Will Privacy Concerns Derail the Electronic Health Record? Balancing the Risks and Benefits

Will Privacy Concerns Derail the Electronic Health Record? Balancing the Risks and Benefits

Candace J. Gibson (The University of Western Ontario, Canada) and Kelly J. Abrams (Canadian Health Information Management Association, Canada)
DOI: 10.4018/978-1-61520-733-6.ch011
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The introduction of information technologies and the electronic record in health care is thought to be a key means of improving efficiencies and effectiveness of the health care system; ensuring critical information is readily available at the point of care, decreasing unnecessary duplication of tests, increasing patient safety (particularly from adverse drug events), and linking providers and patients spatially and temporally across the continuum of care as health care moves out of the traditional hospital setting to the community and home. There is a steady movement in many countries towards eHealth and a fully implemented, in some cases, pan-regional or pan-national electronic heath record. A number of barriers and challenges exist in EHR implementation. These include lack of resources (both capital and human resources), resistance to change and adoption of new technologies, and lack of standards to ensure interoperability across separate applications and systems. From the public’s perspective, maintaining the security, privacy, and confidentiality of personal health information is a prominent concern and privacy of personal health information still looms as a potential stumbling block for the implementation of a omprehensive, shared electronic record. There are some steps that can be taken to increase the public’s comfort level and to ensure that these new systems are designed and used with security and privacy in mind.
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To set the stage for this discussion a few definitions are necessary.

The electronic health record represents the longitudinal lifetime record of an individual’s encounters with the health care system and various health care providers, residing within a computerized architecture. It includes information in different formats, for example, text, voice, and digital images. This information, such as, demographic data, clinical data and diagnostic results, alerts, reminders, and evidence-based decision-making support is accessible to authorized users based on the user’s role and relationship with the patient. Other terms may refer to an electronic patient record, the institutional record of patient encounters, or the electronic medical record, the physician’s office record of care. The electronic health record is seen as the linked multi-user, multi-facility, multi-purpose record connecting the institutional (the EPR) and provider level (the EMR) records to provide the comprehensive lifetime record (Nagle, 2007).

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