(article continues below after commentary)

As electronic records evolve, who has the records, who stores them, who has access, who shares the information and so on is still a highly debated and discussed item.  We all can agree that documentation can lead to better health care, but who will be the "store keeper" here?  Will a patient have "any control" over the "store keeper"?  Will the primary care physician have any influence or control with dealing with the "store keeper"?  As outlined in this article, insurance companies are certainly in the forefront with accelerating this technology and offering various plans and avenues for individuals to document their personal health records and have access via the Internet. 

Next question that comes to mind...once the information is contained in an offering from an insurance company or any other commercial offering , where else does the information go?  Does it go to the huge MIB (medical insurance bureau) to be shared with all members (insurance companies)?   As a patient I am not too overly concerned about the potential hackers at this point, but rather where the information could travel from here and whether or not it could be used against me for qualifying for insurance or have the potential of rejecting medical claims. 

The one comment below from a nurse stating that alcoholics didn't want their condition on paper reflects another side of this coin for fear that it would affect the quality of care they receive.  With all the data collected today, anything along this line has the potential of affecting the quality of care we receive.  If an individual is a diabetic today, how does this affect the quality of care received? 

Physicians are helped immensely by having access to this information to provide a plan of action whether it be health maintenance or emergency care.  We all read the recent stories of Mr. Universe being arrested for behavior related to hypoglycemia, with the misunderstanding that he was intoxicated.  It's a very scary feeling when one is about to pass out and is in need of sugar to relieve the low blood sugar attack and timing can be everything with the individual not having enough time to explain and in a state of panic - just needing the sugar to avoid a black out.  Granted having something with him could have eliminated the incident, but we are human and do the best we can and may not always be 100% prepared, especially if this is a new chronic condition diagnosed or if a new medication was being used, as was stated in this case.  We are humans and sometimes might forget.

When information goes beyond the physician-patient relationship we seem to enter somewhat of a "gray" area.   Some medical record information is now being used in courts and this is the fine line of privacy issues we all worry about.  My real question here is are we creating records for the pursuit of better health care or are we generating "media"?  If you have ever signed a release for a media interview we are aware of the fact that anything we say can be printed, etc., so does the same go for our medical records?  Are they "media objects" or a tool used in the pursuit of better health care?   As data bases of personal information continue to grow and evolve, what is the answer?  Is it possible to remove the financial and political areas of this topic and focus on better health care?

Electronic health records are a good thing and save lives and I could almost bet any physician would not dispute the fact that having this information available is a huge benefit when it comes to better health care and saving lives, and we all depend on their advice, directives and actions in helping us live better lives.  The physician-patient relationship should never deteriorate, nor be coerced to a level of "created media".  As the old saying goes "media loves media" and hopefully we can find a solution for medical records that will neither expose or violate crossing the fine line of privacy and dignity we enjoy as US citizens.  BD

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 HARTFORD, Conn. -- Privacy groups are sounding alarms as the nation's largest insurance companies finalize plans to allow millions more customers to post their health records on the Internet.  Insurers like Hartford-based Aetna Inc. say Web-based tools help patients and physicians keep track of medical information while potentially holding down spiraling medical costs.

But privacy advocates say there's no guarantee that the records will be safe from hackers. Some worry that patients may refuse to disclose some illnesses to their doctors to keep documents out of databases.

"As a former nurse I know that back in the 1980s, patients who were alcoholics did not want to have paper records," said Sue Blevins, president of the Institute for Health Freedom in Washington, D.C.. "They just didn't want people to know. They didn't tell people they were alcoholics. That could affect the quality of their care."

Source:  Privacy arguments follow rollout of electronic health records - Newsday.com

2 comments :

  1. Patients are very wise to distrust a web based solution. The Pentagon, NSA, as well as virtually all major banks and hospitals have suffered as a result of data INSECURITY... yet we are now to naively believe online medical records won't join identity theft as a target for hackers?

    SSL (used for web based banking) is touted as trustworthy by the same people who confuse a 4 digit PIN with secure. Here's a clue: 4 digits can be cracked by any modern home computer in less than a minute. If you doubt that statement, ask any cryptographer.

    Then there is the misuse of information aspect. The current paper based system is horribly inefficient. Said state of confusion is also why an employer can't instantly identify _and terminate_ personnel with current or potential medical issues. Are we so innocent we can't imagine that the same entity known for their penurious health care policy won't mine medical data to cut costs? Come on... these people are proud of just in time inventory so they're equally likely to employ prophylactic purging of any employees that might need health care. Can you really trust anyone who waves the American flag while stocking the vast majority of their inventory via China? Personal Health Records make sense; but NOT online and certainly NOT in the hands of those who may find it profitable to market medical records.

    Instead, put your entire chart in your pocket or purse on a truly secure USB drive. It'll be available instantly but only to doctors you authorize. There are inexpensive alternatives like SafeKeyNet (www.safekey.net). The SafeKeyNet Suite also provides three other programs of equal value to do things like protect ALL the information you can't afford to lose. Full disclosure: I’m the software developer but I also guarantee no one at SafeKeyNet, LLC will EVER see your information except you or the people you authorize. I back that promise with a million dollar bond. See if you get that same assurance from a web site.

    Before Americans line up to surrender their lives to a great data repository in cyberspace, we do well to recall why the Internet exists at all: about 40 years ago, ARPANET was the alternative answer to a single strike nuclear attack. It was determined only an idiot creates a central target and believes it won't get hit. Ipso facto, the Internet design itself inherently has no vulnerability --- unless some buffoon builds what s/he believes is a bomb shelter of straw and sells seats inside.

    Placing medical records on the web may be the most ridiculous idea the technically challenged have ever offered and it' an inevitable debacle that should be stopped immediately. One other fact not to be overlooked: as magnificent as the Internet is, how well does a web site work when the power is out?

    ReplyDelete
  2. Thank you for the comments! I am sure there will be much more to come on this subject too. It really is up to the consumer to get involved in the process.

    ReplyDelete

 
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