Legally eHealth

Chapter

Abstract

The opportunities offered by e-health to decrease risks linked to medical profession need to face with emerging legal risks. Shared decision making process via electronic instruments, e-prescribing, e-genetics offers a new landscape for patient–doctor relationship. In legal arena e-liability and e-discovery issues open a new scenario in courts for health professionals. From the patient point of view, issues of security and privacy with electronic information and communication are the most common concerns. The need is to combine a personal approach to healthcare service delivery in the era of technology. In cross-border healthcare, interoperability and centralization, respectful of privacy and confidentiality, are essential. Nevertheless, differences in legal standard, in standard of care and in malpractice liability systems affect the cross-border e-health, arising the need of harmonization.

Keywords

Electronic health record Information and Communication Technology Liability Informed consent Privacy Cross-border healthcare 

References

  1. 1.
    World Health Assembly 58.28 (2005) eHealth. http://apps.who.int/iris/bitstream/10665/20378/1/WHA58_28-en.pdf. Accessed 1 Dec 2012
  2. 2.
    Moses RE, Feld KA, Feld AD (2011) Physician liability: Electronic medical records. Am J Gastroenterol 106:810–814PubMedCrossRefGoogle Scholar
  3. 3.
    Crosson JC, Schueth AJ, Isaacson N, Bell DS (2012) Early adopters of electronic prescribing struggle to make meaningful use of formulary checks and medication history documentation. J Am Board Fam Med 25:24–32Google Scholar
  4. 4.
    Directive 2011/24/EU of The European parliament and of the council on the application of patients’ rights in cross-border healthcare. Official journal of the European Union. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2011:088:0045:0065:EN:PDF. Accessed 29 Nov 2012
  5. 5.
    EPHA (2011) EPHA briefing on eHEALTH. http://www.epha.org/IMG/pdf/EPHA. Accessed 29 Nov 2012
  6. 6.
    American college of physicians (2008) E-Health and its impact on medical malpractice. Philadelphia: American college of physician; position paper. http://www.acponline.org/advocacy/where_we_stand/policy/ehealth.pdf. Accessed 30 Nov 2012
  7. 7.
    Mangalmurti SS, Murtagh L, Mello MM (2010) Medical malpractice liability in the age of electronic health records. N Engl J Med 363:2060–2067PubMedCrossRefGoogle Scholar
  8. 8.
    Virapongse A, Bates DW, Shi P, Jenter CA, Volk LA, Kleinman K, Sato L, Simon SR (2008) Electronic health records and malpractice claims in office practice. Arch Intern Med 168:2362–2367PubMedCrossRefGoogle Scholar
  9. 9.
    Quinn MA, Kats AM, Kleinman K, Bates DW, Simon SR (2012) The relationship between electronic health records and malpractice claims. Arch Intern Med 172:1187–1189PubMedCrossRefGoogle Scholar
  10. 10.
    Victoroff MS, Drury BM, Campagna EJ, Morrato EH (2012) Impact of electronic health records on malpractice claims in a sample of physician offices in colorado: A retrospective cohort study. J Gen Intern Med. doi: 10.1007/s11606-012-2283-2
  11. 11.
    Ahmad F, Hudak PL, Bercovitz K, Hollenberg E, Levinson WJ (2006) Are physicians ready for patients with internet-based health information?. Med Internet Res doi:  10.2196/jmir.8.3.e22
  12. 12.
    Coulter A, Collins A (2011) Making shared decision making a reality. King’s Fund, LondonGoogle Scholar
  13. 13.
    Siegal G, Bonnie RJ, Appelbaum PS (2012) Personalized disclosure by information-on-demand: attending to patients’ needs in the informed consent process. J Law Med Ethics 40:359–367PubMedGoogle Scholar
  14. 14.
    Hall DE, Morrison P, Nikolajski C, Fine M, Arnold R, Zickmund SL (2012) Informed consent for inguinal herniorrhaphy and cholecystectomy: describing how patients make decisions to have surgery. Am J Surg 204:619–625PubMedCrossRefGoogle Scholar
