Balancing Privacy and Transparency in Patient Relationships

As more physicians adopt advanced technology tools to streamline administrative and clinical duties, there is likely to be some loss in patient confidentiality. New systems like Electronic Health Records, telemedicine and mobile health apps may offer more patients greater access to their medical information, but these tools are hardly perfected.  Increasing patient access also potentially exposes personal information to employers, insurance companies, and various criminal elements.  Access to Personal Information For many physicians who value their patients’ right to privacy, there may be some resistance to transitioning to a completely digital workplace, and it would appear that most patients support them in their unwillingness to adopt these new services.  According to a 2014 HRI survey, more than 70% of respondents prioritized data security regarding medical tests and doctor’s advice over ease of access, and 65% felt the same regarding drug prescription information.  These deep-seated misgivings about technology has important implications for physicians; without assurances of confidentiality, almost 56% of patients would refrain from sharing everything, while 51% would not participate in clinical trials. Physicians have long been trusted with private information that patients would be reluctant to share with others.  This willingness to share private information is predicated on the belief that this information will improve the quality of medical care provided. In a 2006 Markle Foundation survey, almost 97% of patients were willing to grant their physicians access to all of their records in return for the best care possible. Electronic Health Records The government has long been an important overseer defining the limits of patient rights, but the recent implementation of the American Recovery and Reinvestment Act has also made it an active participant in the debate surrounding privacy issues. Under this law, all healthcare organizations must introduce Electronic Health Records by this year or face severe financial penalties. While the process of introducing these digital services is continuing at an accelerated pace, the standardization of health records is a difficult task, one that will likely take several years to complete. Until then there are likely to be significant organizational system incompatibilities which will prevent fully open channels for information dissemination.  It is unknown whether this will facilitate or hamper access to private patient information for unauthorized users, but the recent reports of major data breaches both within and without the healthcare industry suggest that digital security should and will be a high priority for the foreseeable future. Physician Transparency Transparency is also relevant to the professional associations of treating physicians.  As more patients become savvy about professional relationships within the healthcare community, there is a growing desire to know which physicians are earning payments from major pharmaceutical companies.  Almost 37% of respondents in a recent survey were less likely to rely on a doctor who was being paid by drug companies. While compromised physician responsibility is only relevant to a minority of clinicians, the importance of maintaining a robust trust relationship with patients is essential to producing optimal outcomes throughout the profession.  A loss of trust will undermine patient openness and compliance.  The U.S. Department of Health and Human Services found that privacy concerns prevented almost 586,000 Americans from seeking earlier cancer treatment and 2 million Americans from obtain mental health care. There has never been more demanded of physicians than there is today.  With advancing technology, increased governmental intrusion and shifting social values, more and more is expected from doctors who are often tempted to transfer privacy concerns to administrators.  While patient privacy and transparency issues are likely to be lower on the list of concerns, it is vital to their health and wellbeing that a strong trust relationship is cultivated and maintained.

Written by:  Robert Moghim, M.D., CEO- Moghim Medical Consulting Inc.

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