Jennifer, I agree with your discussion on eDiscovery. It is crucial to understand that almost all organizations are going paperless. In fact, Akers, Mason, and Mansmann (2011) give a more detailed definition of electronic discovery. They describe it as the process of searching, preparing, and producing ESI for use in the legal process. Electronically stored information, even though not specifically defined in the Federal Rules, refers to all information on computers and other electronic devices, including thumb drives and cell phones. The process of eDiscovery can be divided into seven stages. Data inventory where the entire potential client ESI is inventoried. This is followed by a collection of all the ESI, which is then followed by data ingestion, where the ESI is copied onto a forensically approved secure network server. Data analytics is the next stage in which data is analyzed. Therefore, from the analysis, data is then processed by filtering by different aspects such as extension names, owners, and dates. Extraction of metadata is also carried out during processing. Next, the resulting ESI is reviewed. The final stage of the eDiscovery process is data production (Orange legal technologies, 2011).
As you mentioned, legal discovery has proven to be a costly process for organizations and corporations of all nature. In 2010, an estimated $1billion-$3 billion was spent on legal discovery processing only. This prompts organizations to employ intelligent approaches to the electronic discovery process. Indeed, to achieve this, organizations need to use a standard methodology for identifying useful data and make use of tools and technology that can help with this process (Akers, Mason and Mansmann, 2011).
As you have put it, electronic discovery is a process of civil litigation involving the collection, analysis, and production of electronically stored information (ESI). ESI refers to all information stored in computers and other electronic devices. Types of ESI include emails, documents, databases, drawings, notes, voicemails, instant messages, or other digital forms of information (DTI, 2014).
I concur with you that fraud investigations and enforcement activities in the healthcare sector have greatly increased in recent years. Often, healthcare institutions are left with the dilemma of why eDiscovery takes so long and costs so much. In recent times, health care delivery services are increasingly being conducted through emails and other specialized databases, making eDiscovery more complex. This makes eDiscovery almost inevitable during these investigations. It is worth noting that the Healthcare entities consist of certain considerations that may not be present in the other sectors. These include patient data, of which privacy and security considerations must be addressed. The federal laws that oversee the privacy and security of patient information are The Health Insurance Portability and Accountability Act of 1996 and the Health Information Technology for Economic and Clinical Health Act. At the point where the government starts an investigation of a healthcare organization, there is to be tackled, the issues are regularly confounded, and the weights to keep up patient security can be difficult. The legal group, including counsel and the providers of electronic discovery, need to use a slightly different approach from the one they would use in firms belonging to other sectors. They ought to set up a working association with the administration all through the eDiscovery activity and build up a methodology for cost regulation while keeping up the security and integrity of the information
In spite of increased awareness levels of the dangers of misuse, abuse and addiction connected to opioid use in the treatment of pain, I agree that there is still a significant level of the same in health setups. However, health service providers have the ability to minimize the dangers through proper evaluation and adoption of an individualized approach to medication. In fact, to choose the best treatment plan for a particular patient, it is crucial to understand the high-risk characteristics related to chronic opioid therapy. In addition, screening all patients can help the healthcare provider even further. To reduce risks and help in early diagnosis of potential misuse or dependence symptoms, healthcare service providers could also implement pain agreements, urine screening and monitor a patient’s absence of pain, everyday living activities, adverse effects, and deviant drug behavior. In fact, we ought to consider an interdisciplinary approach to dealing with pain management, which has proved to be successful in promoting efficacy, reducing risk, and being cost friendly (Holle & Chamberlin, 2013).
However, instead of following these procedures to ensure proper use of pain medication, few health experts are still involved in the unethical and unlawful prescription of pain medication to patients. As you pointed out, this is mainly due to the patient’s recurring requests and complaints of pain. Some health care providers may consider the process of pain management cumbersome, making them opt for the quick fix of prescribing pain medication. Health center management should be vigilant in dealing with such cases by punishing the concerned physicians once they are discovered (Strickland, 2012).
I agree with you that with time, healthcare organizations are often faced with ethical dilemmas at one time or the other, which may implicate patients, family members, or staff. There have been reports of cases involving the adequacy of informed consents, the decision-making capacity of a patient, abuse, HIV/AIDS status of a patient or staff member, confidentiality, and many other issues like the case you just shared. We should also consider that the recognized method of dealing with such undocumented issues is developing a policy whenever such an issue surfaces. However, it is more practical to develop one general policy that serves a number of purposes, like acknowledging that it is not always possible to anticipate all dilemmas. Still, they require a reasonable response in case they occur. This would also give a procedure for obliging to unexpected occasions, thus improving the probability that reactions will be reliable, normal, and convenient. In addition, you can also consider Hofmann (2012) perspective on how dilemmas should be handled. In fact, he highlights that dilemma would require a reflection of the organization’s values
However, in cases such as the one you just discussed, where the organization itself is the incriminating factor; employees should be bold in reporting the matter to a higher authority. The employees’ hesitance to take appropriate action is understandable. However, looking at the bigger picture, one should be able to see the implications of obliging to the supervisor’s unethical profit-oriented suggestion. In fact, once you agree to commit the single unethical act, you are already implicated, and there is no telling how many more ethical rules you will be required to break (Dimick, 2011).
Akers, S., Mason, J. K., & Mansmann, P. L. (2011, December 6). An intelligent approach to E-discovery. Retrieved from http://www.umiacs.umd.edu/~oard/desi4/proceedings.pdf
Christ, J., & Flynn, J. (2014). What Health Care Organizations Need to Know about Electronic Discovery – Five Considerations That Should Not Be Overlooked During Healthcare Fraud Investigations. ABA the Health Lawyer, 26(6). Retrieved April 21, 2016, from http://www.ebglaw.com/content/uploads/2014/09/Christ-Jason-TheHealthLawyer_What-Healthcare-Organizations-Need-to-Know-about-Electronic-Discovery_Aug.2014.pdf
Dimick, C. (2011). Ethical Dilemmas. Journal of AHIMA. Retrieved from http://journal.ahima.org/2011/04/02/ethical-dilemmas/
DTI. A Practical Guide to Understanding eDiscovery . (2013, April 17). Retrieved from https://www.eiseverywhere.com/file_uploads/a71dd8c0a6cd09cb8b078e76b3996a26_DTI_WP_GuideToeDiscoveryInsuranceClaims_140515-print.pdf
Hofmann, P. B. (2012). Responding to unusual ethical dilemmas. Healthcare Executive, 17(4), 50-1. Retrieved from http://search.proquest.com/docview/200362195?accountid=45049
Holle, Lisa M,PharmD., B.C.O.P., & Chamberlin, K. W., PharmD. (2013). Regulatory and ethical issues in pain management. Drug Topics, 157(7), 58-66. Retrieved from http://search.proquest.com/docview/1412579203?accountid=45049
Orange Legal Technologies. (2011, January). Seven steps to eDiscovery. Retrieved April 21, 2016, from http://www.orangelt.com/wp-content/uploads/2011/01/Orange-Legal-Technologies-Seven-Steps-to-eDiscovery-Presentation.pdf
Strickland, J. (2012). The dual problems of chronic pain and prescription misuse.Employee Benefit Plan Review, 66(9), 11-14. Retrieved from http://search.proquest.com/docview/928757379?accountid=45049