Perspectives on Sharing Healthcare Information: Data Exchange to Public Health

Badaki Peter Ilesanmi

Walden University

IF002: Perspectives on the Sharing of Healthcare Information

Dr. Vannesia Morgan-Smith

May 8th, 2022

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Data sharing in practice

Modern technologies are used to develop and disseminate useful healthcare

Information that is created from these data. Sharing healthcare information to improve patient

care is often affected by regulations, providers, or patients’ willingness to adapt/accept

discoveries and the increasing healthcare infrastructure cost. Providers and patients are yet to

benefit from healthcare information shared to improve patient care and public healthcare

delivery.

Nurse Informatics is responsible for utilizing cutting-edge technologies to design and

implement information systems such as the Electronic Health Records to accommodate new

medical discoveries for diagnosis or treatment as evidence-based standards in the workplace.

Nurse Informatics interviewed was Simran Sandhu, RN, BScN, and Nursing Informatics -

Master of Science in Nursing (MSN). Simran is an experienced Registered Nurse with a

demonstrated history of working in the hospital & health care industry. Experiences include

critical Care, Pediatrics, Patient Education, and Patient Safety. She is currently a Clinical

Informatics Analyst at Trillium Health Partners.

This paper aims to describe data exchange to public health, which implies utilizing

research outcomes to facilitate quality patient care and healthcare delivery.

Effect of Precision Medicine on Genetic Testing in General and the Research Trial

Scenario

Genetic testing and Precision medicine are important fields in medical ecology. Both

aim at achieving effective and efficient health care delivery. However, the effect of precision

medicine on genetic testing in general and the research trial described in the scenario

specifically cannot be underestimated.

First, precision medicine promotes the integration of electronic health records in inpatient

care. For example, it has been observed that the combination of data in the EMR and gene
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sequencing information has been a powerful tool for identifying genetic variants associated

with disease and for understanding individual responses to therapies. (Bell et al., 2011;

Ginsburg & Phillips, 2018). This synergy tends to have a tremendous impact on the status of

genetic testing, particularly for researchers to understand how diseases occur and for

physicians to utilize clinical data without stress. Second, precision medicine provides new

ways of ensuring that patients' privacy and confidentiality relating to data are protected and

secured. This trend negates the concern Erdmann, Rehmann-Sutter & Bozzaro (2021) about

the confidentiality of genetic information to families rather than to individuals, which means

that information about a genetic disposition is shared with all at-risk family members. (p.10).

Healthcare providers and patients will now be more willing to participate in research and

clinical genetic testing and trial drugs without violating the HIPAA database system. The

potential of precision medicine to increase the usage of patient genetic and other molecular

data in physicians' daily practice puts to rest the need to determine the clinical utility of

genetic tests based on actionable mutations, as well as a requirement for guidance regarding

how tests can be implemented in clinical practice. (Beuchaw, Wachter, & Rosenberg, 2017;

Phillips, Deverka, Hooker & Douglas, 2018). This means that precision medicine has

succeeded in enlarging the scope of sharing and utilizing research and clinical genetic test

results.

Approach for facilitating the Reluctant Physician’s Use of the Trial Drug and the

Needed Data

The reluctant physician's action relating to the use of the trial drug shows he is aware

of the provisions of both the Health Insurance Portability and Accountability Act of 1996

(HIPAA) and the Health Information Technology for Economic and Clinical Health

(HITECH) Act of 2009 and realized that accepting to use the trial drug would amount to

violation and eventual punishment. Therefore, as a nurse leader, I would recommend the
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following approaches to address the potential misuse of data and information for genetic

testing and research. First, provide further awareness about HIPAA and HITECH

compliance. I would inform the reluctant physician about the HIPAA Privacy Rule that

regulates the use and disclosure of protected health information (PHI), such as obtaining

permission from law enforcement, prior written authorization, and the enormous penalties for

violations. (HITECH Act Enforcement Interim Final Rule, 2017).

Second, promote the protection or management of access to data. I would encourage

the reluctant physician to discourage the misuse of data and information for genetic testing

and research, which amounts to data breach and non-compliance with HIPAA and HITECH

Acts. For example, the ACTs require implementing safeguards to keep health information

private and confidential, improving privacy and security protections for healthcare data.

