NURS FPX 6616 Assessment 1 Community Resources and Best Practices

Name

Capella University

NURS-FPX 6616 Ethical and Legal Considerations in Care Coordination

Prof. Name

Date

Community Resources and Best Practices

Greetings, everyone! I am ______, and I will elaborate on the topic of community resources and best practices in healthcare.

Purpose

As technology advances, various risks emerge; hence, safeguarding system data is a crucial effort. Health systems across many countries are now utilizing electronic health records (EHRs). EHRs are essential components of digital healthcare technologies, encompassing a patient’s medical history, diagnoses, medications, and potential treatments. Their significance lies in enhancing care coordination while simultaneously reducing healthcare costs. However, concerns regarding security breaches have raised questions about this approach (Ceriello et al., 2022).

The primary aim of this presentation is to explore the ethical issues that may arise from using electronic health information, along with proposed solutions.

Scenario

Consider the case of a 45-year-old patient named Stella who has diabetes. She visits the hospital monthly for comprehensive examinations and had one two weeks ago. Although her detailed tests are scheduled annually, Stella missed her appointment due to technical issues that prevented any notifications or reminders from being sent. Upon contacting the hospital a few days later, she discovered that a security breach had occurred, leading to the deletion of her data from their system.

EHRs serve as vital healthcare systems, storing extensive data related to patients, including their histories, assessments, and interventions. They help reduce paperwork for nurses and are increasingly becoming standard practice in numerous countries. EHRs enable healthcare professionals to quickly assess patients’ conditions and access their detailed health information (Marmor et al., 2018). Several ethical concerns arise with healthcare information systems, particularly regarding telehealth and EHR usage. These issues include the risk of unauthorized data disclosure, patient privacy protection, informed consent before data registration, and data security, which encompasses potential data loss and breaches. Additionally, equitable access to healthcare is sometimes hindered by factors such as distance and location (Solimini et al., 2019).

For chronic conditions such as diabetes and hypertension, electronic records are preferable to manual documentation. Nursing staff can access health information efficiently through these automated systems, enhancing patient safety. They provide comprehensive data about the patient, minimizing the risk of adverse medication events. For instance, a diabetic patient may have records of their medications readily available (Ventresca et al., 2020).

Evaluate the Legal Issues of Current Practices & Potential Changes

Legal issues surrounding healthcare information systems in care delivery include the following:

Legal Issues	Description
Professional Liability	Implementing telehealth frameworks must adhere to legal guidelines. For example, the CDC offers recommendations for telehealth during the COVID-19 pandemic. Failure to comply can result in patient data being improperly stored, leading to negligence claims (Austin & Kusumoto, 2019).
HIPAA Compliance	The Health Insurance Portability and Accountability Act (HIPAA) safeguards patients’ healthcare information from unauthorized disclosure. Telehealth practices must comply with HIPAA, which has undergone changes during the pandemic (Edemekong et al., 2019).
IT Security	Data stored in healthcare systems can be susceptible to cyberattacks due to poor security protocols. The Healthcare Association relies on guidelines from the American Medical Association (AMA) to mitigate security risks. Data loss can lead to clinical errors and negatively impact patient safety (Muthuppalaniappan & Stevenson, 2019).

Possible Changes

Telehealth enables healthcare organizations to provide remote consultations, billing, prescriptions, and examinations. Its importance has been highlighted during the pandemic. However, both legal and ethical issues necessitate modifications within the system. Proposed changes include:

Training nurses and staff for effective data management in telehealth (Ahmad et al., 2021).
Utilizing a collaborative approach to address patients’ primary concerns (Nittari et al., 2022).
Following strict security protocols and regulations established by the American Medical Association and the U.S. Department of Health and Human Services Office for Civil Rights (Telehealth HHS.gov, 2022).
Complying with insurance guidelines for effective practice and professional liability protection (Austin & Kusumoto, 2019).
Ensuring patient data confidentiality through adherence to HIPAA regulations (Edemekong et al., 2019).
Considering regulatory aspects based on principles of justice, equity, autonomy, and nonmaleficence (Silva et al., 2019).

Current Outcomes Compared to Outcomes Seen with Best Practices

Evidence-based practices in care coordination have shown significant improvements in outcomes, particularly concerning blood pressure control, medication adherence, patient education, healthcare utilization, patient satisfaction, and care quality. Group-based care is one of the most essential best practices for managing patients with hypertension. A team of healthcare professionals, including doctors, nurses, pharmacists, and other providers, collaborates to manage patient hypertension. Care teams enhance provider coordination and communication, reduce the risk of clinical errors, and ensure that patients receive comprehensive care that addresses their physical, emotional, and social needs (McGilton et al., 2018).

