Medical record confidentiality continues to be the source of hotly contested ethical debates, litigation and academic studies. With the national health care bill passing, it is only a matter of time before medical record confidentiality is put to the very limits of ethical and legal boundaries. The digitization of medical information and the subsequent transfer of this information over the internet will promote speedy treatment, prevent accidents and cut costs. At the same time, a patient's information can become compromised as more people have access and the cost of dissemination decreases. Medical record confidentiality is carefully monitored with protocols in place by both the American Medical Association and the revised Health Insurance Portability and Accountability Act. Society is quickly allowing all aspects of life to be available on the web, but the road must be tread lightly. Trust and security of medical information must be maintained at all times.
The basic concept of the protection provided by the doctor-patient privilege is simple. Information cannot be disclosed about anything found by a doctor during treatment or disclosed by a patient at anytime in the care of the doctor. The rationale is simple. A patient is less likely to disclose frank or sensitive information if that patient believes what he says could be made public. Likewise, a doctor cannot disclose anything that my negatively (or positively) affect the patient's life that is discovered during care. Either of these instances could lessen the quality of care a patient receives. Like the lawyer-client privilege, this medical record confidentiality agreement is sacrosanct.
How is medical record confidentiality maintained?
Whether medical information is on microfiche, microfilm, paper, or digital, the same concept holds true. The information must be authorized by the appropriate parties for release to any third party. This is the only way to guarantee that the patient's best interests are in mind. An authorization does not need to come from the patient necessarily. Juveniles must have information requests signed by a parent or legal guardian, persons with medical Powers of Attorney over another party can authorize release of records and a deceased person's records can be cleared for release by the executor of the estate. Each state has specific statutes detailing the release of information policies and proper procedures for obtaining medical records. These procedures can vary from state to state, but all are specifically geared to maintaining medical record confidentiality.
How does confidentiality improve care and cut costs?
Maintaining the security and privacy of a patient can go a long way to improving care and cutting the costs of treatment. Once medical record confidentiality is properly guaranteed across all platforms, then and only then can electronic records be safely implemented. The ability to transmit information from facility to facility or house information in a public database can literally be a lifesaver. Previous surgeries, allergies, and other medical conditions can be immediately known to current care providers. In an emergency room, this ability to access information can be critical. For both emergent and routine procedures, a facility can instantly determine if the same tests, xrays, or labs were just performed and what the results indicate. This can cut costs by cutting duplicate tests and procedures. Both of these are important benefits to medical record confidentiality.
Medical record confidentiality will continue to be a hot political and social issue in the coming decade. Advances in digitization techniques and devices to receive digital downloads wirelessly are exploding in our culture. The ethical and legal requirements of medical record confidentiality cannot be ignored, however, in this process. Accessibility is important but so is morality.