Cloud computing, your patient information, and privacy

In the not too distant past, healthcare providers sometimes worried that reliance on technology might put private patient information at risk. For example, they might have debated whether having a computer technician restore information from a damaged hard drive might be unethical, as the technician would see confidential patient information.

Gradually, both patients and providers became comfortable with the burgeoning reliance on digital storage of patient records. It was, in fact, the convenience of being able to share the information with specialists, pharmacists, specialists, and so on that made electronic medical records so appealing. Further, patients enjoy being able to access their records online, communicate with providers through email or other web-based technology, and make scheduling and payments over the Internet.

When I first heard the phrase “cloud computing,” I was excited to think I might be able to put things in “the cloud” and access them from various devices. Indeed, I do enjoy being able to access the music and videos I have on iTunes from my laptop, desktop, and handheld devices. I assumed, though, that my files were in the cloud because I wanted them there, but I was surprised when someone told me of having all her files restored by a technician who got them from the cloud. She had no idea that her files were in the cloud in the first place. As excited as she was to have these important files restored, it was a bit disconcerting to know that they were in the hands of third (and fourth or fifth?) parties in the first place. How many technicians in how many companies have access to our information?

So, now we move to electronic medical records, a digital archive of our most private information. As noted in the American Medical News blog, in 2011 55 percent of office-based physicians used electronic health records and 41 percent of those were in a cloud-based system. The blog, by Pamela Lewis Dolan, cites information from Jonathon Padron, senior client service analyst for comScore, and Internet analytics company. From the blog: “Because EHR data give marketers the ability to target messages in a more granular way to the specific physician, it’s very effective for marketers, Padron said. For example, the system can identify the condition a physician is looking at and automatically pup up a drug that can treat it.”

These ads are linked to keywords, of course, just as you see ads related to a condition you search on WebMD. We trust that our searches, the doctors’ searches, and our names and medical records are not combined for nefarious reasons. Howard Burde, a health IT lawyer, offers this assurance: “The technology is improving such that data is more and more secure all the time. The problem isn’t the technology, it’s the people.” Everything is all right then, see?

I see two bits of take-away information in all of this: 1. Our private health information is being spread further in cyberspace than we might care to think about. 2. Pharmaceutical and device manufacturers will aggressively use any means available to insert themselves into our healthcare decisions by targeting healthcare providers and patients with intrusive influence at all levels. Of course, if access to healthcare, or at least health insurance, is actually guaranteed by the Affordable Care Act, we may be less concerned about our information being shared. I don’t want to be embarrassed by my private information, but I prefer being embarrassed to being uninsured.