The use of smaller and mobile technology in sharing patient health information (PHI) is accelerating due to incentives for providers in implementing electronic health records (EHR) technology into practice (Chan, Torous, Hinton, & Hellowlees, 2014). With this new technology being ever more present in the healthcare setting, the ethical issues surrounding their use should be considered and strategies implemented to protect PHI. Nurses are positioned well to address the ethical issues and strategies in the context of mobile technology and its use in sharing PHI.
Ethical Issues
There are a number of ethical issues that have the potential to arise with the use smaller mobile devices, such as smart phones and tablets to exchange patient health information (PHI) (Ozair, Jamshed, Sharma, & Aggarwal, 2015; Meeks, Smith, Taylor, Sittig, Scott, & Singh., 2014). For example, mobile devices because of their size are vulnerable to being lost or stolen. In fact the most commonly seen form of security breach in hospitals is due to mobile device lost or theft with 600 surveyed hospital executives, health insurers and workers and pharmaceutical sciences participants reporting theft of mobile devices accounted for over 66% of breaches over a two year period (Ozai, et al. 2015).

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Strategies
Another problem related to mobile technology is that the majority of physicians and nurses surveyed used their personal mobile device rather than an employer issued device in sharing PHI. This private use of devices poses many risks in terms of authentication, encryption, and wi-fi connections. Strategies to address these risks include conducting assessment of mobile technology use to determine if the device is personal or issued by the employer. A determination should also be made to assess whether protections are in place within the device.

Implications for Nurses
Implementing EHR systems is challenging which can result in patient safety issues. Implementing an EHR system requires a multi-disciplinary team, which includes nurses (Jones, Rudin, Perry, & Shekelle, 2014). Many EHR initiatives fail because the opinions of nurses have been underestimated. Nurses should voice their opinions on how best to implement an EHR system and on how tasks should be delegated. Often clinical personnel are not aware of the workflow in their organization or of the roles other workers play in health care delivery. This lack of awareness results in poor planning in implementing EHR systems. EHR practices should be standardized so the workflow is mapped out and the role each workers takes in the process should be identified. Nurses are well positioned to collaborate with multidisciplinary teams when implementing EHR using evidence-based practice strategies.

    References
  • Chan, R.S., Torous, J., Hinton, L., & Hellowlees, P. (2014). Mobile tele-mental health: Increasing applications and a move to hybrid models of care. Healthcare, 2, 220-233. doi:10.3390/healthcare2020220
  • Jones, S.S., Rudin, R.S., Perry, T., & Shekelle, P.G. (2014). Health information technology: An updated systematic review with a focus on meaningful use. Annals of Internal Medicine, 160(1). Retrieved from: http://annals.org/ on 10/29/2016
  • Meeks, D.W., Smith, M.W., Taylor, L. Sittig, D.F., Scott, J.M., & Singh, H. (2014). An analysis of electronic health record-related patient safety concerns. Journal of American Medical Information Association, 0, 1-7. doi:10.1136/amiajnl-2013-002578
  • Ozair, F.F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in Clinical Research, 692), 73-76. doi: 10.4103/2229-3485.153997