Technological Challenges in the Protection of Privacy and Confidentiality of HIV/AIDs Victims

Subject: Tech & Engineering
Pages: 20
Words: 5421
Reading time:
20 min
Study level: PhD

Introduction

The provision of social work services have greatly been influenced by various factors particularly the applications of modern technology (Coe-Regan & Freddolino, 2008; Marson, 2007; Parrott & Madoc-Jones, 2008). Essentially, social work practice has considerably transformed over the years particularly due to cultural and technological changes (Marson, 2007). In other words, evolutions experienced in cultural aspects and technology have affected the social work practice in relation to the observation of core values including keeping of client self-respect, solitude and right to self-determination. In fact, these experimental codes of ethics in social work have been the guiding principle over decades. However, with increased changes in cultural settings of the client and technological applications, new challenges have emerged affecting the manner in which these principles are applied (Bargh & McKenna, 2004; Sapey, 2007).

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Ethical practices in social work have primarily been surrounded by the application of social work core values. For instance, in the provision of counseling services to the HIV/AIDS victims in community-based programs, increased standards of confidentiality and privacy of the client information is highly observed. Despite the need to observe confidentiality in private information, the applications of new technological advances have greatly affected the manner in which such information can be stored, retrieved and used (Bargh & McKenna, 2004; Coe-Regan & Freddolino, 2008; Marson, 2007). Moreover, most of the clients need services at their convenience across the community boundaries, which can only be possible through the application of technology. Social workers are faced with an ethical dilemma of ensuring confidentiality of the information provided or compromise the principle through the utilization of technological applications as required by the clients.

Social workers working with HIV/AIDS victims in community-based programs often face the challenge of keeping the clients information confidential particularly in the situations where the clients need their services to be delivered through social media and other modern technological applications such as Skype. The implication is that the use of these technologies compromises the confidentiality needed in the services delivery. In other words, the unintended users can easily track most of the information. Contrary to the risk of losing confidentiality of information, most of the clients prefer services to be delivered through these technological applications. The issue is how the social workers can deal with the current wave of the need to apply new technological advances in the services delivery amid increased effect of such technologies in the privacy and confidentiality of information solicited from the clients.

The case presents a situation in which social workers’ values, duties and obligations are in conflict with desires and wants of the clients. According to the National Association of Social Work (NASW) code of conduct, in these circumstances, the core principles guiding social work practice and profession have to take precedence over the obligated duty (National Association of Social Workers, 2005). As indicated, the predicaments that need to be addressed involve the circumstances in which the client’s confidentiality rights are in conflict with the social workers services delivery through the application of new technological advances. One of the major effects of new technological advances is that they compromise confidentiality and privacy of information (McCarty & Clancy, 2002). In other words, social workers are faced with the predicament of offering counseling and other services through social and other digital media as well as ensuring confidentiality and privacy of the information. In all the circumstances where social work practices are in conflict with the principles and standards that govern the social work practices, protection of the clients’ rights and self-determination take precedence (Perron, 2002). Besides, the case presents a situation in which the clients’ rights to confidentiality and privacy are in conflict with the social workers duty of delivering the required services. Nevertheless, as required by moral standards and principles, the social workers have to ensure that the client’s rights and self-determination is observed (National Association of Social Workers, 2005).

The purpose of the paper is to provide a critical analysis in the manner in which modern technological applications affects the social work practices especially in observing ethical principles of privacy and confidentiality. In fact, technological applications have dramatically increased the predicaments social workers constantly face (Giffords, 2008; Car & Sheikh, 2004). In addition, the paper will be examining the manner in which current social work practice is impacted by the new advances in technology. Essentially, social work ethical codes of conduct particularly concerned with confidentiality of private information provided by the client is greatly affected by new development in information technology (Giffords, 2008). In fact, the paper will be probing moral implications of new technological applications in social work practice and associated challenges. Furthermore, the paper will be examining how social workers can find solutions to their problems through the application of various theoretical approaches (Bargh & McKenna, 2004; Coe-Regan & Freddolino, 2008; Marson, 2007). In this case, advances in technology poses a greater challenge to the moral confines in which social workers operate particularly regarding protection of private information. Moreover, social workers are in constant ethical dilemma invigorated by technological applications especially in situation where the revelation of confidential and private information may cause harm to the client (Bargh & McKenna, 2004; Coe-Regan & Freddolino, 2008; Marson, 2007).

