Technology makes it easier to exploit records, and the technological imperative is that anything that can be done profitably must be done. That is the real threat of technology. Activities that were unthinkable, unethical, and unprofitable ten years ago, like marketing, are becoming more routine because technology allows for easy manipulation of data and because the activities promise profits. Health plans and even some health care providers are happy to share records for the right price. At the same time, however, we can also use technology to provide greater protection for records.
Electronic records permit the sharing of information by the byte rather than the megabyte.
Computers make it easier to slice and dice electronic records so that users can receive only the data fields that they really need, and identifying information can be left behind. It would be wonderful to conclude that technology allows for the greater use of deidentified records. To some extent, better information technology may help to limit data sharing, but a free lunch is highly unlikely. So much data about individuals is available in public and private files that almost all patients can be identified no matter how much detail is removed from their records. The nonidentifiable patient record, like health confidentiality itself, is a privacy myth.