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Navigating Ethical Issues with Electronic Health Records in Developmental-Behavioral Pediatric Practice

Nielsen, Britt A. PsyD*; Baum, Rebecca A. MD; Soares, Neelkamal S. MD

Journal of Developmental & Behavioral Pediatrics: January 2013 - Volume 34 - Issue 1 - p 45–51
doi: 10.1097/DBP.0b013e3182773d8e
Review Article

ABSTRACT: The increasing use of electronic health records (EHRs) allows for sharing of information across clinicians, quick access to laboratory results, and supports for documentation. However, this environment raises new issues of ethics and privacy, and it magnifies other issues that existed with paper records. In developmental-behavioral pediatrics (DBP) practice, which relies heavily on a team approach to blend pediatrics, mental health, and allied health, these issues are even more complicated. In this review, we highlight the ethical and privacy issues in DBP practice related to EHR use. Case examples illustrate the potential risks related to EHR access, confidentiality, and interprofessional collaboration. Suggestions to mitigate some of the ethical and privacy issues associated with EHRs at both an administrative level and a clinician level are included. With the expected increase in the adoption of EHRs by DBP clinicians in the near future, professional standards will need to be defined, and novel technological solutions may offer additional safeguards. Until then, professionals and organizations are responsible to uphold the standards of ethical practice while promoting effective information exchange to facilitate clinical care.

*Pediatric Psychology, Department of Psychiatry, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH

Developmental-Behavioral Pediatrics, Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH

Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.

Address for reprints: Britt A. Nielsen, PsyD, 2500 MetroHealth Drive, Cleveland, Ohio 44109; e-mail:

Disclosure: The authors declare no conflicts of interest.

Received June , 2012

Accepted September , 2012

© 2013 Lippincott Williams & Wilkins, Inc.