Identifying the Issue

Patients diagnosed with the conditions of HIV/AIDS are currently in need of social services that are not only within the confines of health practitioners but also social work practice. The services are broad-based and outside the prescribed program areas. Therefore, social workers offering services to people diagnosed with HIV/AIDS within community–based programs are facing new challenges. In most cases, the main role of social workers is to provide counseling services to the patients. While delivering the services, social workers are duty-bound to put in place plans that would help in delivering services needed by the clients. Besides, social workers provide individual or family counseling as well as assist in the formation and functioning of various support groups. While providing services, privacy and confidentiality is one of the critical values that have to be observed. In fact, ensuring confidentiality of information provided is not only a moral obligation but also fundamental in developing trust and good working relations with the client.

The current scenario in the field is that the number of people with HIV/AIDS continues to spread in a larger geographical area. As such, there is need to have a program that can deliver services and met the needs of the clients. In addition, there is need of delivery system that will enable the social services providers to reach their clients that moved away from the designated programmed areas. The only way through which the conditions can be achieved is through the application of modern technologies. New technological advances provide a suitable platform in which services can be delivered effectively and efficiently. Moreover, it is critical to acknowledge that no single model can accommodate all the requirements in services delivery. Therefore, social workers need to apply integrated approaches in their services delivery. Technology acts as a mediating tool in the enhancement of services delivery.

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However, the applications of advanced technology have constantly threatened the observance of the fundamental rights of the client and the moral duty of the social worker. In other words, adhering to the core principle of privacy and confidentiality in the provision of social work services is challenged given the fact that most of the services are being provided through modern technological application. Besides, most of the clients would want to be served at the comfort of their homes through the application of new technology especially the social media. In the community-based programs, most of the clients normally need social workers to offer their services through social media channels. While the use of such channels would lead to reduced costs in terms of time consumed, adherence to the principles of confidentiality is compromised. Moreover, a lot of information is being shared across the social media channels enabling the tracking of private information to be easy.

While it would be possible to offer services through such channels, social workers are still working under the state and federal laws and health regulations that prohibit the use of gadgets and technologies that would compromise the privacy of information of the client. For instance, clients share much information and experiences through most of the medial channels such as facebook and twitter. The manner in which they share information is also the same way they would want services be provided. Facilitation of support group is also easy through the social media channels in which members of the family as well as friends share their experiences frequently and at their convenience.

The exposure and easy access to information pose greater challenge to the provision of services through the application of such technological advances. Issues normally arise in situations when the client needs the social worker to provide the services through the current social network channels. With the increasing in changes in social settings and technological advances clients tend to move far away from the social worker yet need the same person to provide the services. Currently, most of the HIV/AIDS patients believe that counseling services can be provided through Skype particularly when they move out of the communities or hospitals where the programs are based. However, social workers are normally faced with the situation where providing services using the specified technological applications would be unethical and unprofessional. In most cases, social workers working under these conditions are unsure whether communicating with the clients using the stated technologies would lead to unethical conduct. Moreover, most of the states and social work practices guiding principles have not considered the communications through social media or provision of services through digital technology across boundary or state lines.

Matters may be aggravated when the social worker need to keep the conversations as confidential as possible. For instance, most of the private issues such as infecting immediate partners who are normally unaware of the HIV status of the clients are not supposed to be discussed in open forum. Discussing such private issues through digital media poses a threat to the confidentiality and privacy needed in such matters. Social workers normally encourage the clients to share such information with their sexual partners. However, the procedures are not always possible particularly in situations when the health conditions of the client are deteriorating. In most cases, social workers cannot offer services to unauthorized persons unless the client consented on such actions. For instance, the social worker cannot disclose confidential information such as informing the clients’ partners on impending health risks associated with their relationship. In addition, the NASW codes of conduct are not always clear in situations where technology is to be applied. In other words, the NASW codes of ethics as well as diverse laws regulating the confidentiality of information concerning health statuses of people with HIV/AIDS are silent on whether social workers can provide their services through the modern digital technology.

