Introduction
The introduction of information technologies in various areas of activity significantly improves human achievements. In medicine, they can be used to manage large amounts of patient-related data. Quality and truthful data can be the basis for effective treatment and maintenance of patient health. For chronic diseases, the use of technology is critical as it can prevent complications. This paper discusses the use of information systems to manage the treatment of patients with type 2 diabetes (T2D). Diabetes is among the most widespread and dangerous chronic diseases in the world and a known cause of death. It can result in acute complications such as cardiovascular disease, immune impairment, micro-vessels damage, and other problems. Maintaining the required blood sugar levels is critical during diabetes and needs ongoing observation. The use of technology for patients with diabetes helps manage the condition, make effective decisions by health care providers, and support the customers themselves.
Legal Consideration
Medical professionals collect a lot of personal information about their patients, and they have an obligation to ensure confidentiality, privacy, and security. Confidentiality refers to the ability of a specialist not to disclose information. The confidentiality obligation is imposed by the Oath of Hippocrates and the American Health Information Management Association Code of Ethics (AHIMA) (Prater, 2020). Privacy, in turn, is the right of the patient to know and influence how the data will be used or transmitted. Finally, security is the means used to protect the information, such as a key to a file cabinet or a password in an electronic system. Privacy and security are provided through the Health Insurance Portability and Accountability Act (HIPAA) – HIPAA Privacy Rule and HIPAA Security Rule (Prater, 2020). Thus, everyone who works with patients’ data must respect this information and use it carefully.
When working with patients who have diabetes, data are needed – personal health information also called protected health information (PHI). It includes the patient’s personal information (name, address, telephone number, insurance number, and other data) combined with medical information. The data can be used to track a patient’s health status, diagnosis, prescription of medication, and, if necessary, it’s regulation. HIPAA and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 regulate who can receive PHI and how they can use it (Lutkevich et al., 2021). Following these laws, medical personnel working with patients with diabetes will comply with the necessary rules and ensure the confidentiality, privacy, and security of data.
Information Collection
The work concentrates on patients with T2D, in which the most necessary information for treatment is blood sugar levels. It can be tracked using the Continuous Glucose Monitor (CGM), from which data later can be entered into Electronic Health Records (EHRs) (Britton & Britton-Colonnese, 2017). Information should be available to patients and their physicians not only in the office but constantly. For patients, constant access to information is vital for better maintaining their condition, and it is needed by doctors when a patient is hospitalized.
Since diabetes is a chronic condition, a particular part of the patients’ data should be available permanently – for example, reaction to the medication. A large amount of data obtained with CGM cannot be available constantly since it is too voluminous; only general trends are critical. In the case of T2D, care will be provided to patients with this condition and can be offered to their relatives as preventive measures. A demographic limitation can be patients’ location and the availability of a clinic for them, and if inconvenient, the help of closer institutions can be offered.
The documents that will be most useful for working with patients are the following: history and physical (H and P), laboratory data, prescriptions, progress notes, data from CGM, patient education materials, insurance, and patient statements. Based on the required documents, it can be assumed that the following systems are necessary: results management, point-of-care (POC) documentation, computerized provider order entry (CPOE) systems, and E-Rx (e-prescribing). Moreover, a system such as clinical decision support (CDS) helps physicians make the most effective patient decisions. Telemedicine/telehealth systems will also help maintain effective communication and promote improvement for customers with T2D (Tchero et al., 2019). Thus, all EHR systems – administrative, financial, and clinical – are needed to operate an office with a group of physicians working with diabetic patients.
Information Lifecycle
Electronic health information exchange (HIE) between different health care providers promotes better treatment. In the case of patients with T2D, information can be transmitted from the laboratory, provided to the patient, another provider, or an insurance company. Keller et al. (2015) note the convenience of sharing data with pharmacies for patients to receive medication. In order for all critical information systems to be effectively integrated into HIE, interoperability is needed (“Interoperability and connecting to an HIE,” 2019). This feature ensures the secure exchange of information, its practical use, and confidentiality.
Information needed for treatment should be collected by health care providers in the process of communicating with patients or obtained through HIE. In particular, the doctor or nurse at the appointment may keep the necessary records and inform the patient of what part of the data can be used for transmission to the laboratory or pharmacy. Information should be kept in such a way as to ensure its confidentiality, privacy, and security. Access to electronic records should be restricted and monitored by tracking system activities, password usage, two-factor authentication, and data encryption.
Over time, information can be deleted and depending on the state where the health institution is located, the statute of limitations may differ. However, according to McHugh (2020), HIPAA has its standard, which is more important than the state standard if the latter is shorter – 6 years since last use. In EHR, there is the possibility of particular settings for deleting records after the expiration of time. The peculiarity of EHR is that it cannot be removed from the hard disk without the possibility of recovery. For complete removal, it is only necessary to destroy the disk itself.
Health care providers must ensure that their data meets all interoperability standards. According to Monica (2018), the first step towards interoperability is to install certified EHRs where the necessary functionality for improvement will be available. Health facilities can also collaborate with EHR providers during standards development. Nevertheless, compliance with the standards of one vendor of EHR will not provide full interoperability since their suppliers often do not agree on various aspects among themselves (Monica, 2018). As a result, the interaction between health care providers is significantly complicated.
Conclusion
This paper discusses the use of information systems for a group of doctors with patients with T2D. In this condition, it is essential to monitor blood sugar and maintain its healthy level. The use of various clinical EHR applications will be effective for condition management. A necessary aspect of the work is exchanging information with other health care providers, particularly pharmacies. In turn, telemedicine/telehealth systems can be used to train and support customers. To effectively use EHR data for HIE, health care providers need to monitor and comply with health information standards.
References
Britton, K. E., & Britton-Colonnese, J. D. (2017). Privacy and security issues surrounding the protection of data generated by continuous glucose monitors. Journal of Diabetes Science and Technology, 11(2), 216–219. Web.
Interoperability and connecting to an HIE. (2019, February 21). Thornberry. Web.
Keller, M. E., Kelling, S. E., Cornelius, D. C., Oni, H. A., & Bright, D. R. (2015). Enhancing practice efficiency and patient care by sharing electronic health records. Perspectives in Health Information Management, 12, 1-8.
Lutkevich, B., Wallask, S., & DelVecchio, A. (2021). Protected health information (PHI) or personal health information. TechTarget. Web.
McHugh, R. (2020). How to manage medical record retention and destruction. Shred Nation. Web.
Monica, K. (2018). How health data standards support healthcare interoperability. EHR Intelligence. Web.
Prater, V. S. (2020). Confidentiality, privacy and security of health information: Balancing interests. The University of Illinois Chicago. Web.
Tchero, H., Kangambega, P., Briatte, C., Brunet-Houdard, S., Retali, G. R., & Rusch, E. (2019). Clinical effectiveness of telemedicine in diabetes mellitus: a meta-analysis of 42 randomized controlled trials. Telemedicine and e-Health, 25(7), 569-583. Web.