Lorence Daniel P
Department of Health Policy and Administration, The Pennsylvania State University, 120 S Burrowes St, University Park, PA 16801, USA.
J Behav Health Serv Res. 2004 Apr-Jun;31(2):199-207.
Health and human service organizations are becoming increasingly liable for violations of patient privacy as a result of recent federal mandates at both state and federal levels of government. Under such conditions it would seem likely that managers would act to quickly implement such guidelines and mandates, especially in sensitive specialty areas such as mental health. This study sought to examine the degree and type of patient information confidentiality measures adopted in mental health delivery settings, through a national survey of accredited US health information managers. Results suggest that significant nonadoption of basic confidentiality measures continues to exist, despite federal mandates to the contrary. Further examined was the degree to which confidentiality management varies across adoption levels of computerized patient records. Significant variation was found in adoption of patient confidentiality measures between highly computerized and paper-based medical record functions. Similar levels of variation in adoption across practice settings was also discovered. Ramifications for national policy and patient information protection are discussed.
由于近期州和联邦政府层面的联邦指令,卫生与公共服务组织因侵犯患者隐私而承担的责任越来越大。在这种情况下,管理人员似乎有可能迅速采取行动实施这些指导方针和指令,尤其是在心理健康等敏感专业领域。本研究旨在通过对美国认证的健康信息管理人员进行全国性调查,来检验心理健康服务机构中采用的患者信息保密措施的程度和类型。结果表明,尽管有相反的联邦指令,但基本保密措施仍存在大量未被采用的情况。进一步研究的是保密管理在计算机化患者记录采用水平上的差异程度。在高度计算机化和纸质病历功能之间,患者保密措施的采用存在显著差异。在不同的实践环境中也发现了类似的采用差异水平。文中还讨论了对国家政策和患者信息保护的影响。