Comments
When Patients Fear EHR
Threaded  |  Newest First  |  Oldest First
David F. Carr
100%
0%
David F. Carr,
User Rank: Author
7/28/2014 | 9:41:17 AM
Defending the value of EHR versus paper
This is an important counterpoint to the concerns expressed here:

Electronic Health Records: First, Do No Harm?

While it's important to make electronic health records systems safe and usable, it does no good to spread fears about their misuse that drive patients to prefer paper (even when that paper will ultimately be transcribed to an electronic record).
mhasib
50%
50%
mhasib,
User Rank: Author
7/28/2014 | 11:16:13 AM
Re: Defending the value of EHR versus paper
Agree misuse is a human frailty which needs to be dealt with but should not be used to stifle progress and innovation which is already saving thousands of human lives.
David F. Carr
100%
0%
David F. Carr,
User Rank: Author
7/28/2014 | 11:25:28 AM
Re: Defending the value of EHR versus paper
What is your take on the concern over EHR glitches / usability issues leading to medical errors? Is it a real problem?
mhasib
50%
50%
mhasib,
User Rank: Author
7/28/2014 | 11:32:36 AM
Re: Defending the value of EHR versus paper
Medical errors are one of the leading causes of death in the USA but these errors are not caused by technology. They are caused by humans who are either not using technology or misusing technology. Similarly, cars do not cause accidents (except in cases of manufacturing defects) -- people do.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 12:52:27 PM
Re: Defending the value of EHR versus paper
Dr. Hasib, you say innovation is "already saving thousands of human lives." In 2005, RAND published the results of a study which predicted a savings of 100,000 lives and $77 billion a year from EHRs. However, by 2011, history had made it clear that the prediction (based on a heavily biased study) was completely false. Even RAND disowned it. On what evidence do you base your claim that "thousands are being saved?" 
mhasib
50%
50%
mhasib,
User Rank: Author
7/28/2014 | 1:16:23 PM
Re: Defending the value of EHR versus paper
I attend healthcare conferences where I listen to presentations from US and international researchers, scholars and doctors. I also talk to doctors and other practitioners who use EHRs and share with us their research and stories. 
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 1:23:39 PM
Re: Defending the value of EHR versus paper
Can you share the evidence on which you base the claims of EHRs' superior safety and security?

Personally, I haven't seen any such studies.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 1:13:44 PM
Re: Defending the value of EHR versus paper
"Many members of the public mistakenly believe electronic health records (EHRs) are less secure than paper files." As far as I know, you are the first person in years to claim that EHRs are more secure than paper. And for good reason: They are not. The HHS "Wall of Shame" is filled with digital breaches - not paper. On April 8, the FBI warned that EHRs are becoming increasingly vulnerable to hackers. (See: "Health Care Systems and Medical Devices at Risk for Increased Cyber Intrusions for Financial Gain").

http://www.illuminweb.com/wp-content/uploads/ill-mo-uploads/103/2418/health-systems-cyber-intrusions.pdf

Paper records cannot be hacked from the other side of the world.
mhasib
50%
50%
mhasib,
User Rank: Author
7/28/2014 | 1:34:40 PM
Re: Defending the value of EHR versus paper
About 21% of US healthcare organizations do not even plan to have a cybersecurity officer within a year (see my previous article on this). Corporate boardrooms in other industries are also waking up to this as well. So things should start to improve. Public demand and holding organizations accountable as the HHS "Wall of Shame" will drive improvement. The healthcare sector has a long way to go in implementing proper cybersecurity. Just because some people and organizations have been doing a poor job implementing and using technology does not make technology bad. 
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 2:09:41 PM
Re: Defending the value of EHR versus paper
To get back to the main points of your article, can we agree that EHRs have so far not proven to be safer or more secure than paper records?
vnewman2
100%
0%
vnewman2,
User Rank: Ninja
7/28/2014 | 2:32:34 PM
Re: Defending the value of EHR versus paper
I personally don't think it has to do with what's safer or better.  A few non-debatable points:

Neither method is foolproof

There are pros and cons to both

People need to be educated on how their particular healthcare provider/insurance company/doctor handles their information and what happens in case of a breach.

