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    Electronic Records, Private Lives

    Audits Welcome? continued...

    "Sharing personal medical and health information across the Internet requires a certain leap of faith -- or at least a strong sense of privacy and trust," acknowledge the authors of a Pew Internet and American Life Project report on health information online. Asked whether he would ever share health information with someone he "met" online, one respondent to a Pew survey replied, "ABSOLUTELY NOT. I wouldn't dare. You don't know who you are talking to."

    What's to stop a hacker from breaking into one of these systems to steal personal information (such as social security numbers or other personal data)? And even if you've got a system that's harder to break into electronically than it is to get into Fort Knox with a pick and shovel, how do you know who's been looking at your private information?

    "I think it's important to understand that with a paper record, you have no idea who's looking at your record," says Daniel Z. Sands, MD, MPH, professor of medicine at Harvard Medical School, and clinical systems integration architect at Beth Israel Deaconess Medical Center in Boston.

    "With an electronic record, you can have an audit trail of who's looking at your record, and I think that's very important. There is certainly some risk to having electronic records, and perhaps because they're more accessible, there's more of a risk than with paper records," Sands tells WebMD.

    Appropriate Access

    "That being said, nobody has ever died from the inappropriate release of a medical record, but plenty of people have died because people couldn't get access to that information. I think we need to strike a balance between the security and protection of that information and the access to the information."

    Many people willingly share some of their most sensitive personal information with web-based merchants, such as credit card numbers and expiration dates, bank accounts, buying preferences, addresses, phone numbers, and even social security data. Why shouldn't medical information be similarly available, as long as the patient can control access to that information?

    "I meet people who are terribly afraid of all the potential," says Steven Schwaitzberg, MD, director of the Minimally Invasive Surgery Center at Tufts-New England and Associate professor of surgery at Tufts University School of Medicine in Boston. "They're very afraid of the intrusion on their privacy and demand control of the information."

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