Asunto(s)
COVID-19 , Planificación en Desastres/legislación & jurisprudencia , Liderazgo , Salud Pública , COVID-19/epidemiología , COVID-19/mortalidad , Humanos , Pandemias/legislación & jurisprudencia , Salud Pública/economía , Salud Pública/legislación & jurisprudencia , Estados Unidos/epidemiologíaRESUMEN
This article addresses the data protection and product safety regulatory models currently applied to consumer-facing health technologies. It explains how the design and structures of existing data protection and safety regulation in the U.S. have resulted in exceptionally thin protection for the users of consumer-facing devices and products that rely on or that facilitate consumer collection or aggregation of health and wellness data. It also examines some appealing legislative alternatives to the current thin model used in the U.S. and suggests a framework for prioritizing ameliorative regulation. To better understand existing regulatory models, their deficiencies, and how they should be reformed, the article employs an analytical model describing these regulatory systems across two axes. The vertical axis describes the quantity or depth of regulation, such as, for example, the strictness of the rules imposed by the regulatory model. The horizontal axis describes the reach of the regulation, the behaviors, products, or industries to which the regulation applies.
Asunto(s)
Seguridad Computacional/legislación & jurisprudencia , Tecnología Digital/legislación & jurisprudencia , Datos de Salud Generados por el Paciente/legislación & jurisprudencia , Comportamiento del Consumidor/economía , Seguridad de Productos para el Consumidor/legislación & jurisprudencia , Recolección de Datos/métodos , Agencias Gubernamentales , Regulación Gubernamental , Humanos , Estados UnidosRESUMEN
Mobile medical apps (MMAs) are a fast-growing category of software typically installed on personal smartphones and wearable devices. A subset of MMAs are aimed at helping consumers identify mental states and/or mental illnesses. Although this is a fledgling domain, there are already enough extant mental health MMAs both to suggest a typology and to detail some of the regulatory issues they pose. As to the former, the current generation of apps includes those that facilitate self-assessment or self-help, connect patients with online support groups, connect patients with therapists, or predict mental health issues. Regulatory concerns with these apps include their quality, safety, and data protection. Unfortunately, the regulatory frameworks that apply have failed to provide coherent risk-assessment models. As a result, prudent providers will need to progress with caution when it comes to recommending apps to patients or relying on app-generated data to guide treatment.
Asunto(s)
Trastornos Mentales/terapia , Salud Mental , Aplicaciones Móviles/legislación & jurisprudencia , Humanos , Trastornos Mentales/psicología , AutocuidadoRESUMEN
This article explains how the structure of U.S. health-care data protection (specifically its sectoral and downstream properties) has led to a chronically uneven policy environment for different types of health-care data. It examines claims for health-care data protection exceptionalism and competing demands such as data liquidity. In conclusion, the article takes the position that healthcare- data exceptionalism remains a valid imperative and that even current concerns about data liquidity can be accommodated in an exceptional protective model. However, re-calibrating our protection of health-care data residing outside of the traditional health-care domain is challenging, currently even politically impossible. Notwithstanding, a hybrid model is envisioned with downstream HIPAA model remaining the dominant force within the health-care domain, but being supplemented by targeted upstream and point-of-use protections applying to health-care data in disrupted spaces.
Asunto(s)
Seguridad Computacional/legislación & jurisprudencia , Sistemas de Administración de Bases de Datos/legislación & jurisprudencia , Sistemas de Registros Médicos Computarizados/legislación & jurisprudencia , Planes de Asistencia Médica para Empleados/legislación & jurisprudencia , Humanos , Garantía de la Calidad de Atención de Salud/legislación & jurisprudencia , Proyectos de Investigación , Estados UnidosRESUMEN
Mobile health (mHealth) combines the decentralization of health care with patient centeredness. Mature mHealth applications (apps) and services could provide actionable information, coaching, or alerts at a fraction of the cost of conventional health care. Different categories of apps attract diverse safety and privacy regulation. It is too early to tell whether these apps can overcome questions about their use cases, business models, and regulation.
Asunto(s)
Aplicaciones Móviles , Telemedicina , Registros de Salud Personal , HumanosAsunto(s)
Difusión de Innovaciones , Registros Electrónicos de Salud , American Recovery and Reinvestment Act , Actitud hacia los Computadores , Seguridad Computacional , Registros Electrónicos de Salud/economía , Política de Salud , Humanos , Informática Médica , Garantía de la Calidad de Atención de Salud , Estados UnidosAsunto(s)
Confidencialidad/ética , Registros Electrónicos de Salud/ética , Experimentación Humana/ética , Privacidad , Manejo de Especímenes/ética , Confidencialidad/legislación & jurisprudencia , Registros Electrónicos de Salud/legislación & jurisprudencia , Experimentación Humana/legislación & jurisprudencia , Humanos , Autonomía Personal , Privacidad/legislación & jurisprudencia , Investigadores/ética , Sujetos de Investigación , Estados UnidosRESUMEN
Emerging electronic health record models present numerous challenges to health care systems, physicians, and regulators. This article provides explanation of some of the reasons driving the development of the electronic health record, describes two national electronic health record models (currently developing in the United States and Australia) and one distributed, personal model. The US and Australian models are contrasted in their different architectures ("pull" versus "push") and their different approaches to patient autonomy, privacy, and confidentiality. The article also discusses some of the professional, practical, and legal challenges that health care providers potentially face both during and after electronic health record implementation.
Asunto(s)
Confidencialidad , Sistemas de Registros Médicos Computarizados , Australia , Costos y Análisis de Costo , Atención a la Salud/organización & administración , Política de Salud , Humanos , Errores Médicos/prevención & control , Registro Médico Coordinado , Sistemas de Registros Médicos Computarizados/economía , Sistemas de Registros Médicos Computarizados/legislación & jurisprudencia , Sistemas de Registros Médicos Computarizados/organización & administración , Estados UnidosRESUMEN
The EHR is a database record that incorporates a patient's health care details from conception to death and which can be distributed over a number of sites or aggregated at a particular source. This article describes the function and concept of the EHR by relating it to other medical information technologies, parallel changes in health care delivery, and a holistic health information model. The article compares the progress that Europe, Australia and the United States have made in the journey towards EHR implementation and concludes by highlighting some of the costs, barriers and consequences associated with the transition to a comprehensive EHR system.
Asunto(s)
Gestión de la Información/legislación & jurisprudencia , Gestión de la Información/organización & administración , Sistemas de Registros Médicos Computarizados/legislación & jurisprudencia , Sistemas de Registros Médicos Computarizados/organización & administración , Australia , Confidencialidad/legislación & jurisprudencia , Bases de Datos Factuales , Atención a la Salud/economía , Atención a la Salud/legislación & jurisprudencia , Europa (Continente) , Humanos , Gestión de la Información/economía , Sistemas de Registros Médicos Computarizados/economía , Formulación de Políticas , Estados UnidosRESUMEN
The "systems" approach to reducing medical errors is increasingly viewed as dependent upon technology. Issues with the legal system, however, may impede needed reforms. Historically there has been a pervasive disconnect between the legal system and changes in healthcare business models and structures. Further, difficult legal issues will accompany care that is increasingly technologically-mediated. This chapter identifies some of the most serious disconnects and makes suggestions for needed reform.