 
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 3:07:07 PM
Re: Defending the value of EHR versus paper
Ponemon estimates that over 90% of healthcare organizations have experienced at least one reportable data breach in the last two years. Also according to Ponemon, stolen medical identities bring $50 each on the black market while financial identities only bring $5 each.

It matters a lot. 
vnewman2
50%
50%
vnewman2,
User Rank: Ninja
7/28/2014 | 3:13:57 PM
Re: Defending the value of EHR versus paper
@Darrell - I'm not debating that.  Everything has an element of risk.  Everything.  Except doing nothing.  And that's an option too.

You have to decide for yourself how much risk you are going to take and what the cost is.  Sometimes you gamble and lose.

You can just choose to not seek medical treatment completely I suppose.  That would keep your info completely safe.  Smart?  No.

It's just like having sex.  The only thing that offers 100 percent protection is abstinence.  
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 3:19:26 PM
Re: Defending the value of EHR versus paper
The fact is, EHRs are more expensive, more dangerous and less secure than paper records. So what is your argument?
vnewman2
50%
50%
vnewman2,
User Rank: Ninja
7/28/2014 | 3:24:30 PM
Re: Defending the value of EHR versus paper
I'm not making any argument at all. My previous post speaks for itself. NEITHER method is 100 percent secure. This is life.
DarrellP725
100%
0%
DarrellP725,
User Rank: Moderator
7/28/2014 | 3:32:43 PM
Re: Defending the value of EHR versus paper
Informed choices help reduce risks.
vnewman2
50%
50%
vnewman2,
User Rank: Ninja
7/28/2014 | 3:43:55 PM
Re: Defending the value of EHR versus paper
Yes, again, I said this exactly in my previous post, people should get themselves informed and chose for themselves. I stated that very clearly in fact.

I don't get what you are saying. Are you saying there should be no EHRs then?

Do you want better security? Don't we all? Don't think anyone is going to argue that point.

It's an imperfect world. If you wait until things are perfect well...you're going to lose out.

There are clear benefits to EHRs. You have to be willing to sacrifice some things to get them, like privacy or potential breaches or stolen identities etc etc etc to get them. That's just the way it is.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 5:43:51 PM
Re: Defending the value of EHR versus paper
"There are clear benefits to EHRs. You have to be willing to sacrifice some things to get them, like privacy or potential breaches or stolen identities etc etc etc to get them. That's just the way it is."

That is an incredible authoritarian claim that simply won't pass scrutiny with the general public, and I think you know it.

You so easily discount the danger of data breaches, yet if one's medical identity is stolen, the thieves have been known to imperceptively alter allergies and other information in order to use the victim's insurance. That danger simply does not happen with paper records. 
vnewman2
50%
50%
vnewman2,
User Rank: Ninja
7/28/2014 | 7:16:51 PM
Re: Defending the value of EHR versus paper
I don't think it's authoritarian at all.  It's a fact.  This IS how it is.  Hopefully it will change but the threat will never go away.  This is true of electronic anything.

I think the public has accepted it - what's the alternative?

So do you suggest going back to all paper records then?  That's an impossibilty.  

With great progress comes great challenges.

I'm not discounting dangers of data breaches just like I wouldn't discount the danger of driving on the highway, yet millions of people do it every day.  You take risks.  This is life.

Do I think security breaches are an issue?  Of course?  Do we scrap the whole system because of it?  I think not.  You try to make things better.  But you have to move forward not backward.

But if you don't want to take that chance, stay off line, don't use credit cards and don't give any of your personal information to anyone.  We all have that choice.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 10:03:14 PM
Re: Defending the value of EHR versus paper
Let me see if I understand you correctly: Regardless of the ever-increasing cost and danger of EHRs, Americans are trapped?
vnewman2
50%
50%
vnewman2,
User Rank: Ninja
7/28/2014 | 10:49:07 PM
Re: Defending the value of EHR versus paper
If by trapped you mean there are no reasonable alternatives to electronic medical records then yes I mean trapped.
Jeff Jerome
100%
0%
Jeff Jerome,
User Rank: Ninja
7/28/2014 | 11:18:26 PM
Re: Defending the value of EHR versus paper

vnewman - Electronic Medical Records are here to stay.  Sure there is potential risk but there is a strong set of security wrapped around them.  The benefits far outweigh the down side and paper records are to arcane to consider staying with, even if some believe that they are not safe.

Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/29/2014 | 9:26:59 AM
Re: Defending the value of EHR versus paper
@Jeff - I agree, EHRs are definitely here to stay. Is there any business that, having digitized, went back to paper? But I don't believe healthcare organizations are doing enough to promote security. They must do more. Sadly, I don't think that will happen until there's a huge Target-like breach. Then heads will roll and, "suddenly," resources for more healthcare security will become available at more organizations. That's not to say some healthcare orgs don't get it. Some do; some are doing a great job of securing their data, networks, devices, etc. But many, sadly, are not from what security experts in healthcare tell me. 
Jeff Jerome
50%
50%
Jeff Jerome,
User Rank: Ninja
7/29/2014 | 9:38:20 AM
Re: Defending the value of EHR versus paper & REgulatory Concerns

Alison - Your comment; "But I don't believe healthcare organizations are doing enough to promote security. They must do more. Sadly, I don't think that will happen until there's a huge Target-like breach. Then heads will roll and, "suddenly," resources for more healthcare security will become available at more organizations".  This I believe is very true.  And I would add that the folks who are doing EHR initiatives, security initiatives and other initiatives related to healthcare face many challenges.  Some of those challenges are simply resources in the form of people and money.  In addition they have another obstacle which is that they are highly regulated.  Those are some substantial challenges that they have to address day to day which is no easy feat.

Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/29/2014 | 9:56:36 AM
Re: Defending the value of EHR versus paper & REgulatory Concerns
As one high-level security consultant told me, many healthcare organizations don't have a chief security officer (or CISO) to oversee security so the whole area of security is managed incorrectly. Then there's the battle for security professionals, in high demand across all industries. You then have the battle between healthcare pros -- where seconds can count -- and security pros -- who want multiple precautionary layers. And so it goes.
Jeff Jerome
50%
50%
Jeff Jerome,
User Rank: Ninja
7/29/2014 | 11:59:13 AM
Re: Defending the value of EHR versus paper & REgulatory Concerns
Alison - That is a great point about most health care providers not having a CSIO.  I will reach out to a couple of health care clients and see what their take on that is and follow up with another post.
Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/29/2014 | 4:46:42 PM
Re: Defending the value of EHR versus paper & REgulatory Concerns
I just wrote a blog, spurred by this conversation, which should appear soon on InformationWeek about that topic. In one study, slightly more than half the healthcare organizations surveyed had someone on staff dedicated to heading security... that's not a big enough percentage, IMHO. Look forward to learning what you find out, @Jeff!
freespiritny25
100%
0%
freespiritny25,
User Rank: Moderator
7/29/2014 | 5:24:38 PM
Re: Defending the value of EHR versus paper & REgulatory Concerns
I think some patients will continue to be resistant to EHR, but that the vast majority will be pro-EHR despite possible security risks. It's the direction of healthcare and plus patients could suffer with delays due to choosing to stick with having paper records.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 11:22:33 PM
Re: Defending the value of EHR versus paper
Regardless what EHR stakeholders want - regardless what providers want. When patients lose their trust in EHRs - which is happening rapidly - the game ia over. They will simply keep secrets from healthcare providers, which will increase the danger of EHRs even more.

You say that there are no reasonable alternatives to EHRs, yet some providers are already rejecting digital. As costs and danger continue to accelerate, what is to keep more from following? Patriotism?
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 11:25:45 PM
Re: Defending the value of EHR versus paper
EHRs are both more expensive and more dangerous than paper records, Outside a totalitarian regime, that is a hard sell.
Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/29/2014 | 9:24:20 AM
Re: Defending the value of EHR versus paper
I think the answer is secure EHRs, to be honest because I don't see healthcare going back to paper. The reasons I hear for witholding information from healthcare providers is 'big government' and 'intrusiveness' more than EHRs, necessarily. They are concerned their healthcare information is up for grabs by so many, that once "private" information is entered into a hospital system it becomes fodder for government, research, and educational institutions. They're also concerned about the weakening of doctor-patient confidentiality.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/29/2014 | 9:45:25 AM
Re: Defending the value of EHR versus paper
In March, David Blumenthal M.D., the former National Coordinator for Health Information Technology, said this about EHRs: "... from the provider's perspective, there are substantial costs in setting up and using the [EHR] systems. Until now, providers haven't recovered those costs, either in payment or in increased satisfaction, or in any other way." (See: "Why Doctors Still Use Pen and Paper -The healthcare reformer David Blumenthal explains why the medical system can't move into the digital age," by James Fallows, for The Atlantic, March 19, 2014).

