Privacy Issues Are a Key Obstacle to Adopting Electronic Health Records

The United States could achieve significant health care savings if it achieved widespread adoption of electronic health records (EHRs), but insufficient privacy protections are hindering public acceptance of the concept, according to a new report.

Researchers from North Carolina State University (NCSU, Raleigh, USA) and the Virginia Polytechnic Institute and State University (Virginia Tech, Blacksburg, USA) found that a combination of technical and legal improvements in EHRs could make the loss of privacy associated with them be reduced to a minimum. Part of the problem results from the fact that the U.S. legal framework for healthcare privacy is a hodgepodge of constitutional, statutory, and regulatory law at the federal and state levels.

In contrast, it is generally believed that European Union (EU) protection of privacy, including personally identifiable medical information, is more comprehensive than U.S. privacy laws. The researchers argue that the EU anticipates challenges to privacy and is proactive in its legislation; whereas because of its differing viewpoint toward an individual's right to privacy, the U.S. system lacks a coherent framework for healthcare privacy, thus appearing more reactive in its legislative approach. The researchers suggest that if the U.S. is going to address the issue of privacy in EHRs sufficiently, then it must be central to the discussion of EHR implementation and the technical and policy framework that guides it, since the potential healthcare savings of EHR are accompanied by increased risk, either technical or legal, to privacy and security. The report is forthcoming from the Boston University Journal of Science and Technology Law.

"Electronic health records could reduce costs in the U.S. by an estimated $80 to 100 billion each year,” said coauthor says David Baumer, Ph.D., head of the business management department at NCSU. "Using electronic records allows the healthcare system to operate more efficiently, minimizes duplicative testing, et cetera. But you can only get those cost reductions if everyone, or nearly everyone, makes use of the records, from healthcare providers to pharmacies to insurance companies.”

"We are moving in the right direction in regard to putting better privacy protections in place, but we have a long way to go,” added Dr. Baumer says. "For example, approximately 50% of people in the U.S. have EHRs, but doctors will have to check for paper records until EHRs are so widespread that checking for paper records is no longer considered due diligence. By way of comparison, approximately 95% of people in Holland have EHRs.”

The researchers include a list of technical and legal recommendations that could make EHRs more viable in the U.S.; for example, the paper calls for the introduction of civil penalties if people share information inappropriately or with inappropriate parties.

Related Links:
North Carolina State University
Virginia Polytechnic Institute and State University