Designing solutions for securing patient privacy--meeting the demands of health care in the 21st century.
OBJECTIVE
To define the issues surrounding patient privacy, examine the political context in which debate is taking place, and present a novel technology model for addressing privacy, confidentiality, and security in 21st century health care.


CONCLUSIONS
The discussion of privacy addresses one of the basic issues in health care today--the tension between the needs of the individual patient for privacy and confidentiality and the needs of society to effectively manage health care practices and control health care costs. Patient concerns for privacy, confidentiality, and security are legitimate, and can usually be reduced to issues that potentially affect an individual's employment, ability to get and maintain health coverage, and have control over his or her records and care. These concerns, combined with several precipitating events, are forcing the issue of privacy into the political arena, where new health policy decisions will be made. The debate must be framed within a principle-centered approach that focuses on boundaries, security, consumer control, accountability, and public responsibility. A global, distributed electronic health record management model that provides location-independent, secured, authenticated access to relevant patient care records by qualified health care professionals on a need-to-know basis provides solutions. Information asset considerations should be designed to equitably represent the ownership needs of corporate entities, society, and the individual.


CONCLUSIONS
A secure electronic health record structure that systematically ensures a high level of accountability combined with thoughtful dialogue among key stakeholders in the public policy development process can offer the privacy outcomes we seek.
Bluml
B M
BM
American Pharmaceutical Association Foundation, Washington, D.C., USA. bmb@mail.aphanet.org
Crooks
G M
GM
D003695:Delivery of Health Care / Q000379:methods / Q000592:standards*; D004581:Electronics; D005544:Forecasting; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000592:standards*; D010344:Patient Advocacy / Q000592:standards*; D011050:Policy Making; D011057:Politics; D014481:United States