The Paradox of Integration: A Narrative Review on the Ethics and Security of the Centralized Patient Profile in Multidisciplinary Healthcare

Abstract

Background: The drive towards value-based, coordinated care has made the integrated Centralized Patient Profile (CPP) a cornerstone of modern health informatics. This profile aggregates deeply sensitive data from nursing narratives, epidemiological histories, genetic lab results, and administrative sources, creating a comprehensive yet ethically complex digital persona. Aim: This review aims to critically analyze the ethical, legal, and practical challenges inherent in managing the CPP across multidisciplinary boundaries. It focuses on the tensions between data utility for care and the imperative of privacy and security. Methods: A narrative synthesis methodology was employed, analyzing literature from 2010-2024 sourced from PubMed, IEEE Xplore, ACM Digital Library, and grey literature (legal, policy, and technical reports). Thematic analysis was conducted across the domains of ethics, law, security, and clinical practice. Results: The CPP creates a "paradox of integration": while it enhances care coordination, it simultaneously exacerbates risks of privacy harm, discriminatory misuse, and unauthorized access. Key challenges include defining the "right to know" across disciplines, protecting particularly sensitive data (genetic, social), and implementing technically robust yet clinically usable segmentation controls. Current legal frameworks like HIPAA are insufficient for governing complex, inferred data within CPPs. Conclusion: Realizing the CPP's promise requires a paradigm shift from monolithic data sharing to ethical, "privacy-by-design" architectures with granular, context-aware access controls. This must be underpinned by reformed policies, interdisciplinary ethics training, and a culture that balances seamless care with vigilant data stewardship.

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