Although the keeping of electronic health records in hospitals is not new in this technological age, the Obama administration encouraged medical record keeping in 2009.
It was then that the government announced it was putting $1.2 billion towards the keeping of electronic health records in new grants as part of the American Recovery and Reinvestment Act.
The goal was to “promote meaningful use of electronic health records by all individuals in 2011, and to support the development of mechanisms for information sharing through EHRs in the United States,” according to a report in the Journal of the American Medical Association.
There are advantages to this new system, according to Colleen Connell, executive director of the American Civil Liberties Union of Illinois.
“The advantages are to the patients themselves, and in the common interest of having a more efficient healthcare delivery system,” Connell said.
In the Journal’s article, they believe the concept of “patient-centered care” will develop from better record keeping at hospitals.
Connell believes this concept is very patient-centric, and that allowing all patients to decide who has access to electronic health records is the best route.
“There’s been a lot of discussion about the fact that if you had digitized records, you wouldn’t have to repeat tests,” Connell said.
Connell also pointed out that patients would benefit from having a medical database that is accessible from multiple locations.
“It’s an advantage to patients and doctors, in a crisis when time is of the essence, and really very helpful to immediately call up those records and have them in a readable from everyone can access,” Connell said.
Several advocacy groups for both open and electronic health records exist in the U.S., including the online Web site PatientsLikeMe.
According to Lori Scanlon, marketing and communications staff member for the site, the site’s main function is as a health data-sharing platform, with patients encouraged to share health information on the site in order to create a collective knowledge database about disease, health, and treatments for patients.
She points to the sites “openness policy,” which says the site is important, “because when patients share real-world data, collaboration on a global scale becomes possible. New treatments become possible. Most importantly, change becomes possible.”
Listing additional reasons advocating for open health records, the openness policy also says, “currently, most healthcare data is inaccessible due to privacy regulations or proprietary tactics. As a result, research is slowed, and the development of breakthrough treatments takes decades. Patients also can’t get the information they need to make important treatment decisions.”
However, the idea of all medical records being available electronically is not without flaws.
There is a state constitutional right of privacy within article six of the Illinois constitution, according to Connell. This recognized right of privacy includes protection of confidential information that patients have in their own medical records.
“I think that you have certain medical facts and records that not all health care providers need access to,” Connell said. “Why would her pulmonary specialist need access to her reproductive health records? There is no medical purpose served by providing that kind of access to medical records to any professional.”
Family members should not be given access to medical records until a patient allows it, Connell said, exposing another problem within electronic health records. She used the example of a woman having an abortion before getting married, and not wanting anyone else, including her husband, to have access to those records later in life.
“Privacy concerns need to be an important part of the discussion, as should protections that are put into place when we move into a system of digitized records that are easily accessible,” Connell said. “It is important to recognize that the protectable interest belongs to the patient and not the hospital or medical professional.”
Privacy concerns are not the only possible pitfall of electronic health records—security issues have also emerged.
Connell pointed to a Virginia medical record security breach in May 2009 of the prescription-monitoring program maintained by the Virginia Department of Health Professions. State officials said a hacker penetrated the program’s Web site, accessing millions of prescription records.
“Any digitized system has to actually have in place very, very, very, secure firewalls, and I think one could even go to the requirement that medical records be encrypted such that if there is hacking or penetration, you limit the damage,” Connell said.
