Arthur Levin, MPH, director of the Center for Medical Consumers in New York City, predicted that as the demand for quality measurements and outcomes research grows, electronic patient data will become a hot commodity. Also, as employers work to reduce employee utilization of services to cut their health care costs, more and more inappropriate individuals will have access to highly personal medical information. The big worry is that employers will begin deciding who to hire, fire or promote based on their health status, a scenario that privacy advocates claim has already occurred at companies that offer employee assistance programs. That's OK, but there are some questions about whether the patient knows about it and whether the physician on the other end really needs to receive that data. For many clinicians, it may mean having to rethink what is and what isn't confidential.
Confidentiality is in the eye of the patient.
And even more importantly, privacy experts say, giving records special treatment can in itself compromise security, because it draws attention to them. They knew because we were treating those records differently. Ms. Frawley and other privacy advocates say that the real answer to confidentiality issues is legislation that sets uniform standards for how and when patient information can be disclosed. Key to any legislation, they say, are provisions that prevent redisclosing information so that patient records can be used only once for the original purpose. Bills under consideration in both the House and Senate at press time address this issue, but similar privacy legislation has not progressed very far in the last few years.