Electronic Health Records the Debate

Electronic Health Records

The debate about posting health information online used to revolve around the right of insurance companies, hospitals, and doctors to allow confidential health data to become accessible through less-than-secure online storage devices. However, increasingly sensitive forms of personal health information are being voluntarily stored by individuals themselves online. Anyone who has known someone with a chronic health condition like diabetes can understand why the patient might be attracted to a device such as the Zuri, which allows users to track health information statistics like blood sugar readings, medicine dosages and reminders, and other personal health statistics. For diabetics, keeping track of blood sugar levels can be difficult and this device could be potentially life-saving. But notions of 'assumed risk' could mean that if the data was compromised, the individual would have little legal recourse, in contrast to data published by a healthcare institution bound by HIPAA guidelines.

There is also the question of medical error. For example, what if the Zuri was in error regarding a dosage, and the individual suffered a medical emergency: who would be responsible? Will individuals eventually be asked to sign a waiver of responsibility using Zuri or similar devices? Recently, Google Health, "a new free service that lets patients keep all their health records in one place," was lambasted in the Boston Globe for reporting (inaccurately) that a patient's cancer had spread to his spine and skull (Wangness 2009, p.1). Inaccurate or incomplete diagnostic information can prove deadly: it could prohibit an emergency room doctor from administering a life-saving drug or encourage the doctor to administer a contraindicated treatment. Google Health and Microsoft Vault allow users to delete inaccurate health information, but monitoring these systems for accuracy seems to detract from the supposed convenience these services are supposed to provide the patient.

In today's cost-conscious environment, also it is hard not to wonder if these private systems that enable individuals to keep track of their health-related data might be incorporated into the general medical system. It might seem like great convenience that patient data, such as weight or blood sugar readings can be sent directly to a nurse or healthcare provider daily. But will self-reported data really be an effective replacement for human contact? The patient could report inaccurate information if he or she is embarrassed about his or her weight or misread the device used to record the data. And the human contact between nurse and patient is often very important for the elderly and chronically ill. While systems such as the Zuri are presented as an enhancement to face-to-face medical treatment, it is not hard to envision a 'nightmare' scenario where they are used to replace it.