Privacy, security keys to EHR adoption globally

Sydney, Australia – The privacy, security and confidentiality of electronic health records (EHRs) has emerged as the main issues confronting governments worldwide as they push for widespread EHR adoption.

Dr. Ian Reinecke, chief executive officer of Australia’s National E-Health Transition Authority (NEHTA), speaking here at the annual Electronic Health & EH Records Congress, said, “unless consumers are convinced of the privacy [of EHRs], it will be an impediment to adoption.”

Debbie Chin, deputy director general of corporate and information at the New Zealand Ministry of Health, said the privacy and security of EHRs are major issues in her country, too.

Chin said patients need to be assured that only the right clinician looks at the right information in an EHR at the right time. She added that health officials have a strong duty to ensure that information about conditions such as mental illness remains confidential and protected by a high level of security.

Reinecke said that NEHTA, funded and backed by the Australian federal, state and territorial governments, and other governments planning wide-scale EHR deployments need to elevate the discussion of patient consent beyond the questions of “opt-in,” in which a patient’s consent must be obtained to use EHRs, and “opt-out,” in which EHRs are standard unless a patient directly requests that EHRs not be used.

Consent requires a greater level of detail, Reinecke said. For example, multiple clinicians in a wide range of clinical environments might access EHRs, and a standard consent might not be sufficient.

Reinecke echoed Dr. David Brailer, national coordinator for health information technology at the Department of Health and Human Services, when Reinecke said NEHTA needs to have a social dialogue with patients before EHRs are implemented.

Brailer and HHS Secretary Mike Leavitt have made the privacy and security of patient information the first priority for the United States as it starts to develop its nationwide EHR system.

Reinecke believes that consumers can be sold on the concept of EHRs if they understand that electronic records offer better security and privacy than paper records, which are left lying around hospitals and doctors’ offices, lacking the audit trail electronic systems provide.

Robert Whitehead, manager of privacy and policy in the Northern Territory’s Department of Health and Ageing, agreed with Reinecke that “a robust privacy framework is essential to consumer confidence” in EHRs. Australia, like the United States, is working to develop an EHR system amid a thicket of conflicting state laws but without the benefit of a national privacy act.

But once consumers start to develop confidence in EHRs, they willingly embrace them, Whitehead said. The Northern Territory has deployed an EHR system serving a remote, aboriginal population, with the more elderly members of that population quick to grasp what EHRs can do for their health. “There’s a high level of understanding by older [aboriginal] people about EHRs,” Whitehead said.