Abiding by the 'burden of proof' requires proof that the violation did not result in the

unauthorized disclosure of protected health information PHI. The HITECH Acts detail

specific patient information breach guidelines for healthcare providers to be more observant

in protecting private patient records and the vast fine that await violators of different

categories. (HITECH Act Enforcement Interim Final Rule, 2017).

Third, I would inform the physician about the implication of the Amended HITECH

Act to healthcare providers that are operating within established industry best practices. For

instance, I would let him know that the amended Act creates a safe harbor for companies that

have implemented recognized security best practices prior to experiencing a data breach

(Alder Steve, 2021). This provision is to ensure that healthcare providers that have adopted

recognized cybersecurity framework enjoy some level of protection against potential

violations of the HIPAA Security Rule. Thus, if he has adopted a recognized cybersecurity

framework and decides to utilize the genetic trial drug in line with best practices then
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enforcement against violation of the HIPAA Security Rule which he is aware of could be

negotiated with the regulatory authority.

Lastly, I would encourage the reluctant Physician to adopt an established

cybersecurity framework or any other recognized security practices if he is yet to adopt one

to avoid being expose to cyber-attack or enjoy the benefits specified for entities that are

HIPAA compliance as emphasized in the Amended HITECH. For example, Alder Steve,

(2021) claims that the healthcare industry is extensively being targeted by hackers and

healthcare data breaches are becoming much more common. Therefore, the physician would

enjoy tremendous benefits if his healthcare facility has adopted recognized security best

practices.

Nurse Informaticist Role and the Genetics Trial Drug Use in the Research Scenario

Nurse Informatics bridges the gap between healthcare information and the application

of technology to facilitate improved patient care and quality healthcare delivery. Hence,

concerning the genetics trial drug use, the nurse informatics promotes compliance to the

HITECH Acts by educating the nurse geneticist on the changes in the HIPPA. Such as the

right of access allows individuals to obtain a copy of their health data in an electronic mode

based on their preference—the new enforcement law relating to data breaches and the

violation of the HIPAA Privacy Rule. Similarly, nurse informatics promotes the meaningful

use of certified integrated electronic health record systems to allow both the nurse geneticist

and the reluctant physician to transmit patients' data and details about the trial drug

electronically.

In conclusion, data sharing can enhance the achievement of patient outcomes.

Therefore, promoting healthcare providers’ compliance to the HITECH Acts of meaningful

use and fully-integrated Electronic Health Record (EHR) in their facilities would make

information exchange a seamless and beneficial engagement in healthcare delivery.

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Reference

Alder Steve (2021, January 12). HITECH Act Amendment Creating Cybersecurity

Safe Harbor Signed into Law. HIPAA Journa.l Retrieved from

https://www.hipaajournal.com/hitech-act-amendment-creating-cybersecurity-

safe-harbor-signed-into-law/? May 8, 2022

Erdmann, A., Rehmann-Sutter, C. & Bozzaro, C. Patients’ and professionals’ views

related to ethical issues in precision medicine: a mixed research

synthesis. BMC Med Ethics 22, 116 (2021). https://doi.org/10.1186/s12910-

021-00682-8

Gameiro, G. R., Sinkunas, V., Liguori, G. R., & Auler-Júnior, J. (2018). Precision

Medicine: Changing the way we think about healthcare. Clinics (Sao Paulo,

Brazil), 73, e723. https://doi.org/10.6061/clinics/2017/e723

Ginsburg, G. S., & Phillips, K. A. (2018). Precision Medicine: From Science To

Value. Health affairs (Project Hope), 37(5), 694–701.

https://doi.org/10.1377/hlthaff.2017.1624

Office for Civil Rights. (2017, June 16). HITECH Act Enforcement Interim Final

Rule. Retrieve from https://www.hhs.gov/hipaa/for-professionals/special-

topics/hitech-act-enforcement-interim-final-rule/index.html May 5, 2022

Phillips, K. A., Deverka, P. A., Hooker, G. W., & Douglas, M. P. (2018). Genetic

Test Availability And Spending: Where Are We Now? Where Are We

Going?. Health affairs (Project Hope), 37(5), 710–716.

https://doi.org/10.1377/hlthaff.2017.1427