ABSTRACT
Telecommunication assisted forensic assessments of capacity and mistreatment by geriatricians with expertise in elder abuse and self-neglect are helping to meet the demand for such forensic services for Adult Protective Services (APS) clients in remote and underserved areas of Texas. The use of synchronous audiovisual assisted interviews instead of in-person interviews with clients to provide capacity assessments has become more important with the arrival of the COVID-19 pandemic. There is growing interest in establishing similar programs in other states using geriatrician faculty from medical schools to serve the clients of their state Adult Protective Services agencies. The arrangement between APS and the geriatricians at McGovern Medical School in Houston, Texas is novel. The structure of the arrangement is important for the success of the program. Legal, ethical, and practical considerations are discussed in this article, including approaches to the Health Insurance Portability and Accountability Act, physician liability, state law, and resource limitations. It is hoped that sharing how one such collaboration has addressed these important issues will suggest approaches for the structuring of similar programs.
Subject(s)
COVID-19 , Elder Abuse , Forensic Medicine , Geriatric Assessment/methods , Telemedicine , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/methods , Elder Abuse/diagnosis , Elder Abuse/ethics , Elder Abuse/legislation & jurisprudence , Elder Abuse/prevention & control , Forensic Medicine/ethics , Forensic Medicine/legislation & jurisprudence , Forensic Medicine/methods , Humans , Organizational Innovation , Program Evaluation , SARS-CoV-2 , Telecommunications/organization & administration , Telemedicine/ethics , Telemedicine/legislation & jurisprudence , Telemedicine/methods , United States/epidemiology , Vulnerable PopulationsABSTRACT
Electronic health records are valuable for clinical and translational research. Institutions must protect patient privacy and comply with applicable regulations while allowing appropriate access to clinical data for research. The processes that investigators must follow to access clinical data can be substantially different at different institutions. In this paper, we describe the process developed at our institution that has been active for 5 years and was used to satisfy over 200 requests for access to identified clinical data, usually within 1 day for internal requests and 3 days for visiting researchers.