The current federal law, Health Insurance Portability and Accountability Act (HIPAA) is silent on whether the social services can be provided by the current digital media. By implications, the act is concerned with the manner in which technology is applied to store information concerning the statuses of people with HIV/AIDs. The law requires that the information regarding HIV/AIDS statuses of individuals be kept confidential. HIPAA is the federal law that offers protection of private information concerning the health status of an individual. According to HIPAA, both the health and social services providers have the responsibility of keeping the information confidential.

Various states have domesticated the federal act and have enacted various laws concerned with the protection of individual rights. For instance, the Pennsylvania state act 148 known as the Confidentiality of HIV-Related Information Act (CHIV-RIA) prohibits healthcare or social service provider from sharing any information concerning the HIV/AIDS status of an individual. However, the law allows the sharing of such information with consent of the victim or under limited conditions permitted by the court proceedings or legislations. Moreover, the law dictates that the local health providers are supposed to be furnished with names and statuses people with HIV/AIDS for appropriate storage. The role of the department of health is to ensure confidentiality of the information stored and keeping trail of the endemic. As can be observed, both the current state and federal laws are silent on offering services through the application of digital media. However, technologies are allowed only in the storage and keeping the information confidential.

New technological technologies are current developments that were not taken into consideration by the legislations. The question is whether such regulations can be repealed to provide for the usability of technology to deliver services. However, the current state of affairs is that the social workers have to go the traditional way or seek the consent of the client if the confidential information can be shared through the social networking channels. The only remedy social workers have is to seek consent of the client.

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The scenarios presents numerous challenges social workers currently face in services delivery particularly with the changing cultural belief systems of the clients as well as the need to use the digital technology to provide services to the needy clients. In fact, the scenario in the provision of counseling services to HIV/AIDS victims is one of the ethical challenges the current social workers face. Essentially, social work practice has moved from the traditional setting to the current system where new technological developments are applied to recognize, review and deal with some of the ethical challenges facing social workers. The current changes in social work practices are to take into cognizance the importance of technological advances.

In social work services delivery, ethics becomes a major concern. Despite the changes brought about by advances in technology and cultural settings, ethics need to be considerably strengthened. Moreover, the advances in technology have brought about a situation where privacy and confidentiality, which is the backbone of social work services delivery, is pervasive. As such the values concerned with privacy and confidentiality need to be strengthened systematically with the new changes within the social work practice and profession.

One of the key elements in the observation of ethical values amid current challenges is the application of NASW code of conduct. According to the code of conduct, social workers have to demonstrate ethical principles guiding their professional practice. In addition, social workers have to recognize and manage individual values that guide their professional practices and services delivery. In making ethical decisions, social workers have to take into consideration ambiguities existing in the social work services delivery in order to resolve ethical conflicts. In addition, social workers need to apply strategies involved in ethical reasoning in order to come up with principled decisions in social work.

One of the major concerns of social work is the observation of values. In other words, social work practices are based on fundamental set of values that prioritizes services delivery and commitment. In fact, social workers have to indicate commitment to the observations of the clients’ right to privacy, self-respect and significance and self-determination. In addition, social workers have to indicate commitment to values that emphasizes integrity and social justice.

Ethical Dilemma

Social workers are in constant circumstances in which ethical values they are supposed to uphold clash with current developments in the practice. In these circumstances, the social worker have to decide whether the value as contained in the core principles guiding social work practice and profession have to take precedence over the obligated duty. In this case, the ethical dilemma that need to be addressed involve the circumstances in which the clients confidentiality rights are in conflict with the social workers services delivery through the application of new technological advances that compromises this right. In other words, social workers are faced with the dilemma of offering counseling and other services through social and other digital media and ensuring confidentiality and privacy rights of the client. In all the circumstances where social work practices are in conflict with the principles and standards that govern the social work practices, protection of the clients’ rights and self-determination take precedence. In most cases, the clients’ rights to confidentiality and privacy are always clashing with the social workers duty of delivering the required services.

Besides, moral predicament arises when the social worker needs to observe confidentiality and privacy right of the client while the client need the services to be provided through the application of the technologies. As indicated, services delivery through the application of such technologies compromises the privacy right of the client. In addition, the core principle of confidentiality, which forms the fundamental basis in services delivery under these settings, is violated. For instance, most of the private issues such as infecting immediate partners who are normally unaware of the HIV status of the clients are not supposed to be discussed in open forum. Discussing such private issues through digital media poses a threat to the confidentiality and privacy needed in such matters. In this situation, a moral predicament arises. Social workers are in a dilemma of abiding by the principal codes of ethics guiding their practices or go with the recommendations of the client.

