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Health Informatics

Social Justice & Digital Health Policies

Jasmine Kang, James Kim, Camila Jaramillo, Jenn Kennedy

Key Learnings

Digital Health Policy

Definition

  • Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals (WHO, 2013).

How Are Policies Formed?

  • When creating policies there is a focus on addressing inequalities (Rich, Miah & Lewis, 2019).

Who is Responsible for Health Policies?

  • CNO, CNA, RNAO, and other Nursing Bodies
  • Institutions

Health Policy Issues

Issues

  • Patricia Brennan discussed four policy issues when it comes to EHRs, privacy and confidentiality were included (Benbow, 2019).
  • Managing access to EHRs is not enough to secure their information.
  • Security policies are essential to protecting patient's information (Jamshed, Ozair, Sharma, & Aggarwal, 2015).

1. Privacy and Confidentiality

Solutions

- CNA’s Code of Ethics states that “Nurses advocate for and respect policies and safeguards to protect the person’s privacy” (CNA Code of Ethics for Registered Nurses, 2002).

- Current policies offer protection only to personal information. Deidentified personal information is no longer protected (Ethics in Practice for Registered Nurses, 2003).

- Nurses have the responsibility to participate in the formation and review of institutional policies and practices (Ethics in Practice for Registered Nurses, 2003).

2. Information Security Policies

2. Security Policies

- “Ontario’s health information legislation requires custodians to transfer PHI in a secure manner” (Canada Health Infoway).

- The EHR Security Policy by ehealth Ontario states that Institutions and organizations must protect the EHRs against theft, loss, unauthorized use, disclosure of personal health information, unauthorized copying, modification and disposal. The institutions must “protect the integrity, security and confidentiality of the personal health information contained in the electronic health record” (Goodman, 2012).

9 Principles of

Information Security Policy

(EHR All-in-One Security Policy, 2017)

9 Principles

1. Acceptable Use of Information and Information Technology

2. Cryptography

3. Electronic Service Providers

4. Information and Asset Management

5. Information Security Incident Management

6. Information Security Training

7. Network and Operations

8. Privacy and Security Assurance

9. Threat Risk Management

Bringing it together

Fred, a senior whose first language is not English lives at a retirement facility and he would like to access his EHR. Steve, the nurse on staff, does not offer Fred the same opportunities to access the computers because he is not comfortable helping Fred because of the language barrier. From a nursing perspective does this scenario speak to issues of social justice or digital health policy?

Key Learnings:

Social Justice

What is Social Justice?

- The Canadian Nurses Association (2010) defines social justice as "the equitable or fair distribution of society's benefits, responsibilities and consequences".

- In their conceptualization, they see social justice as grounded in four key ideas:

1. Fairness

2. Relative position or social advantage

3.Understanding inequities in society

4.Taking action to eliminate those inequities

(CNA, 2010)

Social Justice

6 hrs

This is what happens when we remove barriers in society!!! :)

("Equality, Equity, and Justice", n.d.)

CNA and 2,548 others

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...Keeping in mind social justice issues to engage in social criticism and social change. Focusing in the analysis, critique and change of social structures, policies, laws, customs, power, and privilege that disadvantage or harm vulnerable social groups through marginalization, exclusion, exploitation, and voicelessness. (Fawcett, 2019)

How can we relate Social Justice with Policy...?

-It is not only an important component in improving the quality of health care but also an integral portion of fulfilling our standards of practice to protect and promote the health and well being of the public (CNO, 2009)

...So what does this mean for Nurses?

Emancipatory Nursing- Challenging the stauts quo (walter, 2017)

What Walter (2017) found is that because of increasing complexities of power and privilege, and the dynamic priorities of Western Societies today, nursing finds itself in difficult territory when it comes to engaging in social justice.

Can anyone think of ways to motivate current and future nurses to engage in advocacy and social justice action?

" Technology has changed the nature of activism in our world" (McNutt,2018)

...It allows local activists to expand their reach globally. As nurses we just need to remember that technology that supports advocacy requires 4 functions: Research, Educating the public, Recruiting and organizing, and applying power to decision makers (McNutt, 2018)

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