Do the risks to personal privacy posed by the advent of electronic medical records systems outweigh the rewards?
The answers given by the general public in a recent phone survey provide a warning to physicians and hospitals regarding just how skeptical Americans are about whether their privacy will be protected in the coming age of healthcare information technology.
About 47% of U.S. adults in the survey said the risks from EMRs outweigh the benefits; 48% or so said the benefits outweigh the risks; and another 4% indicated they weren't sure.
Of five specific privacy concerns regarding EMR use, the most intense level of fear was registered regarding the sharing of medical information without a patient's knowledge, cited by 42% of respondents who were "very concerned."
Persons interviewed indicated there was a way to ease their fears -- building into the EMR systems ways for patients to track their own personal information "and exercise the privacy rights they were promised." These privacy-check features were deemed "very important" by 45% of those surveyed and "somewhat important" by another 37%.
"I view this as a powerful, publicly derived privacy design specification for any national EMR system," said Alan Westin, in a copy of prepared testimony presented along with the survey to the National Committee on Vital and Health Statistics last Wednesday.
Westin, a graduate of Harvard Law School, is the director of the Program on Information Technology, Health Records and Privacy. The program is run by Privacy & American Business, an initiative by the Center for Social and Legal Research. Westin also is a professor emeritus of public law and government at Columbia University.
The nationwide survey of 1,012 adults was conducted in February for Westin's organization by Harris Interactive, a Rochester, N.Y.-based global research company.
Patient access to the EMR is "always going to have to be carefully done," Westin said in a telephone interview. Clinicians' notes about mental illness, for example, might not appropriately be opened to the patient, nor would comments contained in a medical record of a wife about her husband's behavior, he said.
But, Westin said, "for three quarters of the public you could create a system where you could sign on from your bedroom, verify your identity with a biometric identification system and look at those parts of the medical record that are not screened off."
In addition, he said, patients should be able to see who has looked at their medical records.