Journal of Nursing

Doctors and Patients Worry About E-Health for Different Reasons


A new study finds while both government and industry organizations have been pushing electronic records systems, doctors remain reluctant to do so

Concerns about costs, adverse affects on patients and the danger of being locked in to outmoded technology have so far stopped all but 17 percent of US physicians from adopting an electronic records system, according to a new study.

The study finds while both government and industry organizations have been pushing health carers to adopt electronic records systems, doctors remain reluctant to do so.

The study comes as a non-profit advocacy group has issued a new call for the adoption of a comprehensive privacy and security framework for e-health to protect patients' interests.

The study - led by Catherine M DesRoches at Massachusetts General Hospital's Institute for Health Policy - found just 17 percent of US physicians use electronic records systems, defined as one encompassing patients' medical records, prescription lists, problems, and notes from past visits and which allows doctors to order prescriptions and tests, and review results from those tests. Patients should also be able to easily access and transmit their own medical records when necessary.

"When you use a good definition of what a record system is, very few physicians appear to have one," DesRoches says.

Of the 2758 doctors the report's authors surveyed nationwide, just four percent reported having a fully functional system, with another 13 percent claiming to be running a basic system.

Primary care doctors and doctors with large practices or those in hospitals or medical centres were significantly more likely to have electronic medical record systems.

The findings are slated to appeared in an upcoming edition New England Journal of Medicine. Doctors cited concerns about implementation costs and return on investment, system downtime preventing them from seeing patients and that their systems would not prove either scalable or flexible enough to meet future technology needs.

Despite those concerns, however, physicians who do have electronic health records systems in place are "very satisfied with them", the report finds.

The study comes as The Centre For Democracy & Technology issues A Briefing On Public Policy Issues Affecting Health Information Technology calling for the adoption of a comprehensive privacy and security framework for Health IT.

CDT says the increased use of IT to support exchange of medical records and other health information has created a need to adopt a comprehensive privacy and security framework for protection of health data. It says privacy and security protections will build public trust, which is crucial if the benefits of health information technology (health IT) are to be realized.

"In CDT's view, implementation of a comprehensive privacy and security framework will require a mix of legislative action, regulation and industry commitment and must take into account the complexity of the evolving health exchange environment," the report says.

"Privacy and security are paramount concerns for any health IT system and must be addressed at the outset. With a comprehensive, thoughtful, and flexible approach, we can ensure that the enhanced privacy and security built into health IT systems will bolster consumer trust and confidence, spur faster adoption of health IT, and bring the realization of health IT's potential benefits.

"Without a comprehensive health IT privacy and security framework, patients will engage in 'privacy-protective' behaviours, which may include withholding crucial health information from providers or avoiding treatment. The consequences are significant - for individual as well as population health," it says. The centre wants health IT policies and practices to be built on three fundamental principles, as outlined by the Markle Foundation's Connecting for Health:

  1. Implementation of core privacy principles,

  2. Adoption of trusted network design characteristics, and

  3. Establishment of oversight and accountability mechanisms.

Copyright 2008- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved


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Editor-in Chief:
Kirsten Nicole

Editorial Staff:
Kirsten Nicole
Stan Kenyon
Robyn Bowman
Kimberly McNabb
Lisa Gordon
Stephanie Robinson

Kirsten Nicole
Stan Kenyon
Liz Di Bernardo
Cris Lobato
Elisa Howard
Susan Cramer