Another best practice involves leveraging technology, such as computerized provider order entry (CPOE) and telemedicine, to improve communication and coordination among healthcare professionals, patients, and their providers. While telehealth facilitates remote consultations and monitoring, CPOE offers detailed insights into patients’ clinical histories, medications, and care plans. Utilizing technology to coordinate care can lead to reduced hospital readmissions and better medication management (Houwelingen et al., 2021).

The Chronic Care Model (CCM) aims to enhance care for individuals with chronic diseases such as hypertension. The CCM emphasizes the importance of evidence-based, team-based, and patient-centered approaches. Proactive patient engagement, consistent follow-up, self-management support, and clinical decision assistance are essential components of the CCM. This framework has gained widespread acceptance and is applied in healthcare settings worldwide to enhance the delivery of high-quality chronic care (Yeoh et al., 2018).

Health Information Technology (HIT) can also support care coordination. By leveraging health information technology, patients can actively engage in their treatment, facilitating communication among care team members and providing real-time access to patient information. Electronic health records (EHRs) can be utilized to document patient data, monitor medication adherence, and alert healthcare professionals when a patient’s blood pressure readings fall outside the normal range (Sheikh et al., 2021).

Medication reconciliation, medication review, and adherence support are examples of evidence-based interventions for medication management. Medication reconciliation involves reviewing a patient’s current and past medications to ensure they are taking the appropriate medications at the correct dosages. The medication review assesses the appropriateness of a patient’s medications, considering potential interactions and adverse effects. Patient education, updated systems, and medication therapy management are key components of medication adherence support (Margolis et al., 2022).

Nurses play a crucial role in patient care and outcomes as they interact directly with patients. Their ability to understand patients’ needs and concerns significantly impacts care delivery. However, challenges arise when nurses lack adequate training. Therefore, enhancing nurses’ skills is essential to reducing errors. Evidence suggests that improved knowledge equips nurses to effectively manage various health conditions. Skill acquisition can be achieved through education and training programs. Enhancing collaboration also helps address the concerns and challenges faced by staff and nurses (Peltonen et al., 2019).

Role of Stakeholders & Interprofessional Teams

The Chronic Care Model heavily relies on stakeholders and interprofessional teams. Stakeholders involved in the care of individuals with chronic illnesses—including patients, their families, healthcare professionals, and healthcare organizations—can significantly influence the success of the CCM. Patients and their families, as treatment recipients and key partners in care planning, are essential stakeholders in the CCM (Yeoh et al., 2018).

Stakeholders such as nurses, healthcare professionals, staff, and educators are responsible for identifying issues and correcting them. Each group has specific roles and responsibilities. Board members oversee funding for the implementation of interventions. For instance, educators should develop appropriate curricula for nursing informatics education, enabling nurses to understand the integration of technology into the healthcare system. This knowledge enhances the effective utilization of healthcare systems and technologies (Peltonen et al., 2019). The executive director is responsible for implementing the changes or interventions.

Stakeholders are also crucial for the effective implementation of telehealth. Interprofessional collaboration is essential for any organization to achieve optimal outcomes. Team members collaborate in meetings, sharing perspectives and suggestions. For instance, they disseminate evidence-based interventions to address telehealth security concerns among all healthcare association members (Husband et al., 2021).

Data-driven outcomes rely on analysis and interpretation of evidence. By assisting healthcare professionals in monitoring and improving the quality of care provided to patients with hypertension, data-driven results play a significant role in care quality (Borza et al., 2019).

Healthcare professionals can identify patients with diabetes at increased risk of adverse health outcomes, such as heart attacks or strokes, by analyzing data on blood pressure readings and other health indicators. This ability allows healthcare professionals to prioritize these individuals for more intensive interventions, including medication management or lifestyle counseling (Pilotto et al., 2018).

Improving Care Coordination

Healthcare professionals can ensure that patients receive comprehensive, coordinated care by sharing information about blood pressure readings and other health indicators with other care team members, such as pharmacists and nurses (Garcia et al., 2021).

Analyzing Data on Outcomes

Healthcare professionals can evaluate the effectiveness of hypertension treatment programs based on outcomes such as blood pressure control and hospital readmission rates, making necessary improvements to the quality of care for older individuals with hypertension (Margolis et al., 2022).