http://www.theatlantic.com/magazine/archive/2014/04/the-paper-cure/358639/
Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/29/2014 | 9:58:55 AM
Re: Defending the value of EHR versus paper
EHR advocates argue one reason the software has been less effective is because of interoperability. Since Hospital A cannot necessarily communicate with Dr. X, Lab Y, or Hospital C, savings are nonexistent. As Mansur said in his article, HIXs were supposed to eliminate those problems. 
mhasib
50%
50%
mhasib,
User Rank: Author
7/29/2014 | 11:08:38 AM
Re: Defending the value of EHR versus paper
This is an important point. While researching for stories for my articles and books, I spoke to executives in the well functioning health information exchange in Delaware. I learned that the cost of a typical transaction was brought down from $1.25 to $0.25 by the exchange. So hospitals, labs and other providers have opted to use and pay the exchange for these transactions resulting in long-term financial sustainability for the exchange. Statewide adoption of EHR and electronic transactions is well in the high 90% range.
Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/29/2014 | 4:48:39 PM
Re: Defending the value of EHR versus paper
If you think about storage alone, and the cost of renting warehouse space for all the paper documents associated with serving thousands and thousands of patients each year, you can start seeing how savings will begin to add up! Those papers should (but aren't always) be protected by guards and wire and alarms, etc., too, so they need securing too.
mhasib
50%
50%
mhasib,
User Rank: Author
7/29/2014 | 5:16:18 PM
Storage Costs and Retrieval
@Alison - your comment about the logistics of storage and cost of paper records is on point.  Also imagine the impossible nature of search and retrieval. 
freespiritny25
100%
0%
freespiritny25,
User Rank: Moderator
7/29/2014 | 5:27:04 PM
Re: Storage Costs and Retrieval
I know of a healthcare organization that keeps paper records and duplicates the information electronically, which doesn't seem too logical to me.
tzubair
100%
0%
tzubair,
User Rank: Ninja
7/30/2014 | 5:29:19 AM
Re: Storage Costs and Retrieval
"I know of a healthcare organization that keeps paper records and duplicates the information electronically, which doesn't seem too logical to me."

@freespiritny25: I think they may be doing that as a pressure from different stakeholders. Having the information stored electronically may be a requirement from the authorities while their patients would be more comfortable with the paper records. To please both stakeholders, they might be caught in the middle and be forced to maintain the information in both forms.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/29/2014 | 6:46:48 PM
Re: Defending the value of EHR versus paper
EHR news this week:

July 25 - "Confidential records targeted by thieves"

http://www.westsussextoday.co.uk/news/county-news/latest-news/confidential-records-targeted-by-thieves-1-6195180

July 28 - "Haley Chiropractic of Tacoma notifies 6,000 patients after office burglary."

http://www.phiprivacy.net/haley-chiropractic-of-tacoma-notifies-6000-patients-after-office-burglary/

July 28 - "When departing employees take your PHI with them...."

http://www.phiprivacy.net/when-departing-employees-take-your-phi-with-them/

July 28 - "Study: Data Breaches Pose a Greater Risk"

http://www.foxbusiness.com/personal-finance/2014/07/23/study-data-breaches-pose-greater-risk/

Criticizing paper records for the cost of storage in an effort to increase the perceived value of EHRs is transparently disingenuous. In light of the epidemic level of data breaches from digital records - that is only getting worse - the storage rationalization makes no more sense than promoting EHRs because of doctors' careless handwriting, or as protection from national disasters.

