What are the privacy and security implications of adopting electronic health records?

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jameadows eNotes educator| Certified Educator

There are many benefits to electronic health records (EHR), including the ease of patients' access to their own health information. This access could improve patients' ability to become more aware of their needs and to advocate for their needs with medical professionals. In addition, electronic health records help different types of health providers, often separated geographically, to provide a continuity of care for patients and to avoid drug-related errors.

Many people have expressed concerns about the safety and security of keeping electronic health records. For example, in the U.K., patients chose to keep particularly sensitive health information out of the National Health Service database. According to Pagliari, Detmer, and Singleton (2007), encryption can help provide more security for health records. The authors also believe concerns over the privacy of health records is greatest among family members, who may be able to access these records.

In the U.S., under HIPAA (the Health Insurance Portability and Accountability Act), the federal Health and Human Services Office for Civil Rights is responsible for keeping health records private. Under these laws, a patient can request his or her health record and correct any mistakes on it. In addition, doctors' offices and hospitals are required to set up physical and technical safeguards for electronic health data, including passwords and encryption. If there is a security breach, they are required to let you know about it. 

Many patients fear security breaches of their electronic health records, and according to the American National Standards Institute (see the link below), millions of health records have had security breaches in recent years. As a result, the implications of adopting electronic health records are that some patients might delay or forgo treatment because they fear sensitive health information might be revealed publicly. For example, soldiers suffering from Post-traumatic Stress Disorder might not want to be treated because they fear their condition might be made public. Other sensitive situations involve people's diagnoses of cancer, heart disease, or other health conditions; people seeking treatment for mental health conditions; or teenagers seeking treatment for sexually transmitted diseases. Rather than facilitating treatment, fear of public exposure can negatively affect treatment.


Potential of electronic personal health records. Claudia Pagliari, Don Detmer and Peter Singleton. BMJ 2007; 335; 330-333.