Ethics Conflicts in Rural Communities: Health Information Technology
Updated: August 22, 2016
By The Dartmouth Institute for Health Care and Clinical Practice, 2009
The use of health information technology (HIT) is becoming increasingly important in medical providers’ efforts to support decision-making and to promote quality health care delivery and equitable access to services in rural areas. However, technological interventions in remote settings have attracted ethics concern and conflict. Complex patient information processes, service shortages, high demand, and a widening array of medical interventions and treatments constantly challenge health care providers as they struggle to maintain standards of care. For patients in rural areas, barriers to reasonable access for even basic health care services, such as primary care, screenings, and prevention, are also common. Numerous technologies have been introduced in recent years to remote sites, with the intention of enhancing quality and improving access. However, as with any well-meaning and innovative medical advance, these technologies bring both intended and unintended consequences to the lives and welfare of patients. This chapter will address four domains of health information technology: telehealth, electronic medical records, electronic clinical support, and online prescribing services. These technologies bear careful scrutiny when deployed in rural settings, due to both the nature of the setting and the complexity of the technology. When deploying HIT in any setting, rural or urban, health care providers must place patient welfare above all other considerations, protect confidentiality, ensure privacy, promote trust in the healing relationship, and ensure fair and equitable access to quality services.