Electronic Medical Records: Threats & Opportunities

It has been a while since I wrote about electronic/online medical records, but two stories popped onto my radar that deserve mention.

The first focuses on the inherent threats of having medical information stored and displayed electronically: bugs. Apparently one-third of the Department of Veterans Affairs 153 medical facilities fell victim to a bug in a recent software update, causing electronic medical records to display incorrect or misleading patient data, including vital signs, medications, stop orders, and lab results. As a result, a handful of patients received incorrect doses of intravenous medication — including the blood thinner heparin, which at excessive doses can be fatal.

The VA seemed to brush it aside as a rarity, explaining that “What we found was that the glitch that could occur didn’t occur routinely…It was hit or miss, and didn’t happen with all patient records. It was very sporadic.” To me, the sporadic nature of the glitch is no comfort, as that means it is harder to predict why it happened and harder to ensure it won’t happen again. Equally discomforting is the fact that while the computer bug emerged in August 2008, it apparently wasn’t fully corrected until December, and wasn’t made public until a whistle blower exposed the bug in January 2009. The agency’s excuse: the agency has a duty to inform patients only in cases in which harm is done, and “It was determined that no patients suffered harm as a consequence of this.”

Unbelievable.

Of course, reliability isn’t the only threat of relying on electronic, and increasingly online, records to manage our health. Privacy remains a major factor, so much so, that it is emerging as a central issue in the Obama’s administration’s push to “make the immediate investments necessary to ensure that within five years all of America’s medical records are computerized.”

Just days before Obama’s inauguration, the NY Times reports on new opportunities for ensuring privacy in online medical records. Some lawmakers are insisting that any new spending must be accompanied by stronger privacy protections. The Obama campaign had previously only hinted at its position on medical privacy, but the Times points out that Rahm Emanuel, Obama’s incoming chief of staff, has advocated such safeguards when he was a House member from Illinois, stating “As we move forward on health information technology it is absolutely essential that an individual’s most personal and vulnerable information is protected.”

Hopefully we have an opportunity here for change, and will see the strengthening of HIPAA and its applicability to the third-party management and processing of patient records.