Describe at least two ways that health information technology has affected the clinician-patient relationship, for better or for worse.

Case Studies and Discovery Questions
Paper , Order, or Assignment Requirements

1.You must answer one of the case study questions and one discovery question from the list.

Your answer needs to be a minimum of 250-words for each answer. Your answer must be substantive and bring in some kind of analysis that relates to the material. You also must engage others

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While you are encouraged to use examples from personal experience, you should be looking for and including outside sources that you find addressing the topic at hand.

Case Studies and Discovery Questions, please pick one of each to answer

Case 1

A family practice clinic in a rural area is associated with a major academic medical center in an urban area 100 miles away. The clinic director plans to switch to electronic health records (EHRs). The community using the clinic opposes this move because people are concerned about their privacy. Do you implement the system over the objections of the community? What ethical principles and/or theories support your position?

Case 2

Harry is a 16 year old in need of a kidney transplant. His parents (Lydia and Ken), aunts, uncles and adult cousins all get tested for histocompatibility of the human leukocyte antigen (HLA). The transplant nephrologist learns two things as a result of the tests: (1) no one from the family is a suitable donor, and (2) Harry is not biologically related to Ken. The nephrologist was not checking for paternity; however, all biologically related parents share at least one HLA match with their children, and Ken has less than that. The hospital has an informal policy stating that unintended discovery of misattributed paternity will not be disclosed or entered in the patient record. Upon learning that there were no matches, Ken tells the nephrologist that he wants a copy of the records so that he can get a second opinion. Later, Lydia approaches the nephrologist and asks that the records not be given to Ken. What should the nephrologist do? What ethical principles and/or theories justify your answer?

Case 3

The board of a small community hospital is considering authorizing funds for the ACME telehealth program. This program can only be used by English-speaking patients and those with Internet access. People with sensory or motor disabilities would not be able to use the telehealth website. The cost would be prohibitive for the hospital to make telehealth accessible to everyone. Ethically justify the purchase of the ACME telehealth program or explain why it is not justifiable.

Case 4

Blackacre Hospital is upgrading its enterprise Acme ZenApp environment from version 6.8 to 7.5. Yesterday, your supervisor stopped by and instructed you to push out the apps on the new 7.5 environment. You tested the apps in question and they both ran without error in the upgraded environment and are confident that they will perform as in previous versions. In conducting due diligence you called various application vendors to get certification for their apps on the 7.5 environment, and you discover that two of Blackacre’s apps, the EKG and EEG apps, are not certified for ZenApp version 7.5 yet. The apps appeared to work based on your tests, but the vendor of the apps does not yet certify them for the ZenApp 7.5 environment upgrade. In these situations you have been trained to ask, “If we move them anyway, will you support us if we have issues?” The response from the EKG and EEG app vendor this time was a resounding, “No. Our contract clearly stipulates that we are not liable for uncertified use. ZenApp is a new release and we require time for proper testing.”

You report your findings to your boss who says, “It’s your responsibility to test them and they tested without error. The 6.8 and 7.5 versions are so similar that there will be no impact. I expect you to sanction the applications for production even though the vendor has not certified them — that’s what we’re paying you for.” Do you sanction use or not? What are the ethical justification for your answer and your next steps?

General Discovery Questions Pick one to answer

Describe at least two ways that health information technology has affected the clinician-patient relationship, for better or for worse. What are the ethical implications?

What are the roles and obligations of the following groups in selecting, testing, and implementing health information systems: vendors, purchasing organizations, providers who will use the system, patients, and other stakeholders who may be impacted by the new system?
Are decision-makers always better off with more information rather than less?


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