  15. 15.
    Hilgart J, Hayward JA, Iredale R (2012) E-genetics: exploring the acceptability and feasibility of using technology in cancer genetics services. Clin Genet 81:514–520PubMedCrossRefGoogle Scholar
  16. 16.
    Kluge EH (2011) Ethical and legal challenges for health telematics in a global world: telehealth and the technological imperative. Int J Med Inform doi:  10.1016/j.ijmedinf.2010.10.002
  17. 17.
    Coulter A, Parsons S, Askham J (2008) Where are the patients in decision-making about their own care? WHO 2008 and WHO on behalf of the European Observatory on Health Systems and Policies, DenmarkGoogle Scholar
  18. 18.
    Smith J (2004) Building a Safer National Health System for Patients: Improving medication safety. Department of Health. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4071443 . Accessed 30 Nov 2012
  19. 19.
    Bates DW, Teich JM, Lee J, Seger D, Kuperman GJ, Ma’Luf N, Boyle D, Leape L (1999) The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc 6:313–321PubMedCrossRefGoogle Scholar
  20. 20.
    Scott GP, Shah P, Wyatt JC, Makubate B, Cross FW (2011) Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors. J Am Med Inform Assoc 18:789–798PubMedCrossRefGoogle Scholar
  21. 21.
    Crosson JC, Etz RS, Wu S, Straus SG, Eisenman D, Bell DS (2011) Meaningful use of electronic prescribing in 5 exemplar primary care practices. Ann Fam Med 9:392–397PubMedCrossRefGoogle Scholar
  22. 22.
    Redwood S, Rajakumar A, Hodson J, Coleman JJ (2011) Does the implementation of an electronic prescribing system create unintended medication errors? A study of the sociotechnical context through the analysis of reported medication incidents. BMC Med Inform Decis Mak 11:29. http://www.biomedcentral.com/1472-6947/11/29. Accessed 2 Dec 2012
  23. 23.
    Sittig DF, Singh H (2011) Legal, ethical, and financial dilemmas in electronic health record adoption and use. Pediatrics 127(4):1042–1047CrossRefGoogle Scholar
  24. 24.
    Vigoda M, Dennis JC, Dougherty M (2008) E-record, e-liability. addressing medico-legal issues in electronic records. J AHIMA 79:48–52PubMedGoogle Scholar
  25. 25.
    Directive 95/46/EC of the European Parliament and of the Council on the protection of individuals with regard to the processing of personal data and on the free movement of such data. Official Journal L 281. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:31995L0046:en:HTML. Accessed 2 Dec 2012
  26. 26.
    Dumiak M (2012) E-health’s future frontiers. Bull World Health Organ 90:328–329PubMedCrossRefGoogle Scholar
  27. 27.
    Geissbuhler A (2011) How can eHealth help fix broken health systems? Methods Inf Med 50:297–298PubMedCrossRefGoogle Scholar
  28. 28.
    Boussi Rahmouni H, Solomonides T, Casassa Mont M, Shiu S, Rahmouni M (2011) A model-driven privacy compliance decision support for medical data sharing in Europe. Methods Inf Med 50:326-336Google Scholar
  29. 29.
    Wachter RM (2006) The “dis-location” of U.S. medicine—the implications of medical outsourcing. N Engl J Med 354:661–665PubMedCrossRefGoogle Scholar
  30. 30.
    Singh SN, Wachter RM (2008) Perspectives on medical outsourcing and telemedicine–rough edges in a flat world? N Engl J Med 358(15):1622–1627PubMedCrossRefGoogle Scholar
  31. 31.
    Feess E (2012) Malpractice liability, technology choice and negative defensive medicine. Eur J Health Econ 13:157–167PubMedCrossRefGoogle Scholar
  32. 32.
    European Commission, ISA (2012) Bringing cross-border interoperability to healthcare.http://ec.europa.eu/isa/actions/02-interoperability-architecture/2-12action_en.htm. Accessed 8 Dec 2012

Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  1. 1.Medical and Surgical SciencesUniversity of BolognaBolognaItaly

Personalised recommendations