Electronic health records

Drug and Device Blog reports on a California Court of Appeal decision in which an intermediate appellate panel held that the California Confidentiality of Medical Information Act does not allow for plaintiffs to sue over the negligent maintenance of their confidential medical information unless their information was accessed wrongfully or without authorization.

In the underlying case, a doctor took home a hard drive containing the personal health information for 16,000 patients. The hard drive, as well as the encryption passcodes, were stolen, but no one knows if the thief viewed or tried to view the patients' personal health information.

Drug and Device Blog said the case has "broad appeal because the fact pattern is so typical of 'data security breach' lawsuits: Private information resides on a stolen hard drive or is sent off into the ether with nary an indication that anyone received, reviewed, used, or otherwise paid any attention to the information. At another level, such lawsuits (which are usually class actions) almost never articulate any credible basis that the plaintiffs suffered any actual harm."

The RAND Corporation, which was commissioned by the American Medical Association to identify the factors that influence physicians' professional satisfaction, found that those physicians surveyed do not want to go back to paper charting. But they are reporting several issues with the deployment of electronic health records: "Among the key findings of the study was how electronic health records have affected physician professional satisfaction. Those surveyed expressed concern that current electronic health record technology interferes with face-to-face discussions with patients, requires physicians to spend too much time performing clerical work and degrades the accuracy of medical records by encouraging template-generated notes. In addition, doctors worry that the technology has been more costly than expected and different types of electronic health records are unable to 'talk' to each other, preventing the transmission of patient medical information when it is needed."

A physician-legislator opined this weekend in The Washington Post that a moratorium should be declared on rolling out electronic health records. One problem is "entry errors and inconsistencies are becoming common." Another problem is different institutions all have different systems. Another problem is doctors end up staring at computer screens, not listening to patients during visits. The columnist wants one national system.

The ACLU has raised concerns that the Alaskan Health Information Exchange for sharing electronic health records is not secure against hackers and governemental intrusion by the NSA. For example, the ACLU opined: "Let’s be clear: electronic medical records can be a good thing. They can improve our health and make it easier for doctors to care for us. But a medical exchange that isn’t secure against spies and hackers is bad for Alaskans." The full OP/ED can be read here: http://m.newsminer.com/opinion/community_perspectives/risky-electronic-h...

But healthcare providers hit back, arguing the exchange is secure and that penalties for not ensuring patient privacy are high.

Electronic health records are going to become more and more prevalent as the Centers for Medicaid & Medicare Services have offered payments to health-care providers to implement EHRS with 'meaningful use': http://www.healthit.gov/policy-researchers-implementers/meaningful-use

But with this new way of managing patient information and records comes likely problems, including medical identity theft. Gigaom reports on a survey that finds that medical identity theft is rising:

"According to a new survey from the Ponemon Institute, an independent group that focuses on privacy and data security, medical identity theft is on the rise: since 2012, the number of people affected by medical identity theft has increased nearly 20 percent. The survey, which was sponsored by the Medical Identity Fraud Alliance and ID Experts, found that a total of about 1.84 million people in the U.S. have been affected."

Electronic health records are being incentivized in health law, regulations and funding on the rationale they'll improve patient care and other goals. But a recent Pennsylvania study showed that default values within such systems can lead to mistakes in caring for patients: 

"Using default values in electronic health records can boost efficiencies and standardization, but can cause adverse patient safety events when used improperly, according to a new advisory issued by the Pennsylvania Patient Safety Authority."

Read more: Inappropriate use of EHR default values harms patients - FierceEMR http://www.fierceemr.com/story/inappropriate-use-ehr-default-values-harm...
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