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In George Orwell’s 1984, Winston is forced to join in compulsory fitness exercises following instructions given by a woman from the telescreen. Through a two-way screen, she is watching him as well; and when he slacks off, she reprimands him. The implication is that there is no room for the weak, the sick, or the lazy in this invasive society controlled by the Party and Big Brother.
It’s interesting to me that in a survey conducted early this year by Computer Sciences Corp, 70% of respondents said they would be more likely to vote for a presidential candidate who supports the creation of a nationwide health information network (NHIN). The survey respondents clearly see the value of electronic health records (EHR). They cite benefits like improved patient care with rapid access to individual health records, fewer hospital errors, and decreased costs and hassles—all points that I, too, favor.
But isn’t anyone concerned about privacy? Don’t consumers fear that their health information could potentially fall into the wrong hands or be misused in some manner? And while my reference to an Orwellian world is intended to be dramatic, it is not so far-fetched to think that more individuals and more institutions will have access to our personal health data with the advent of EHR. That, in turn, leaves room for discrimination. Could a potential employer gain access, for example, and rule out job candidates with certain medical conditions? Could that prescription you’re taking for depression be used against you somehow?
No doubt, electronic medical records (EMR) can make for greater efficiencies in health care delivery. Moreover, adoption is growing in the industry. According to the 300 health care IT professionals who participated in the 19th Annual HIMSS Leadership Survey, investments in EMR technology will be the top IT priority at their organization over the next 2 years. But interestingly, on the subject of IT security, the same group of survey respondents identified an internal breach of security as their primary concern regarding data security, and one-quarter reported that their organization has experienced a security breach in the past year.
Security of data and privacy rights of individuals/patients are my key concerns regarding EMR. The issue gets even more complicated when you consider the growing interest in personal health records (PHR) like the new venture launched by Google.
I didn’t know all that much about Google’s PHR service, so I, well, googled Google. According to information online from the company, Google Health will empower users (that is, consumers) to “collect, store, and manage their own medical records online.” News reports say Google Health is working with physicians’ groups, pharmacies, and labs to help them securely share sensitive health data.
In its Google Blog, a company executive aims to assuage any concerns about privacy issues and Google Health, writing, “Google Health will protect the privacy of your health information by giving you complete control over your data. We won’t sell or share your data without your explicit permission. Our privacy and policy practices have been developed in thoughtful collaboration with experts from the Google Health Advisory Council.” It all sounds good, and the service offers enormous advantages. But still, can Google protect us—and our private data—from hackers or human error?
Whether it’s the health care industry, the government, or corporations like Google, EMR are on the way and here to stay. We can only hope that privacy is top priority. When I log on to my EMR or PHR or whatever, it better be a one-way screen.
Marianne Matthews, editor
