EHR and externalities

Most experts believe that electronic health records will provide many benefits. My experience with the VA system has taught me that increased access to information streamlines evaluations. Often we can quickly find something in the old record which explains an abnormal lab test or radiologic finding.

However, all advances bring new concerns (else we would never have had the development of Luddites). Confidentiality fear over records

This article comes from Britain, but many US physicians share these concerns.

A survey released by the BMA on Thursday shows members of the public recognise the potential value of the new system – but many are seriously concerned about its security.

Dr Richard Vautrey, a GP from Leeds and lead for IT on the BMA’s GP committee, said: “Doctors have a fundamental duty to protect the confidentiality of the information that patients tell them.

“And many doctors remained concerned that we seem to be sleepwalking into a system where a significant amount of personal and medical information is held on a national database without either us or patients fully understanding the long-term implications.”

Dr Vautrey said there was an urgent need for a public debate about the changes, both about the amount of information that is held on the system, and how patients could opt out without compromising access to healthcare.

He acknowledged the system had securities built in.

But he added: “An IT system is only as secure as its weakest link.

“There are access controls so that doctors or other health professionals can only access what information is relevant.

Looking from a societal viewpoint, EHR will clearly help overall patient care. Looking from an individual viewpoint, some patients will have their data at risk. We have seen this problem in the US with unscrupulous reporters obtaining confidential files on celebrity patients. However, this problem precedes electronic records. Probably, EHR increases the risk of confidential information being “hacked”.

I believe that the benefits outweigh the risks. EHR should decrease errors and possibly decrease health care costs. One must always worry about the externalities however.