New Study: Patient Privacy Rules Hamper Adoption of Electronic Medical Records

Posted on April 29, 2009 by Jeff Bone

A recent article from Computerworld reports that, according to a new study conducted by researchers from MIT and the University of Virginia, "EMR [Electronic Medical Record] adoption is often slowest in states with strong regulations for safeguarding the privacy of medical records."   According to the study, in states with "strong privacy laws", the number of hospitals using EMR systems is up to 30% lower than in states with "less stringent privacy requirements."  The study, "which looked at EMR adoption in 19 states over a 10-year period", concludes that the reason for the disparity is that "privacy rules often made it harder and more expensice for hospitals to exchange and transfer patient information, thereby reducing the value of an EMR system."  According to the article, one of the study's authors, Catharine Tucker, stated that "[p]olicy-makers are going to have to choose how much EMR adoption they want and at what cost to patient privacy.

It is worth noting that the study's methodology has been subject to some criticism.  According to the article, Deven McGraw, director of the health privacy project at the Center for Democracy and Technology, said that "the study was based on old data and didn't consider all of the factors that a health care organization would typically look at when deciding whether to adopt an EMR system."  Instead, according to McGraw, the study "looked at whether a state has a medical privacy law and then looked at EMR adoption in that state to draw its conclusions."  Deborah Peel, chair of the Patient Privacy Rights Foundation in Austin, Texas, also criticized the studies conclusions.

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Lessons from the VA: what you can learn from someone else's problems

Posted on March 19, 2009 by Colin J. Zick

For all their problems, Veterans Affairs medical centers across the country are at the vanguard of the implementation of electronic health records. As such, there is a lot to learn from the problems that the VA system has experienced in this area. According to an article in the March 4, 2009 Journal of the American Medical Association, the problems experienced by the VA include mixed-up patient names and missing medication orders. These types of problems are probably endemic in any EHR system.  (This very point was made by Drs. Jerome Groopman and Pamela Hartzband in their March 12, 2009 Wall Street Journal op-ed.) Given these built-in weaknesses, frequent auditing of records, with strong and persistent audit trails, are a vital component to any EHR system.  Also, communications between all levels of workers in the care setting are important, to provide similar feedback.  The VA has adopted these mechanisms as part of its EHR systems. VA health care workers are encouraged to report problems with the electronic medical record systems, and those reports are closely monitored. Ironically, this may be why we hear so much about the VA’s issues – they are finding problems that others have in their data systems, but do not yet know about.

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