References

Ahmad, R. W., Salah, K., Jayaraman, R., Yaqoob, I., Ellahham, S., & Omar, M. (2021). The role of blockchain technology in telehealth and telemedicine. International Journal of Medical Informatics, 148, 104399. https://doi.org/10.1016/j.ijmedinf.2021.104399

Austin, C., & Kusumoto, F. (2019). Updates in medical professional liability: A primer for electrophysiologists. Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing, 56(2), 151–158. https://doi.org/10.1007/s10840-018-0453-9

Ceriello, A., Prattichizzo, F., Phillip, M., Hirsch, I. B., Mathieu, C., & Battelino, T. (2022). Glycaemic management in diabetes: Old and new approaches. The Lancet. Diabetes & Endocrinology, 10(1), 75–84. https://doi.org/10.1016/S2213-8587(21)00245-X

Edemekong, P. F., Annamaraju, P., & Haydel, M. J. (2022). Health Insurance Portability and Accountability Act. In StatPearls. StatPearls Publishing.

Garcia, A. P., Shelley Ann Francisco, & Mercado. (2021). Senior health information systems are available in Philippine government tertiary hospitals and health facilities.: Cross-sectional study. Journal of Medical Research, 24(2). https://doi.org/10.2196/29541

NURS FPX 6616 Assessment 1 Community Resources and Best Practices

Groom, L. L., McCarthy, M. M., Stimpfel, A. W., & Brody, A. A. (2021). Telemedicine and telehealth in nursing homes: An integrative review. Journal of the American Medical Directors Association, 22(9), 1784–1801.e7. https://doi.org/10.1016/j.jamda.2021.02.037

Legal considerations. Telehealth.HHS.gov. (2022). Retrieved December 22, 2022, from https://telehealth.hhs.gov/providers/legal-considerations/

Margolis, K. L., Anna R., Crain, A. L., J., Solberg, L. I., Beverly B., Haugen, P., Sharma, R., Rehrauer, McKinney, Z. J., Kottke, T. E., Rae Ann, & O’Connor. (2022). Contrasting in-person treatment. Hypertension, 79(12), 2708–2720. https://doi.org/10.1161/HYPERTENSIONAHA.122.19816

Marmor, R. A., Clay, B., Millen, M., Savides, T. J., & Longhurst, C. A. (2018). The impact of physician EHR usage on patient satisfaction. Applied Clinical Informatics, 9(1), 11–14. https://doi.org/10.1055/s-0037-1620263

Muthuppalaniappan, M., & Stevenson, K. (2021). Healthcare cyber-attacks and the COVID-19 pandemic: An urgent threat to global health. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 33(1), mzaa117. https://doi.org/10.1093/intqhc/mzaa117

Nittari, G., Khuman, R., Baldoni, S., Pallotta, G., Battineni, G., Sirignano, A., Amenta, F., & Ricci, G. (2020). Telemedicine practice: Review of the current ethical and legal challenges. Telemedicine Journal and e-health: The Official Journal of the American Telemedicine Association, 26(12), 1427–1437. https://doi.org/10.1089/tmj.2019.0158

NURS FPX 6616 Assessment 1 Community Resources and Best Practices

Peltonen, L. M., Nibber, R., Lewis, A., Block, L., Pruinelli, L., Topaz, M., Perezmitre, E. L., & Ronquillo, C. (2019). Emerging professionals’ observations of opportunities and challenges in nursing informatics. Nursing Leadership (Toronto, Ont.), 32(2), 8–18. https://doi.org/10.12927/cjnl.2019.25965

Pilotto, A., Raffaella, & Petermans, J. (2018). Elderly technology. Aging, 47(6), 771–774. https://doi.org/10.1093/ageing/afy026

Sheikh, A., Anderson, M., Albala, S., B, Taylor, D., Tibble, & E. (2021). Digital innovation and health information technology. The Digital Health, 3(6), e383–e396. https://doi.org/10.1016/S2589-7500(21)00005-4

Silva, T. N. D., Freire, M. E. M., Vasconcelos, M. F., Silva Junior, S. V. D., Silva, W. J. C., Araújo, P. D. S., & Eloy, A. V. A. (2018). Deontological aspects of the nursing profession: understanding the code of ethics. Revista Brasileira De Enfermagem, 71(1), 3–10. https://doi.org/10.1590/0034-7167-2016-0565

Solimini, R., Busardò, F. P., Gibelli, F., Sirignano, A., & Ricci, G. (2021). Ethical and legal challenges of telemedicine in the era of the COVID-19 pandemic. Medicina (Kaunas, Lithuania), 57(12), 1314. https://doi.org/10.3390/medicina57121314