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Brase: There is a definite danger that the information can be shared and be transmitted and it can be linked all in ways that the patient isn't comfortable with. And in the end, the convenience won't be as important anymore as is the protection of confidentiality.Most people concerned about the privacy of their medical records worry about insurance companies or their employer getting too much information. Life insurance companies decide who to underwrite and how much to charge them based on an assessment of their health. That assessment is checked against information from a health database called the Medical Information Bureau.
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Battis: We have an obligation to our clients that already have insurance to price risks correctly and accordingly and if we don't do a good job, we won't have money around for them. So we watch very carefully, do we want to continue on a contract where we can't get a hold of any medical information and they won't answer any questions? It puts us at a very hard choice as to how do we proceed or do we proceed.There are also concerns that some companies may access health records to help make personnel decisions, something federal law clearly seeks to prohibit. Joe Thompson, staff vice president at 3M, says that would be unethical as well as illegal.
Thompson: There isn't a lot to be gained by getting this information as I see it from an employer's perspective. All you can get is controversy and questions about something that you really can't use if you have it. It's hard to fathom how that data could help.Those who tout the benefits of electronic records say the computer data can be protected using technology. But right now, health institutions are responsible for deciding how much security to provide.
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Schacker: Any computer that I can sign on to, I can access their laboratory information, their x-ray information, their pathology; that's not wrong, that's good. In order for me to provide effective care, I have to be able to do that. But the down side is that we don't have a good way yet to make sure that the people who shouldn't see that information don't.Schacker says he's heard medical staff gossiping about HIV diagnoses in hospital elevators. He tries to head that off by sometimes using aliases on the chart on a patients hospital door but he cant change their name on the computer records.
Fraser: What we want to do is provide so much security that it will be easier to break into the office and get the paper record than to attack the electronic side. I think if we can raise the security level to that height then we truly will have increased security over the paper record.And Fraser says people have a misconception of how secure their paper records are.
Fraser: It's simply a folder that gets put down on a counter, it gets put in the door of your waiting room, and it's all paper based. There really is no security on that except there's some physical security, it might get locked up at night. But it gets transmitted through fax machines, it gets transmitted through mail, through couriersThe beauty of the new technology is also its weakness. It's highly efficient. One computer disc can hold information on thousands of patients; in the wrong hands, it can cause significant damage. Those who worry about the misuse of medical documents hope the new federal regulations from the Department of Health and Human Services will deter most people from violating the privacy of computerized health data. But they still worry it will be too difficult to detect and prosecute those who do.