In my opinion, clueless, vulnerable Americans would be better served if EHR advocates would take ownership of their ever-increasing cost and safety problems rather than serving red herring. 
DarrellP725
IW Pick
100%
0%
DarrellP725,
User Rank: Moderator
7/30/2014 | 8:13:05 PM
Re: Defending the value of EHR versus paper
"Medical identity theft can threaten health as well as bank account," by Julia Dahl for CBS News, July 28, 2014.

http://www.cbsnews.com/news/medical-identity-theft-can-threaten-health-as-well-as-bank-account/
Susan_Nunziata
50%
50%
Susan_Nunziata,
User Rank: Strategist
7/30/2014 | 8:21:04 PM
Re: Defending the value of EHR versus paper
@DarrellP725: This is quite true. Although it can happen both electronically and on paper. A good friend of mine had his identity stolen at a doctor's office in Florida where he was required to write his social security number on a new-patient form. Turned out one of the employees at the doctor's office was selling patient identity--and no electronic records were involved. It took my friend over 5 years and cost him thousands of dollars to clear his name. The use of Social Security Numbers as identifiers in medical facilities should be eliminated altogether, whether records are on paper or electronic.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/30/2014 | 9:43:00 PM
Re: Defending the value of EHR versus paper
Susan, your argument isn't with me. It's with CBS.
Susan_Nunziata
100%
0%
Susan_Nunziata,
User Rank: Strategist
7/30/2014 | 9:58:04 PM
Re: Defending the value of EHR versus paper
@DarrellP725: I didn't realize I was arguing. Then again, I'm Italian, and in my family a normal dinner conversation would sound to other ears like a raging argument.

:)

 
Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/29/2014 | 9:19:40 AM
Re: Defending the value of EHR versus paper
Breaches in EHRs can definitely be life-threatening. If the hacker is not malicious and steals your data expressly to sell it (for the $50 we see bandied around), then someone else could use your medical ID for treatment, surgery, medications, etc. When you, the real patient, need surgery or other healthcare services, you could discover you cannot get treated because "you" owe the hospital thousands of dollars (in unpaid deductibles); you "have a drug problem" (courtesy of a doctor-shopping alter-ego), or "your record" shows you can't be pregnant because your insurance paid for a hysterectomy last year. Or it may show you have no allergies -- when, in fact, you are very allergic to a regularly prescribed antibiotic, for example, leading to health complications or even death. 

It's one reason we cannot let healthcare organizations slide on the amount and resources they spend on security. When we see studies like this -- Healthcare IT Security Worse Than Retail -- we must demand better.
Hospice_Houngbo
100%
0%
Hospice_Houngbo,
User Rank: Strategist
7/29/2014 | 4:43:07 PM
Re: Defending the value of EHR versus paper
@Alison_Diana

You raised some legitimate concerns, but we can we say the same thing about our banking information? People haven't given up online banking despite the threat that cybercriminals might steal access codes for personal bank accounts, credit card and other types of payment card numbers.
Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/29/2014 | 4:50:03 PM
Re: Defending the value of EHR versus paper
No, people have not given up on banking. And I don't think people should give up on EHRs. I do think, however, healthcare organizations should do better (although I empathize with the complex situation some find themselves in, with budgets, mandates, lack of c-level buy-in, etc.).
mhasib
50%
50%
mhasib,
User Rank: Author
7/28/2014 | 3:43:28 PM
Re: Defending the value of EHR versus paper
@vnewman2 - Good points. 
Hospice_Houngbo
50%
50%
Hospice_Houngbo,
User Rank: Strategist
7/29/2014 | 4:31:21 PM
Re: Defending the value of EHR versus paper
@DarrellP725

"Paper records cannot be hacked from the other side of the world."

But this doesn't mean that electronic records are more "risky" than paper records.

"The HIPAA Security Rule is intended to protect Electronic Protected Health Information (EPHI) from unauthorized or accidental theft, loss, destruction or access, from individuals either inside or outside the practice." ....

"if electronic records are properly secured, they would be encrypted such that even if someone were to breach a medical practice's network and get to the data, they would not be able to actually decode the data without the encryption key."

