Confidentiality of electronic medical records in the managed care environment

Over the past three decades, increasing sophistication in the application of information technology has created new opportunities to improve both the efficacy and efficiency of the health care delivery system. Electronic data transfer, facilitated by linkages between computers, allow physicians and others to access records of interest rapidly and easily. It is anticipated that the health care industry will eventually be served by an integrated electronic communication network allowing any agency within the industry to exchange information and process transactions with any other agency within the system. This capability could drastically reduce both administrative and health care delivery costs. Unfortunately, the very strength of the envisaged industry-wide communication network is also its weakness. The network's ability to access vast amounts of health care information rapidly and easily, which could be profoundly sensitive and private, effectively decentralizes the physicians' control on intelligence gained thorough a highly personal relationship of trust. This article explores alternatives available to the health care industry for assurance of confidentiality and privacy to the patient.