patient autonomy. If tracking is unnecessary, patient privacy will likely be violated, possibly discouraging them seeking out future care. It is also possible that tracking might not be necessary to improve care.

According to the study authors, “…in the absence of clear and substantial added benefit to education, one could reasonably conclude that, according to the principle of nonmaleficence, students should not perform this action because it is potentially harmful to patients.”