Currently, social workers are grappling with broad-based efforts to deal with numerous challenging ethical dilemmas they constantly face in the field. In fact, social workers tend to contend with new challenges involving protecting confidentiality and privacy of information provided by the client. Essentially, balancing the need to adopt the new technological advances in the services delivery and the observation of ethical principles ranging from protecting the clients rights of privacy to informed consent is a greater challenge to the current social work practice. Critically, the ethics in social work has drastically changed over time. Ethics was once a cursory observance in the provision of services to the client. However, ethical consideration in the services delivery has significantly altered into premeditated and wide-ranging endeavors to deal with undeniable questions that unavoidably take place in social work practice.

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In this scenario, the application of new technology compromises confidentiality and privacy required in the delivery of services. On the contrary, the need to provide the services through the application of technologies is difficult to avoid. Besides, the case presents the circumstances when the technological advances directly affect the social work practices. In as much the clients in this case may want the services be delivered through the preferred medium, the social workers have to observe actions that might compromise the core principle of privacy and confidentiality.

Applicable Ethical Principles

Client Rights

The rights of clients are one of the fundamental areas that need to be taken into consideration (Giffords, 2008; Car & Sheikh, 2004). In other words, wide-ranging and clear-cut outlines of the rights of clients need to be evaluated. The social worker plans and strategies particularly on how to deal with confidentiality of information, accessibility to information and services provisions are supposed to be evaluated (Perron, 2002). In addition, principles dealing with policies concerning informed consent as well as the right to refuse services and options for alternative services and referrals are supposed to be taken into consideration (Bargh & McKenna, 2004; Coe-Regan & Freddolino, 2008; Marson, 2007). In reality, the acknowledgment of individual self-determination, fairness and tranquility for the basis of social work services delivery.

Confidentiality and Privacy

Confidentiality and privacy is the area that is greatly affected by the applications of modern technology in social work delivery (Hawn, 2009; Perron, 2002). In this case, the manner in which technological applications affects the principles of privacy and confidentiality is given greater focus. While the uses of technological applications in the services delivery have increased benefits, the clients’ right to privacy is a critical aspect that cannot be ignored. Modern technological applications have increased potential of disclosing private information concerning the client (Bargh & McKenna, 2004; Sapey, 2007). As such, social workers are charged with the duty of ensuring that sensitive information retrieved from the client is securely stored. Besides, social workers only seek for essential confidential information that is imperative in the provision of services. Moreover, the consent of the client is critical while giving out the information.

As indicated, critical in the relationship between privacy and confidentiality as well as technology is the strategies used to evaluate and ensure that clients rights are protected (Hawn, 2009; Perron, 2002; Bargh & McKenna, 2004; Sapey, 2007). Besides, strategies used to reveal the clients’ sensitive and private information need to be evaluated constantly. In other words, the procedures used in the storage, release and sharing information through mediums such as computers, electronic mails, video charts need to be checked to ensure increased security (Bargh & McKenna, 2004; Sapey, 2007). Moreover, the protection of confidential information provided by the client whether written or in electronic form is critical. According to the stated standards, social workers are required to take practical and realistic actions that ensure sensitive information provided by the clients is secured and cannot be accessed by illegal individuals.

Informed Consent

Informed consent is one of the significant social work ethical codes of conduct that should be considered particularly in situations where technology is applied in the services delivery. National Association of Social Workers (NASW) provides a broader perspective on informed consent application. According to NASW, code of ethics social workers can only offer services to clients in the circumstances that the legitimate and conversant sanction of the client is sought (National Association of Social Workers, 2005). In relation to technological application, certain information can only be shared through the available platform with the client consent. As such, social workers exploit exclusive rights and comprehensible lingo in notifying clients on the rationale of using such technological platform as well as the likely risks in relation to privacy and confidentiality of information (McCarty & Clancy, 2002). Therefore, close evaluation of social workers’ well-versed consent documents and procedures is a critical component of social work practice. For instance, videotaping as well as audiotaping are critical technological applications that informed consent of the client is necessitated (Beaulaurier & Radisch, 2005; Stocks & Freddolino, 2009).

