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Electronic health records as a threat to privacy.

Article Excerpt
Introduction

Governments across Canada are investing millions of dollars into the creation of electronic health records systems. While these systems offer great promise of improving the nation's health care system, they also pose considerable risks to individual privacy.

In this brief paper I hope to do two things. First, I hope to foster a clearer understanding of the risks. The risks are often misrepresented or misunderstood because of some prevalent misconceptions about the nature of the proposed electronic systems. For that reason, some explanation of the systems is needed. I use Alberta's Electronic Health Record as an exemplar. Once the nature of the risk is delineated, I sketch some of the steps which I believe are necessary for dealing with them.

Alberta's Electronic Health Record--Wrestling with Misconceptions

Discussion of a provincial or national electronic health record (EHR) often conjures up the image of a massive new database created by the government and containing a lifetime of one's health information. This picture is undoubtedly fostered by the loose descriptions which are so often offered by proponents of such systems. But it is mistaken on at least two significant counts.

In the first place, there is no new warehouse of information. Rather, the Alberta's EHR is an electronic network that links the patient records which are collected and maintained by health professionals and by regional health authorities. The EHR provides a portal through which this information can flow from one care provider to another. Pharmacist Kumar, who operates a community pharmacy, can use his computer to obtain information about a patient from Dr. Lee's record. A crucial point to emphasize is that professional responsibility is maintained by those who have traditionally had responsibility for the collection, use and disclosure of health information. I will return to this point below.

A second common misconception is that all information collected by any health professional will be made available through the data exchange system. This need not be the case, and at the present time...

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