Engarde!!!

I promise that I won't dwell on this issue but this morning there was an ABC News article (here) that briefly reviews cyber attacks on Sony, Sega, Citibank, Lockheed Martin, the U.S.Senate & the CIA public website.  Sen. Susan Collins (D-Maine) is quoted as saying that "...the computer systems of the Executive Branch agencies and the Congress were probed or attacked an average of 1.8 billion times per month last year (italics added)."

There will probably be EMR/EHR systems that are well-protected and others that will be more vulnerable.  It's an ongoing battle.  When the hacks are supported by governments they've even been referred to as acts of war.  So, I think that we can expect there to be hacks of health care information. But there are many levels to this fight and even if a system is illegally entered the information within can be coded so as to make any use of the information difficult.  That is the goal:  Make it as difficult as possible and track and find those responsible. But we're not going to be able to prevent all of the hacks.

Daisy, Daisy...

It’s no secret that coordination of care is one of the big problems facing the healthcare system.  In concept, your primary care physician is the hub in your wheel of care. Each spoke representing a specialist or special venue of care (hospital, nursing home, etc). The problem is how to keep everyone informed and up-to-date on your health.  If everyone knows how each provider views and treats you then you’ll get better care and be subject to fewer mistakes (like being prescribed two medications that shouldn’t be taken together). In practice, this has been impossible to do.  Until now.

Enter information technology.  By taking advantage of the same powers that allow you (and the financial institutions) to know your financial situation at any given time and from almost anywhere in the world; you and the healthcare system could know your healthcare situation.  Thus is born the Electronic Medical Record (EMR) or Electronic Health Record (EHR).

For some this is a scary prospect.  Fears of Big Brother knowing your health status and using this information to deny you insurance or even a job are not uncommon. While there are many legal protections there are no guarantees (See NY Times article on medical data breeches here).  

Still, the upside is huge.  If all the providers know your health situation they are less likely to inadvertently kill or harm you. Also, all of that health information is a potential boon to research in understanding and treating diseases (no need for researches to know who you are so information that could identify you is stripped away).  Some have argued that as patients in the healthcare system we have an ethical obligation to share our information in order to help others benefit from the system in the way we hope to benefit.

The unfortunate aspect of EMR/EHRs is that our information can and will be stolen. Just as financial information about us can be stolen.  Just as any information about us can be stolen.  There are no guarantees.  But in order to improve the treatments we all will need; we must move judiciously forward.