Ethical implications and practices in patient-clinician messaging

Ethics of Client Messaging

As is made clear in the document Online Patient-Clinician Messaging: Fundamentals of Ethical Practice, a publication of the National Ethics Committee of the Veterans Health Administration (2004), there are man broad and varied ethical considerations when it comes to using online communications to facilitate healthcare inquiries and provision. These concerns range from security and privacy issues, and the manner in which online communication could potentially lead to greater threats in these areas, to the quality of care and the relationship of the clinician and the patient that develops via such communications (VHA, 2004). Also of importance are the elements of technical expertise on the part of both clinicians and patients, which could affect utilization of these technologies, and the need to keep such programs voluntary and on par with non-electronic healthcare provision (VHA, 2004).

There are many steps that hospitals and other healthcare institutions can take to ensure compliance with the ethical constraints and principles of online clinician-patient messaging. Forming appropriate training courses and materials for both clinicians and patients and making them readily available (or mandatory in the case of clinicians), being proactive in the development of security measures and disclosures to patients, and ensuring that the technology utilized is the best available in terms of security protections are all means of ensuring ethicality alongside the efficiency of these systems. Like any new policy, operation, or technology, this new form of communication must be undertaken with the proper foresight and care.

Privacy Concerns

Reading over the Fox News (2008) report, "Over 120 UCLA Hospital Staff Saw Celebrity Health Records," it does not seem that a training initiative is all that is required to correct the issue at this institution. It is certain that training regarding the privacy of patient records and the appropriate access of these records -- as well as the strong imperative to never access such records unless explicitly authorized -- needs to take place, but there are other measures to take that would be better equipped to truly address the issues at the hospital. It is evident from some of the information in the article that at least one and likely many if not most or all of the workers who inappropriately accessed patient records knew that they should not be doing so, having used passwords that were not their own to gain access, and thus greater oversight and control is needed (Fox News, 2008). This could perhaps be achieved through the training of managers and supervisors, but top-down policy needs to change.