Raabia Ansari

TECH Writing 4700.001

2/12/15
Abstract Assignment
Descriptive Abstract
Electronic Health Records (EHRs) are increasingly being utilized in medical clinics and
hospitals in the United States. Medical students are now using them in internships during clinical
hours in order to advance their clinical education. This recent technology is important to teach to
students, and can be used to advance their training. One way that students can use EHRs to learn
is by tracking patients who have already left a clinics direct care. This practice enables
students to follow a history of diagnoses and view follow-up information about the patient they
are tracking. Although the tracking presents an educational advantage, there are ethical issues
regarding whether or not students should be allowed to have access to patient information.
Ethical guidelines must be formed and followed in order for students to use EHRs for tracking.
Informative Abstract
In 2009, the United States Congress brought together funds to begin the development and
utilization of electronic health records (EHRs). This resulted in the immediate implementation of
EHRs in private practices, hospitals, and academic health centers. EHRs are primarily for the
improvement of healthcare as a whole. They speed up the process of patient care, and provide a
better way to safeguard information. Although a majority of research focuses on the primary
function of EHRs, there is much work to be done on the other functions that EHRs hold. These
functions include educational methods. Clinicians agree that since EHRs are now widely
adopted, this technology should be utilized in an educational way to benefit future physicians.
EHRs pose many opportunities to improve clinical training. One opportunity, named
tracking, has raised ethical concerns within the medical community. Tracking is the practice of
following a patients health record after the patient has already left the care of their provider.
Students can use tracking to follow a history of diagnoses and view follow-up information about
the patient they are tracking. Before EHRs, students were able to do this but the process was time
consuming, as all charts were on paper. EHRs provide an easier way for students to check the
updates on charts, as they can access charts easily and view the physicians notes in real time.
Students are able to view updated imaging scans, outpatient visit reports, and lab results. This
type of access to information not only helps a student view different types of medical documents,
but also track the patients progress over time. Students are able to expose themselves to different
types of diagnoses and learn the extent of illness. This improved training of medical students
benefits society as a whole. It is a prime example of what is referred to as case-based learning,
which ties theory to implementation through the application of knowledge to real-world cases.
Tracking is a self-motivated, self-paced type of learning. A good physician has not only studied
books, but also has applied his/her knowledge in a practical setting.

Despite the educational benefit of tracking, there are arguments in opposition to the
practice. The main argument is that tracking can compromise the autonomy of the patient, and a
patient could feel that their records are not being handled responsibly. Patients have a right to the
privacy of their records, and a student accessing their older records may violate their privacy.
This can lead patient reluctance to see a physician due to the way their information is used. There
is a considerable amount of data that suggests patients are already uncomfortable with EHRs,
since they feel that their information is more easily accessed through a computer than through a
physical chart. This data implies that some patients would be against tracking, even if they are
aware of its potential benefits to the medical community. Another argument is that prospective
physicians do not require tracking to get a full medical education, as the physicians of today
were not able to learn this way. This is plausible, since there is not yet applied data of how
tracking can enrich a students education.
Concerns have been raised regarding tracking in the workplace, specifically whether it is
ethically and legally permissible to track former patients in the Electronic Health Record.
Legally, medical staffs are allowed to view records of patients who have already left a clinics
direct care. Ethically, physicians are responsible to professionally make sure that tracking is done
in an appropriate way. There are many confidentiality standards in the medical workplace,
including HIPAA regulations. These must be followed by students who engage in tracking, but
there must be guidelines that students follow under physicians. A balance must also be present
between patient autonomy and educational benefit. Patients should be given information about
tracking and how its done. They must have the ability to refuse to have their chart tracked if they
feel that their privacy is being infringed upon. Students should be able to track patients with
limits and under the supervision of physicians, only after gaining permission from the patients
they will be tracking. Limits do not end simply after gaining a patients permission; students
should be continually assessed by physicians on their use of patient information. Guidelines are
still to be developed on how to effectively use tracking simply for educational benefit and not for
any other use of a patients information. Once these are established, the practice of students
tracking EHRs will maintain public trust in medicine and determine that a guarantee of medical
education can coexist with commitment to placing patients privacy first.
References
Brisson, G., Johnson, K., Tyler, P., & Barnard, C. (2015). Should Medical Students Track
Former Patients in the Electronic Health Record? An Emerging Ethical Conflict. Academic
Medicine, XX. Retrieved February 10, 2015, from
http://www.ncbi.nlm.nih.gov/pubmed/25565261