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Bring up the subject of digitizing medical records and you're likely to get a paradox of a discussion. Everyone thinks it will help save money and improve health care, and everyone has grave reservations. Get ready to hear more as a massive economic stimulus bill works its way through Congress, which includes IT health care spending measures. Although lawmakers are close to pulling the trigger. ensuring the privacy of patients' electronic health records (EHR) remains a top concern. "I very firmly believe that the Achilles heel of health IT is privacy," said Sen. Jim Whitehouse, a Rhode Island Democrat who chaired a hearing this morning examining the appropriate safeguards government should insist on before it doles out billions of dollars to help providers computerize patients' records. Champions of health IT argue that EHRs and interoperable systems to integrate data among providers would drive down healthcare costs while greatly reducing medical errors. Just 17 percent of physicians currently have even basic EHRs. The Center for Disease Control has estimated that as many as 98,000 preventable deaths occur in U.S. hospitals each year, many of which could presumably been avoided with more accessible patient data. "If 100,000 Americans were being killed by anything else, we'd be at war," Whitehouse said.

Overview Privacy is a fundamental human right. It underpins human dignity and other values such as freedom of association and freedom of speech. It has become one of the most important human rights of the modern age.[1] Privacy is recognized around the world in diverse regions and cultures. It is protected in the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, and in many other international and regional human rights treaties. Nearly every country in the world includes a right of privacy in its constitution. At a minimum, these provisions include rights of inviolability of the home and secrecy of communications. Most recently written constitutions include specific rights to access and control one's personal information. In many of the countries where privacy is not explicitly recognized in the constitution, the courts have found that right in other provisions. In many countries, international agreements that recognize privacy rights such as the International Covenant on Civil and Political Rights or the European Convention on Human Rights have been adopted into law. Defining Privacy Of all the human rights in the international catalogue, privacy is perhaps the most difficult to define.[2] Definitions of privacy vary widely according to context and environment. In many countries, the concept has been fused with data protection, which interprets privacy in terms of management of personal information. Outside this rather strict context, privacy protection is frequently seen as a way of drawing the line at how far society can intrude into a person's affairs.[3] The lack of a single definition should not imply that the issue lacks importance. As one writer observed, "in one sense, all human rights are aspects of the right to privacy."[4]

Twenty-three of the 24 major U.S. government agencies contain weaknesses in their information security programs, potentially placing sensitive data at risk to exposure, according to a government report issued this week. The U.S. Government Accountability Office (GAO) studied how the agencies were responding to the regulations described in the Federal Information Security Management Act of 2002 (FISMA). The mandate requires government entities to develop and implement an agencywide information security program. Inspectors general conduct annual reviews of agency progress. The GAO review, which took place between last December and this month, concluded that, partly based on inspectors general and federal Office of Management and Budget (OMB) reports, that 23 of 24 agencies contain lax controls to ensure that only approved users can access system data. Meanwhile, 22 of 24 agencies described information security as a "major management challenge," according to the report.

The problem with securing data and insuring its safety is that there is simply so much more stored electronically these days that opportunities for outside hackers or insiders to steal valuable, confidential information off a company's computer systems are growing exponentially, according to those in the insurance industry who make it their business to cover this expanding exposure. Indeed, "you can take out more data in a thumb drive now than people could take out in a super-computer 10 years ago," according to Kevin Kalinich, co-national managing director for Professional Risk Solutions at Aon. The risk of a data breach is very real for companies large and small across almost any industry, noted Mr. Kalinich. He cited a report from the University of California, Berkeley, that more data has been aggregated and stored in the last three years than in the entire history of mankind. He also noted that between 75 and 85 percent of Fortune 2000 companies have suffered a "material data breach," meaning there is a growing market for those selling insurance coverage for liability and repair costs, as well as loss control services. Companies that take an "it won't happen to me" approach to securing data need only look at news headlines to see that organizations are often hit by breaches, and as more data is being stored electronically, the potential for, and impact of possible breaches increase. Princeton, N.J.-based credit and debit processing company Heartland Payment Systems reported that it had been compromised in 2008 in a breach that involved up to 100 million records, which would be tops for number of records accessed in a breach. The Heartland incident would displace the 2007 breach of TJX, in which over 45.6 million credit and debit card numbers were stolen. The TJX breach, in turn, took the record set by a breach of CardSystems Solutions in 2005.

Urging Privacy Protections with Health IT Privacy safeguards are needed if funds are to be provided for implementation of health IT systems in economic stimulus package. At today's news conference, the Coalition for Patient Privacy is releasing a letter sent to Congress advocating for the inclusion of privacy safeguards with any funding given to implement health IT systems in the proposed economic stimulus package. In the letter, the bipartisan coalition, representing over 30 organizations, individual experts and the Microsoft Corporation, welcomes the renewed commitment in Congress to protecting consumers over special interests, but makes clear that trust is essential to health IT adoption and participation, and only attainable with privacy protections. The coalition is calling on Congress to "A.C.T.", by providing: accountability for access to health records, control of personal information, and transparency to protect medical consumers from abuse. Consumer trust is essential to health IT adoption and participation, and only attainable with privacy safeguards. Through these three tenets, implementation of health IT is not only attainable, but would protect the right to privacy for consumers, employees, and providers.