Will Electronic Records Really Improve Health Care?

"The reality is, of course, today, many of our records are already digitized," said M. Eric Johnson, director of the Glassmeyer/McNamee Center for Digital Strategies at Dartmouth's Tuck School of Business.

"The U.S. health-care system is made up of a ton of unsophisticated players," he said, noting that current digitized records are held in a variety of small laboratories and clinics.

"I would much rather have Google or Microsoft or someone else doing that rather than my doctor's office in Hanover, N.H.," said Johnson. "I think the reality is those companies are in the business of IT and security, and they're much better than my local doctor."

When he speaks about potential problems in a piecemeal health records system, he isn't speaking hypothetically.

Last week, Johnson released a paper in which he said he and his fellow researchers were able to uncover a number of medical records and other files with medical information online, using file-sharing services generally associated with song-swapping, like LimeWire and Kazaa.

Because the networks operated by pulling information from shared folders from other users, someone who is not taking the proper precautions could expose files on the hard drive by downloading and running a peer-to-peer file-sharing program.

So, simply having a doctor whose secretary's son likes getting free music online might cost you your medical privacy under the current system.

"It's a symptom of a fragmented system without a universal, enterprise technology in place," said Johnson.

Lee Tien, the senior staff attorney with the Electronic Frontier Foundation, expressed a bit more skepticism about potential problems with centralized electronic health records. For one thing, he noted, Microsoft and Google are not currently covered by the Health Insurance Portability and Accountability Act (HIPAA), which regulates privacy of patient records.

"It's more convenient," he said of a centralized health records system, "but it also can lead to rapid disclosure of information that people might not want disclosed."

He said that having one large database of health information can have what he called the Fort Knox effect, where a single vault of information becomes more attractive to hackers.

"It's not easy to say this is definitely going to be more secure or not," said Tien. "How many people are you trusting, and with how much information?"

A Concern for Some Is Others' Peace Of Mind

While some might be concerned with their medical records' security, others find the portability might give them peace of mind.

Sameer Samat, the director of product management for Google Health, noted in the company's blog last week that a few years ago, he found himself in the emergency room for his father and had no idea what medications his father took. Though he gave this as his personal reason for wanting a way to grant adult caregivers access to their parents' medical records, Google is not the first to offer this service.

In Kaiser's records, adults caring for their parents may be granted access to medical records for parents in the same manner that parents are granted access to medical records for their minor children.

Doctors who have used Kaiser's system, such as Dr. Peggy Latare, chief of the family medicine department at Kaiser Permanente in Hawaii, noted other benefits.

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