- See more at: ttp://www.physicianspractice.com/blog/are-electronic-health-records-%E2%80%98safer%E2%80%99-paper-records#sthash.FaeXodI5.dpuf
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/29/2014 | 4:52:10 PM
Re: Defending the value of EHR versus paper
@Hospice:

I said that paper medical records cannot be hacked from the other side of the world and you replied, "But this doesn't mean that electronic records are more 'risky' than paper records."

Sure it does.
Jeff Jerome
50%
50%
Jeff Jerome,
User Rank: Ninja
7/29/2014 | 5:25:32 PM
Re: Defending the value of EHR versus paper
@ Hospice HIPPA wow now we are getting real and referencing the rule book.  Great add thank you,
pcharles09
100%
0%
pcharles09,
User Rank: Moderator
7/28/2014 | 9:45:47 AM
How will they know?
In many cases, how will the patients know EHR is used? They usually still fill out paper forms.
mhasib
50%
50%
mhasib,
User Rank: Author
7/28/2014 | 11:12:21 AM
Re: How will they know?
As I mentioned in the article, frequently they do not know. It is important to inform and educate people. Healthcare providers such as doctor's offices that have implemented electronic health records should have patients fill out paper forms. My doctor's office gives people a tablet computer to review and update information. It is quite cool and makes my visits a lot more pleasant - I hate filling out paper forms.
pcharles09
100%
0%
pcharles09,
User Rank: Moderator
7/29/2014 | 10:44:58 PM
Re: How will they know?
@mhasib,

I agree. I think the only concern is the misconception that the good 'ol way of pen & paper is more 'secure' than digital. Once enough information is provided, consumers should understand that there's a digital footprint either way. So they might as well go with the less inconvenient method.
tzubair
50%
50%
tzubair,
User Rank: Ninja
7/30/2014 | 5:32:55 AM
Re: How will they know?
"I think the only concern is the misconception that the good 'ol way of pen & paper is more 'secure' than digital"

@pcharles09: I think more than security, people are concerned about the privacy issue when it comes to EHR. Most people try to relate whatever technology they interact with to an existing technology. When it comes to EHR, a lot of people might relate it to social media because that's very common. They know their pictures and content that they put on social media is secure but they also know that anyone can view it. Hence, the fear that they feel with EHR for the information to get leaked out is natural.
pcharles09
100%
0%
pcharles09,
User Rank: Moderator
7/31/2014 | 9:28:23 AM
Re: How will they know?
@tzubair,

I can understand and appreciate that. At the same time, it does take a lot of education to quell those fears. The problem is that the education is not free & takes a lot of time and hard work.
Alison_Diana
100%
0%
Alison_Diana,
User Rank: Author
7/28/2014 | 2:26:38 PM
Mind the Gap
There seems to be a real lack of knowledge between healthcare customers -- patients -- and providers, in terms of data: How it's used, who has access to it, where it's stored, whether it can be shared, and so forth. Does anyone know of a reputable study regarding consumers' awareness of PHI "ownership and rules," so to speak, which seems to be a natural leapfrog off the topic of EHRs v. paper.
Alison_Diana
50%
50%
Alison_Diana,
User Rank: Author
7/28/2014 | 5:22:17 PM
Wall of Shame
When you view the wall of shame, many breaches are the result of stolen or lost laptops. Some HIPAA breaches are paper-based. It's imperative that healthcare organizations, as a whole, do a better job of securing patient records, no matter where they reside. 
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/28/2014 | 5:48:15 PM
Re: Wall of Shame
According to Ponemon, here's the difference between paper breaches and digital: Only 5% of identities are breached from paper records, and most of these are because of improper disposal. On the other hand, hackers specifically target identities.

This is fun.
mhasib
50%
50%
mhasib,
User Rank: Author
7/29/2014 | 10:08:57 PM
A Helpful EMR Article
This ia a helpful article:

