Online medical records versus privacy

Online medical records versus privacy

BANDUNG (JP): In the past two years, I have had my throat
checked by doctors eight times. Most times I had severe pain in
my throat, perhaps due to my failure to properly protect myself
against hazardous chemicals.

My work environment demands that priority be given to the
safety of workers, but my glasses for shortsightedness makes me
hesitant to use the bulky protective mask supplied to cover my
face.

I never go to the same doctor. I used to check out doctors who
gave cheap medicine and promised a speedy recovery. The downside
was the doctor always asked me the same boring questions. A lot
of valuable time was wasted with questions such as "how old you
are", "are you allergic to any medications", "what medicine did
you last take", or "do you have hypertension". My classic answers
were "maybe" or "don't know", answers that a doctor would
probably consider unsatisfactory.

Then after the doctor examined my throat and nose, it would be
my turn to ask him/her about my condition and the medicines to be
prescribed. Most doctors would not answer my pointed questions,
except to advise me to take a lot of rest and eat many fruits and
vegetables to speed up the process of recovery, another answer I
would find unsatisfactory, of course.

Here is one possible scenario: It's 3 a.m. and an unconscious
man is rushed to the emergency room. Little is known about the
patient, no relative or family accompanied him. His medical
records are not available.

What action should the doctors take?

Online medical records could possibly improve the quality of
health care and cut its costs by giving doctors and their staff
instant information on the patient.

Access to medical records in the middle of the night from
institutions all over the world would be very helpful. That is
the vision of PersonalMD.com (http://www.personalmd.com), a
Californian company which has launched a free online medical-
records service.

The company hopes to persuade and encourage doctors and
patients to replace paperwork on medical information about
patients' medical histories with digital files that can be
accessed anytime, anywhere.

PersonalMd lets you create a personal medical dossier on the
Web to access in an emergency situation, or even when you make a
routine visit to a doctor's office.

Doctors and patients are encouraged to put necessary and
important medical data into a patient's private webpage, such as
what medication a patient is on, digitized Electro Cardio Graph
(EKG), Magnetic Resonance Imaging (MRI) and X-ray images.

When you sign up for this free service, you get a medical card
that directs a doctor to a website or a fax-back service where
medical staff not connected to the Internet can access your
medical records.

Medical staff must enter your password (either found on the
card or by asking a patient for a pin number) and enter the
doctor's license number before opening your medical records. Thus
any doctor who has checked your medical records can be traced.

Whether the average person will enter sensitive personal
information remains to be seen. But if successful, online medical
records perhaps could rapidly change the doctor-patient
relationship. It is increasingly common for patients to share the
same medical records as doctors when researching medical
treatment. Soon physicians may be asked to share information that
patients have a right to review but in practice rarely request.

From a practical standpoint, we have to recognize that some
patients who did not grow up in the Internet world will not
immediately embrace this service. This new service relies mainly
on the patients themselves to obtain medical records from doctors
and post them on their private webpages on the Net.

Once patients acquire medical records, they can scan and e-
mail them to PersonalMD or, if they don't have a scanner, they
can fax it directly to a secured fax machine at PersonalMD.
PersonalMD staff will convert the documents into a digital file.

Similarly, emergency room doctors and other physicians can
send the records via the Net or fax with a patient's prior
consent.

PersonalMD is voluntary, but it still raises security, privacy
and safety concerns for many people. Any database of medical
records can be cracked by hackers or abused by devious people for
their own benefit.

Something as simple as incorrect blood types could be fatal if
a hacker changed or submitted the wrong information. There is
another problem; doctors may fear that patients entering their
own information might omit potentially embarrassing but medically
important details in fear of their secrets being revealed.

Computerized medical records are vulnerable to misuse and
abuse because security is often overlooked. As more records
containing more private personal history, identifying information
goes online, some analysts worry that the tendency to abuse
privacy will grow. Part of the problem is a lack of effort from
health care facilities to upgrade security.

Patients could be shocked and outraged to find that privacy
can be so easily compromised.

The use of encryption software technology and by imposing
controls such as passwords or electronic blocks or "Firewalls" to
deny unauthorized users are absolutely necessary. But the problem
is not that easily solved. Why? Because there are concerns that
encryption is not a strong enough measure. What is strong enough
today will most likely not be strong enough tomorrow.

Considering sensitive matters, we should evaluate the risks
and benefits associated with using such databases. Protecting the
privacy of someone is important, but saving someone's life is
more important.

Therefore, supporting the use of this technology, provided
there are adequate safeguards to protect patients' privacy,
should be encouraged. Technology can actually build a better
doctor-patient relationship.

The idea of this service is very interesting. Its application
in Indonesia could be promising in that it can improve the
awareness of the need for a healthy life.