Dreams And Nightmares: Database Analysis

Time was taken to identify possible negatives to the implementation of an electronic health information system. Research was conducted using the Cumulative Index to Nursing and Allied Health Literature (CINAHL) database. The database search was narrowed to nursing articles published within the last five years that were peer-reviewed. Several articles were reviewed and one was selected based upon its relevance to the issue of ethical considerations for the use of information technology in healthcare. The article, Dreams and Nightmares: Practical and Ethical Issues for Patients and Physicians Using Personal Health Records, was selected for its in-depth analysis of issues surrounding the means by which the healthcare enterprise stores and

The authors, Wynia and Dunn, consider both the pros and cons to developing a patient-accessed and controlled medical record. In an ideal world, PHR’s offer the patient the ability to track and manage their own healthcare. From logging their daily blood pressures, to reviewing their current medications and laboratory results, a PHR should be the link between physician and patient. These are separate from the electronic medical records stored at a doctor’s office or hospital. PHR’s contain the same information found in the patient’s chart but also include educational material and health tracking

This requires patients act as informed consumers regarding their own health. There are many concerns with this issue. On one hand, patient involvement in their own care is seen as good for both the patient and the physician. These patients are engaged and tend to desire and work toward a healthier lifestyle. On the flip side, there are those patients who may not be capable of assuming higher responsibility, or simply may not want to (Wynia & Dunn, 2010). In rural areas, some patients may simply not have the means to access electronic information on the internet. The ethical dilemma here is how to engage those who do not want to be involved, or are unable to be involved, in their own healthcare as the industry makes a broad move toward electronic health records. How do we address those in the population who are uncomfortable becoming a healthcare consumer and desire to remain a patient? As the authors point out, “there is no simple solution to this dilemma, which balances the values of autonomy and personal responsibility against the virtues of beneficence and forgiveness” (Wynia & Dunn, 2010, p.