http://www.healthcareitnews.com/news/ending-debate-emr-effectiveness
tzubair
100%
0%
tzubair,
User Rank: Ninja
7/30/2014 | 5:24:44 AM
Selling the change
@Mansur: Great article about the concerns people have about EHR. I think it all comes down to how it's equally important to sell change to the people. Just having a great technology is not enough. When you have a change that will impact the way people have been doing things for a very long time, it's important that you sell the change to them and address to their concerns. The part where you make the new system penetrate into people's lives and replace the existing one is as important as making the new system.
mhasib
50%
50%
mhasib,
User Rank: Author
7/30/2014 | 9:06:53 AM
Re: Selling the change
@tzubair - Thanks. Personally I try not to "sell" people on anything. Rather I try to explain their choices and the consequences in a balanced way. People feel empowered once they are educated. I also explain their rights to them and the fact that the custodians of their data have a legal obligation to protect the privacy of their information. I also explain the questions they should be asking any provider and how they should be engaged in making sure that their providers provide better service and correct any incorrect information.
Susan_Nunziata
100%
0%
Susan_Nunziata,
User Rank: Strategist
7/30/2014 | 6:55:37 PM
Disaster Recovery?
@mhasib: I find it fascinating in your field conversations with people that they did not realize their records would ultimately be rendered in electronic form anyway, as well as run thru a copier where the information could be stored and easily retrieved in the copier's hard drive.

I'm joining this robust discussion late, so you may have already talked about this. My biggest concern about elecronic health records is in the instances of natural disater or other mass disruption, as with Hurricane Sandy in NYC. what do you advise recgarding patient records -- espeically for hospital or ciritcal care facilities -- in terms  of disaster recovery if there is no power available, as was the case for some facilities where generators were underwater and mobile phone service was knocked out.

 
mhasib
IW Pick
100%
0%
mhasib,
User Rank: Author
7/30/2014 | 7:37:35 PM
Re: Disaster Recovery?
@Susan - I teach an entire semester long graduate course on disaster recover and business continuity so I will not be doing justice to your question here. Most often, when EHR is unavailable other healthcare equipment will also cease to function. This has to be planned for. Basically every organization must create plans and conduct exercises using various scenarios. A more common scenario is a lengthy power loss. Most health organizations have emergency operations departments who are real experts at this and can work with IT and other teams to plan scenarios and training and then lead the execution during an actual crisis. It was really fascinating for me to to see what a great job various departments from the City of Baltimore did during major storm power outages. Good strategists always maintain EHRs in multiple geographically distant locations. For most organizations EHR is only 1 of many IT as well as non IT systems and risks for every system has to be planned for.
Susan_Nunziata
50%
50%
Susan_Nunziata,
User Rank: Strategist
7/30/2014 | 8:18:24 PM
Re: Disaster Recovery?
@mhasib: Thanks for your response, much appreciated. I hope that if I'm ever in a healthcare facility during a disaster, that its recovery and continuity plans will have been developed by one of your former students!
mhasib
50%
50%
mhasib,
User Rank: Author
7/30/2014 | 8:42:21 PM
Re: Disaster Recovery?
@Susan - luckily disaster/emergency operations in healthcare is a very mature field and there are many great experts (who are not my students) in this field.
D.M. Romano
100%
0%
D.M. Romano,
User Rank: Moderator
7/31/2014 | 8:20:31 AM
Better?
To be honest, I'm baffled at the fact that people think paper records are in some way better. Notice I said better. Are your records safer in a physical state rather than being online? Maybe. Is there more of a chance for an attacker can sabotage, utilize, or even manipulate your records in this fashion? Sure. But personally I'd rather allow the risk of my information being compromised for the sake of expediency (if that were the issue). And I'm saying this while working as a security analyst where I review vulnerability on a daily basis. 
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/31/2014 | 10:54:28 AM
Re: Better?
D. M. Romano, you have never experienced identity theft, have you.
D.M. Romano
50%
50%
D.M. Romano,
User Rank: Moderator
7/31/2014 | 10:56:50 AM
Re: Better?
@Darrell - indeed I have. And while I understand the reluctency of some who prefer "paper transactions," the world we live in nowadays just won't support this strategy for much longer. 
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/31/2014 | 11:11:33 AM
Re: Better?
D. M. Romano: In spite of the fact that EHRs are more expensive, less secure and more dangerous than paper records? That would be foolish.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/31/2014 | 12:07:54 PM
Re: Better?
Simply saying something is inevitable, doesn't make it so, even with a mandate. Until HIT stakeholders take ownership of the devastating problems with EHRs - by first acknowledging that paper records are increasingly superior - there will never be an urgency to resolve the problems, and EHRs will never reach their potential.

