Advanced Health Informatics

Advanced Health Informatics




Advanced Health Informatics

Li Wong is a Chinese American woman who has been the victim of a hit and run. As the woman does not appear to be critically injured, they first ask her which means of payments she is going to use. Mrs. Wong produces a Medicaid card, her health insurance claim number appears to have an issue as she is still married to Mr. Wong on record. However, Mr. Wong died recently making the widow eligible thus the new HICM number should be active and reflect the above change in status. The information was on the hospital system but not updated. Using the little mandarin, she can muster, courtesy of a two-week online course, the official at admission convinces her to waive her Medicaid benefits and pay directly as her documents have a mix up and they will delay her admission. The woman not fully contemplating the implications of her decision agrees.

The patient is taken to the outpatient ward for check up and diagnosis. The two good Samaritans that have brought the woman in are Indian tourists yet to be conversant with the English language. It follows that the doctor solicits the assistance of a nurse in the emergency department to translate to enable him get a clear visualization of the accident. Though the nurse has Pakistani roots, she in not in touch with her culture since her formative age. Currently, she does not understand much Indian past the greetings and formalities. In order to show her prowess she attempts to make out what the witnesses observed from recall. She misses a critical translation of the word hip and back thus relays that the impact was on the latter rather than the former. Doubting her language proficiency yet another nurse is recruited into the process to fortify communications subsequently concurring with her colleague.

The two nurses go away discussing the case into the lunch hall. The doctor has to look into the patient’s medical history thoroughly. He stumbles across some interesting facts not related to the existing case. Despite the wrong information and the barrier of dealing with a third party rather than the patient directly, x-ray reveal that the hip is slightly cracked. After regaining consciousness, Mrs. Wong demands immediate release, as she does not trust western medicine. She would rather be released to treat herself with proven Chinese herbal medicine. Furthermore, she refuses to take the medication prescribed to her. No Asian staff or official translator can help affirm the validity of her claims. As the patient’s stay in the medical facility is her own prerogative, unless her situation is dire, the doctor accepts to discharge her.

The key errors highlighted in the above scenario are a breakdown in communication, lack of patient confidentiality, and invasion of patient privacy. The failure to update their information systems to align with changes made by the Medicaid organization represents a lack of discipline and a preventable communication constraint. Administrator at the admission and emergency breaks the law by persuading a patient waiver her rights for Medicaid upon admission (Blobel, Lopez, & Gonzalez, 2016). The lack of a department of official translators impeding the quality of services offered to minority groups. Similarly, the lack of diversity in the staff adds to the problem as patients become comfortable when around familiar faces especially when their immediate family members are absent.

The second overarching error was the breach of the patient confidentiality ethics clause that attempts to limit the circumstances of the case to only essential staff. By incorporating several staff to the case to assist in translation the specifics of the patient’s case becomes public knowledge as evidenced by the triage nurses discussing the case in the lunch hall. Other peers may tend to overhear the case and offer their opinions (Purnell, 2012). The loss of patient-clinician confidentiality may undermine the trust upon which the relationship is founded. Subsequently, the patients may fail to divulge critical information to the doctor.

Thirdly, the doctor is oversteps his boundary when he reads critical information about Mrs. Wing’s life out of interest rather than necessity. This amounts to a breach of the patient’s privacy. The health practitioner is required to limit his access to information relevant to the case. Apart from the ethical responsibility, knowing less impedes the probability of unconsciously discussing the case with third parties.

The systems should be updated and linked to other organizations systems like the pharmaceuticals and insurance companies to limit communication breakdowns. The hospital should practice affirmative action to promote representative hiring. The above is not only for public relation purposes but also to the exploit the benefits of diversity (Purnell, 2012). Similarly, the hospital should enact an official department for translation to increase inclusiveness. The department will also help protect the patient confidentiality by limiting the circle of participants to the bare minimum. The above will eliminate need for third parties. The doctors ought to restrict the access to their knowledge that is essential for the patient’s treatment and diagnosis; this will help prevent them from subconsciously discussing the case with third parties. This is towards building trust between the patient and clinician apart from the ethical responsibility.



Blobel, B., Lopez, D. M., & Gonzalez, C. (2016). Patient privacy and security concerns on big data for personalized medicine. Health and Technology, 1-7.

Purnell, L. D. (2012). Transcultural health care: A culturally competent approach. FA Davis.


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