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The loss or destruction of data occurs during the transmission of data; This raises concerns about the accuracy of the database, as patient care decisions are based on them. [24] A growing problem is medical identity theft. This leads to the entry of inaccurate information into the victim`s file. The person`s insurance company is charged for medical services that are not provided to the actual policyholder, and the patient`s future treatment is guided by erroneous information that neither the patient nor the provider immediately recognizes. Healthcare organizations involved in a legal dispute are subject to the investigation phase of the legal process. Parties involved in litigation may obtain or discover any non-privileged matter, including EHRs, relevant to the lawsuit. Information or documents may be found even if they are inadmissible at trial, if they are “reasonably calculated” to lead to the discovery of admissible evidence. It is important that doctors are informed about the new rules on eDiscovery, identification and the use of electronic data as evidence in legal proceedings. Lawyers recognize the wealth of information stored in electronic systems that paper records do not provide.10 However, issues that require special attention are important.

The electronic transmission and storage of patient data raises medical law issues that go beyond the applicability of tort law to telemedicine and e-mail communication issues. This includes protecting patient privacy, documentation issues, limited access, and hardware and software issues.5 Healthcare organizations face major challenges during EHR implementation, resulting in wasted resources, frustrated providers, loss of patient trust, and patient safety issues. The development, implementation and maintenance of EHRs requires appropriate resources and the involvement of many people, including clinicians, information technologists, educators and consultants. [19] Electronic health records facilitate several innovations that enable health care reform. Despite their promise, many legal, ethical and financial issues currently unanswered threaten the widespread adoption and use of EHRs. Important legal dilemmas that need to be addressed in the short term relate to the extent of clinicians` responsibilities for reviewing the computer-accessible global clinical summary from multiple clinicians and institutions, the responsibilities arising from global warnings and warnings for clinical decision support, and mechanisms for clinicians to publicly report potential safety issues in EHRs. Ethical dilemmas that require further discussion include opt-out provisions that exclude patients from storing electronic records, the sale of anonymized patient data by EHR providers, the control of adolescents` access to their data, and the use of electronic data to rethink the country`s healthcare and payment mechanisms based on statistical analysis. Finally, a damning financial question is who should pay for the implementation of the EHR, as most users and current owners of these systems will not receive the majority of the benefits. The authors recommend that key stakeholders begin discussing these issues in a national forum. These measures can help identify and prioritize solutions to key legal, ethical, and financial dilemmas so that widespread, safe, effective, and interoperable EHRs can help transform healthcare. In the past, medical records were considered hearsay and inadmissible in court proceedings.

However, the Federal Rules of Evidence and the Uniform Rules of Evidence have codified the hearsay rule exemption for commercial records, allowing for the use of health records in court.6 Finally, the reduction in health care costs is long overdue, but many are concerned about the downstream impact of EHRs and the reduction in HI`s health care expenditures. For example, it is estimated that the availability of previous test results in local ISRs would result in an annual loss of $10 million for all hospitals in the Portland, Oregon metropolitan area.67 Although there is currently no evidence as to whether or how the cost changes will occur, these problems are also likely to lead to dilemmas that need to be resolved. As federal and state laws face the need to address the electronic disclosure of protected medical information, a routine assessment of acceptable alternative options for complying with such disclosures is recommended. In the event of a conflict, clarification should be sought from legal counsel. The HIPAA security rule must be referenced when the information is published electronically. Appropriate security measures must be taken if the transaction falls under the security rule. Subpoena duces tecum: a written order directing a person to appear, testify and bring all documents, papers, books and records described in the subpoena. The devices are used to obtain documents during the pre-trial discovery and testimonies during the trial. The legal system, which builds on precedents and lags behind the adoption of new technologies, including EHRs, offers little guidance to manage the transition from paper to electronic records.3 With the new push to expand local, state and national health information exchange (HIA), for example, 4.-6 suppliers will finally have fast computer access to more than one paper diagram of a single organization. have. While these initiatives address long-standing issues related to the lack of clinical information7,7 there is no legislation or precedent addressing the extent to which clinicians are responsible for reviewing information in an integrated Community-wide EHR that includes data from many sources.8 Many providers currently find it impossible to verify the full set of data within a reasonable period of time.

In addition, the integrated EHEA introduces several additional liabilities.9 First, unlike paper records, where incomplete or illegible information is not uncommon, EHRs can store virtually unlimited amounts of perfectly legible and immediately accessible documents that encompass almost all aspects of care, regardless of where and when they took place, which are all “discoverable”. For many years, 11-12 patients in large integrated EHR early adoption facilities (e.g., Kaiser Permanente Northwest13 and the U.S. Department of Veterans Affairs Health System14) have already collected individual archives of clinical notes, laboratory results, X-rays, and provider-to-vendor correspondence.