We have all witnessed that just because a now discredited 2005 RAND study promised savings of $77 billion and 100,000 lives a year by adopting EHRs doesn't make it so. And just because President George W. Bush promised that virtually all healthcare providers would have interoperable EHRs by 2014, also doesn't make it so.

In case anyone missed it, a couple of days ago, in addition to the FBI's April 6 warning that EHRs are becoming increasingly more susceptible to hackers, I mentioned that David Blumenthal M.D., the former national coordinator for health information technology says "... from the provider's perspective, there are substantial costs in setting up and using the [EHR] systems. Until now, providers haven't recovered those costs, either in payment or in increased satisfaction, or in any other way." (See: "Why Doctors Still Use Pen and Paper -The healthcare reformer David Blumenthal explains why the medical system can't move into the digital age," by James Fallows, for The Atlantic, March 19, 2014).

http://www.theatlantic.com/magazine/archive/2014/04/the-paper-cure/358639/

A few days ago, I read an InformationWeek article by Alison Diana announcing that the Senate Appropriations Committee is seeking an investigation into whether "taxpayer-supported software is preventing the free exchange of patient records between non-partnering healthcare organizations" (See: "Senate Committee Seeks EHR Interoperability Investigation - Bipartisan Senate Appropriations Committee wants an investigation into poor interoperability, possible 'information blocking' in electronic health records").

http://www.informationweek.com/healthcare/electronic-health-records/senate-committee-seeks-ehr-interoperability-investigation/d/d-id/1297580

Because of strategic misinformation, lack of transparency and wishful thinking in the HIT industry, interoperable EHRs are sounding less and less like a sure thing by 2014, 2016 or even 2020.

Interoperability is the key to EHR success. You'll never get there by attempting to discount the value of paper records. People will simply stop believing you.
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
7/31/2014 | 2:40:03 PM
Re: Better?
"Provider Use of EHRs Could Deter Patient Disclosure, Study Finds," iHealthBeat, July 31, 2014.

http://www.ihealthbeat.org/articles/2014/7/31/study-provider-use-of-ehrs-could-deter-patient-disclosure

"Some patients withhold information from their health care provider out of privacy and security concerns related to the use of electronic health records, according to a study published in the Journal of the American Medical Informatics Association, FierceEMR reports (Durben Hirsch, FierceEMR, 7/28)".
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
8/3/2014 | 1:19:58 PM
Re: Better?
"Complaints about electronic medical records increase," by Bill Toland for Pittsburgh Post-Gazette, August 3, 2014

http://www.post-gazette.com/business/2014/08/03/Complaints-about-electronic-medical-records-increase/stories/201407250006#ixzz39LmZEvLE
DarrellP725
50%
50%
DarrellP725,
User Rank: Moderator
8/7/2014 | 9:30:26 AM
Re: Better?

 


"U.S. Homeland Security contractor reports computer breach"

http://news.msn.com/science-technology/us-homeland-security-contractor-reports-computer-breach

"A company that performs background checks for the U.S. Department of Homeland Security said on Wednesday it was the victim of a cyber attack, adding in a statement that 'it has all the markings of a state-sponsored attack.'"

 



The Business of Going Digital
The Business of Going Digital
Digital business isn't about changing code; it's about changing what legacy sales, distribution, customer service, and product groups do in the new digital age. It's about bringing big data analytics, mobile, social, marketing automation, cloud computing, and the app economy together to launch new products and services. We're seeing new titles in this digital revolution, new responsibilities, new business models, and major shifts in technology spending.
Register for InformationWeek Newsletters
White Papers
Current Issue
InformationWeek Tech Digest - September 10, 2014
A high-scale relational database? NoSQL database? Hadoop? Event-processing technology? When it comes to big data, one size doesn't fit all. Here's how to decide.
Flash Poll
Video
Slideshows
Twitter Feed
InformationWeek Radio
Sponsored Live Streaming Video
Everything You've Been Told About Mobility Is Wrong
Attend this video symposium with Sean Wisdom, Global Director of Mobility Solutions, and learn about how you can harness powerful new products to mobilize your business potential.