Privacy hindering EHR progress, say researchers

Privacy concerns remain the key obstacle in the widespread adoption of electronic health records in the U.S., according to researchers from the North Carolina State University.

The paper, "Privacy and Security in the Implementation of Health Information Technology (Electronic Health Records): U.S. and EU Compared," outlines steps that could be taken to boost privacy and promote the use of EHRs.

"Electronic health records could reduce costs in the U.S. by an estimated $80 to 100 billion each year," says David Baumer, head of the business management department at NC State and co-author of the paper. "Using electronic records allows the healthcare system to operate more efficiently, minimizes duplicative testing, et cetera. But you can only get those cost reductions if everyone, or nearly everyone, makes use of the records, from healthcare providers to pharmacies to insurance companies."

Researchers say that a lack of public support related to privacy concerns has hindered EHR progress. Baumer says the concerns are not entirely unwarranted. For example, there is some evidence showing that EHRs can facilitate identity theft. But EHRs have become prevalent in the European Union, which has significantly more stringent privacy protections and whose citizens feel more comfortable with the EHR concept.

"We are moving in the right direction in regard to putting better privacy protections in place, but we have a long way to go," Baumer says. And that lack of privacy protection is hindering the adoption of EHRs. "For example, approximately 50 percent of people in the U.S. have EHRs, but doctors will have to check for paper records until EHRs are so widespread that checking for paper records is no longer considered due diligence." By way of comparison, approximately 95 percent of people in Holland have EHRs.

Researchers included a list of technical and legal recommendations that could make EHRs more viable in the U.S. For example, the paper calls for the introduction of civil penalties if people share information inappropriately or with inappropriate parties.

"Incorporating EHRs into our healthcare system is important," says Baumer. "The Obama administration's health plan relies on EHR savings as part of its effort to be revenue neutral. And more privacy protections are needed to make those savings a reality."

The paper, which will be available in the Boston University Journal of Science and Technology Law, was co-authored by Janine Hiller and Matthew McMullen of Virginia Tech and Wade Chumney of Georgia Tech.

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DC-HIT say: privacy hindering ehr research?

EHR's sales are increasing, the problem of connectivity to other EHR's is the problem (ask GE, Epic and the other point to point only HIE's want to be's, which is not an HIE).There are real HIE builders, like Axolotl is #1 and Medicity is #2 in KLAS. Security is getting better, be it through token or cards (very expensive) or better through cell phone two factor authentication (TFA) or voice bio-metrics. My Health Vet and other's are using a company called Anakam for TFA, which has done away with the old expensive and not secure cards and tokens. Finally, comparing the USA to Holland, typical academic excercise...Holland is a little less than twice the size of New Jersey (this is an example of the comparison research?).

dch say: Lack of public support

Don't know upon what data the study concludes public support to be important to EHR adoption.

Last I checked, EHR vendors don't go to lay people to sell their wares.

They go to the healthcare providers.

Why don't healthcare providers adopt EHR technologies at a faster pace?

From my state-level workgroup activity and my hospital level EHR daily use, I am left with the strong impression that the people with the strongest investment in EHR adoption are NOT the clinicians working at the sharp end of care.

Rather, it seems that administrators, bureaucrats, politicians and vendors carry a disproportionate interest in our use of EHRs.

I think this contributes significantly to a near absence of "usability" considerations in EHR design and implementation.

Clinicians want a usable, reliable, secure, affordable EHR system that feels intuitive and smooth, and makes us work faster, smarter, safer, and more profitably at the point of care.

Give clinicians these things, and federal incentives won’t be needed. (The phenomenon of smart phone adoption by physicians is evidence of our spontaneous willingness to adopt usable, useful technologies.)

Don’t give clinicians these things, and federal incentives won’t be enough.

* * *

I think a simple solution would be standardization of patient database structures.

Do this, and clinicians could feel free to interchange EHR application/GUI layers at will. The current idiosyncracies of proprietary product database structures render EHR product change prohibitively expensive due to the cost of data migration.

On the other hand, if vendors know I can easily ditch their products in favor of better ones, market forces will drive improvements in product quality and cost.