Ethical Analysis and Approaches

The benefits of technological applications to social work practice cannot be ignored. In other words, the contributions of new technological advances in social work practice are immense. However, the technological advances should be applied within the confines of social work practice (Perron, 2002; Giffords, 2008). In other words, the use of modern technologies should not have negative effects or hamper the services delivery. Essentially, in the circumstances that technology is applied in such a way that it takes into consideration the values of social work practice, it is described as the electronically arbitrated actions applied in the performance of aptitude and deliverance of social work services (Coe-Regan & Freddolino, 2008; Marson, 2007; Parrott & Madoc-Jones, 2008).

The expansions in the use of modern technology in social work practice have influenced every aspect of actions currently being undertaken by the social worker (McCarty & Clancy, 2002; Bargh & McKenna, 2004; Sapey, 2007). However, in this case, the focus is on ensuring confidentiality of the information provided by the client. In other words, confidentiality and privacy of information are highly emphasized.

The expansion and growth of new technological applications have transformed the manner in which social workers interact with clients as well as how services are delivered (McCarty & Clancy, 2002). The current generations are in an environment in which complex networks that utilize technology are continuously increasing. As such, the importance of new technological advances will continue to grow (Bargh & McKenna, 2004; Coe-Regan & Freddolino, 2008). The social work practice has been deficient of the applications of technology due to various conflicts with core values of social work services delivery. Though technology has been blamed invariably to be the cause of some ethical dilemmas, it can still be applied appropriately to enhance services delivery. Even though technology is widely applied in social work research and education, applying similar technological advances in social work practice remains challenging (McCarty & Clancy, 2002).

However, ethical principles and standards recognize the importance of human relations in social work services delivery. In fact, new technological advances affect every day activities and actions of the individuals. Such interactions have bigger insinuation in activities and actions of social workers (McCarty & Clancy, 2002; Bargh & McKenna, 2004; Sapey, 2007). Specifically, majority of people are engaged in relations that are interceded by a number of new technological advances including electronic messages, social networking and video charts such as Skype. Therefore, social workers need to appreciate the role of technological advances in determining the daily interactions of the client. Studies have indicated that online interactions are similar to face-to-face interaction in self-help groups (McCarty & Clancy, 2002; Bargh & McKenna, 2004; Sapey, 2007). Given the increasing rate of online relations, social workers need to be aware of the positive and negative consequences they have on the clients. In addition, social workers need to acknowledge the manner in which social interactions are mediated by the modern technological advances (Hawn, 2009).

However, ethical standards emphasizes on the protection of individual right to confidentiality. Essentially, social workers have to contend with the responsibility of protecting sensitive information retrieved from the client. In other words, social workers have the greater responsibility of keeping sensitive information provided by the client confidential through appropriate process, storage, retrieval and usage (Perron, 2002; Giffords, 2008). Conversely, the increasing numbers of information being shared electronically threaten the safety of stored information. Besides, with increased knowledge in the applications of technological advances, it would be impractical to assume the security of electronic storage of data.

Nevertheless, social workers are required to ensure continuity of services delivery even if significant interruptions are experienced due to disclosure of sensitive information regarding the client (Bargh & McKenna, 2004; Coe-Regan & Freddolino, 2008). In other words, certain conditions may force the social worker to continue delivering services despite the consequences of violating the clients’ rights to privacy through disclosure of sensitive information. For instance, natural disaster may cause inaccessibility to the clients who are in greater need of social services. In such circumstances, the social work may resort to the use of procedures that may compromise the plight to privacy. However, consultations, advice and counsel should constantly be sought in case such consultations are for the benefit to the client (Hawn, 2009; Perron, 2002; Giffords, 2008).

Moreover, social workers should take reasonable steps to sensitize the clients on the current developments and knowledge as well as positive and negative effects of the applications of technology in services delivery (McCarty & Clancy, 2002; Bargh & McKenna, 2004; Sapey, 2007). The reason is that both the social worker and the client should remain current with emerging knowledge relating to social work services delivery particularly concerning the observation of ethical standards.

