Privacy vs. efficiency as Britain moves to electronic health records

The dueling priorities of the convenience and efficiency of digitalized health records and the significance of patient privacy is one that is looming as health care reform continues its long, slow slog through Congress. But it's possible that we are getting a preview of potential problems to come with recent events in England.

A new electronic medical records database is causing quite a stir: among the complaints about the system are that the system is being pushed through too quickly, and that health officials will potentially have access to patients' sensitive health information without their knowledge or consent. Indeed, the British Medical Association admitted that some patients' records might have gone into the system without the appropriate 12 weeks' prior notice - time that was intended for patients to decide whether to opt-out of participating in the system.

According to the BBC, so far a little more than 1 million records have been entered into the system; and 50 million are projected to go in by 2014. Reports the BBC: "Before a patient's details go into the database, they will receive a pack containing information about the Summary Care Record. If they decide they do not want to be on the database, the pack contains an order form and pre-paid envelope which they can use to order an opt-out form."

According to Sky News, the database system was settled over a different option, wherein patients would have their own personal "smart card" containing their medical records, that could be easily accessed if necessary. Officials ultimately believed that system would be too unreliable.

Digital medical records were brought up several times during the 2008 presidential campaign by both Barack Obama and John McCain. President Bush at one point also identified a goal of every citizen having his or her own electronic medical record by 2014. But initiating such a system can be extremely costly - although it would likely save money in the long term, in addition to improving preventative care and reducing errors. The New England Journal of Medicine estimated in 2008 that initial costs of implementing electronic records can be as high as $36,000 per doctor, because of the computers, servers and software required.

Though the U.S. lags behind other countries in many health-related areas, electronic records included, USA Today suggests that the model for a digitalized system is in our own backyard: "One needs to look at the Department of Veterans Affairs for an optimal model. All of the VA's primary care physicians, specialists and hospital-based doctors across the country use the same electronic record system. It has played a significant role in the reduction of medical errors, optimization of cost efficiency, and attainment of high scores in preventive care measures."