Don’t get me wrong, I’ve really taken a shine to my online personal health record. It’s convenient. It’s easy. There’s little I can say bad about it. In fact, there’s really nothing bad I can say about it.

Except……

I must admit, I am worried. I hear more and more about how our health care system is going to go online and electronic with our medical records. Even our government has plans to go with online records, and is planning on having a Nationwide Health Information Network, a system that will connect all patients’ records to health care providers, insurance companies, pharmacies and laboratories electronically. The goal is to have it up and running by 2014.

But that worries me. As we’ve gone electronic and online with so much of personal information – our banking, our shopping, our Netflix preferences – I also hear more and more of breaches of online security systems.

As  one example, just this past May the records of as many as 26.5 million veterans had their names, birthdates, social security numbers, and their disability records stolen from the home of a Department of Veteran Affairs employee.

This makes me very nervous. Oh, so nervous.

The solution, of course, is better systems with better security. And the folks who provide this security will have to upgrade their systems constantly, always trying to stay ahead of the hackers and thieves who seemingly have little better to do than work to overide security and "get in."

Three gentleman in Massachusetts – two of them from Children’s Hospital in Boston and the other from the Massachusetts Institute of Technology – have a nice report in the BMJ online and they say this:

Computerized medical information systems are at the start of what promises to be a rapid evolution. We are still in a position to look ahead and consider the promise and pitfalls of such systems as we design and deploy them. We need not feel wedded to the structure and processes of current systems. …

In order for electronic medical records to eliminate the fragmentation of health information, be universally accessible, and guard patients’ privacy, systems must be built according to public standards and controlled by patients. 

 

Still, I’m nervous. Online systems are built by humans and can never be perfectly secure. Someone, somewhere will take it upon himself to hack in.

Or as one women, commenting on that same BMJ article, put it so well regarding the conundrum between the ease and efficacy of online records and their inherent risk to patient privacy::

Here is my dilemma. I want my notes to be strictly confidential but readily accessible to those who will need them. Electronic notes….set alarm bells ringing…. I am not a technophobe, but I am wary of giving out personal financial information over the internet, and the thought of my entire medical history floating somewhere in cyberspace doesn’t fill me with confidence. Perhaps I have seen too many films about ingenious hackers.

I’ve seen those films too. Nervous I am. Nervous.