Applications of the Theoretical Models

Studies indicate that solutions to ethical dilemmas are not always through the application of the codes of ethics and standards (Finn, 2009; Bargh & McKenna, 2004; Coe-Regan & Freddolino, 2008; Marson, 2007). As such, having a framework through which any emerging ethical dilemma could be analyzed and the final decision reached is significant in social work practice. In other words, solutions to the moral predicaments social workers face can be solved through the application of various theoretical models apart from ethical standards and principles (Salem, Bogat & Reid, 2007). The reason is that moral predicaments are usual occurrences in many professions and practices. As indicated, such ethical predicaments are normally resolved through the applicable ethical decision-making models (Salem et al., 2007). In this case, ethical decision-making models including ethical relativism and moral ethical developments have been applied to come up with solutions to the ensuing ethical dilemma.

Applying the Ethical Relativism

The school of thought focuses on upholding ethical standards cultural practices, belief systems and norms in finding solution to the problems facing the clients (McCarty & Clancy, 2002). In other words, the social worker should uphold practices and values that protect the rights of the clients. In fact, understanding the needs of the client is one of the major steps towards solving the ethical predicament the social worker is facing. In this case, understanding the problems and challenges facing the client and their needs is significant in finding solution to the ethical predicament. Essentially, it is critical to create a balance between the needs of the client and challenges in order to come up with objective solution to the moral issues influencing the services delivery (Beaulaurier & Radisch, 2005).

The aspect of culture, norms and actions in relation to the social work practice is an important competency. Being culturally competent will enable the social worker to understand a variety of complex social issues affecting people with HIV/AIDS, their vulnerability to social stigma, the need to observe privacy and confidentiality of information and the manner in which technology affect their social interactions (Stocks & Freddolino, 2009). Observing these values is one of the ways through which trust can be build with such clients. Ensuring privacy and confidentiality is the foundation of delivering services to the clients. As such, being vigilant on practices and actions that may compromise the right to privacy and confidentiality is significant in the services delivery. In any social work practice, the aspect of trust plays a significant role in the relationship created with the client (Beaulaurier & Radisch, 2005; McCarty & Clancy, 2002). In this case, trust can be built through observing and respecting the values of the client as well as respecting their statues. Creating an environment based on cultural trustworthiness is critical in the services delivery without any emerging moral predicaments (Stocks & Freddolino, 2009). Studies indicate that most of the HIV/AIDS will often share confidential information particularly their statuses under the conditions of anonymity (Beaulaurier & Radisch, 2005; Stocks & Freddolino, 2009). Moreover, the clients need to be educated on the effects of technology on confidentiality and privacy of information provided.

The model is critical in ensuring that the client understands the strategies of the social workers as well as the effects of using technological applications on services delivery on their information. In other words, the model simplifies the complexities involved in the processes of services delivery. Even though the benefits of using the technology cannot be ignored, their effects on privacy and confidentiality in services delivery cannot be ignored (Beaulaurier & Radisch, 2005; McCarty & Clancy, 2002; Coe-Regan & Freddolino, 2008; Marson, 2007).

Applying Moral and Ethical Development

The moral and ethical development model argues that practices and actions are assessed to prevent problems that are likely to be encountered which culminate into an ethical dilemmas being experienced in social work practice. Besides, the theoretical model provides levels in which moral judgment be developed ranging from preconvention to post-conventional. According to the model, individuals follow social order and cultural aspects to arrive at decisions. Moreover, the model upholds individual rights as contained in most of social constructs. As such, Social workers can erratically apply the model to get solution to some of moral predicaments.

However, in this case, moral and ethical development can be applied in enhancing the clients understanding of the consequences of using technology in most of the services being provided. Providing counseling services is challenging particularly in the social media in which majority of friends having similar page shares information (Bargh & McKenna, 2004; Giffords, 2008). Similarly, it would not be easy to disclose confidential information in situations where privacy is limited. As such, it would be critical for clients to understand the effects of using such applications in services delivery even though such procedures may look appealing.

Conclusion

While cases of HIV/AIDS were concentrated on cities, majority are currently being observed in rural areas. The scenario requires a service delivery system that is capable of meeting the unique needs of the population. Moreover, the delivery system needs to cut across large geographical areas. Such delivery system can only be achieved through the application of current technological developments. While the need to utilize new advances in technology to deliver services, various obstacles hinder such developments. As mentioned, current laws, and set regulations does not allow extensive use of new technologies in delivery of services due to their vulnerability to compromise the confidentiality needed in the services delivery. However, changes in social settings continue to put more pressure for the need to provide services to clients spread in larger geographical locations. In addition, the emphasis on confidentiality required in services delivery hamper the utilization of technological advances.

References

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