Although US doctors back the use of electronic health records, concerns about potential privacy breaches are still an issue, indicate two pieces of research published in the January issue of the Journal of the American Informatics Association (JAMIA).
The first study is based on the views of more than 1,000 family practice and specialist doctors across the State of Massachusetts in the US, who were asked whether they thought electronic health information exchange (HIE) would drive down costs, improve patient care, free up their time and preserve patient confidentiality.
They were also asked whether they would be willing to stump up a monthly fee to use the system.
The electronic exchange of health information (HIE) among different long distance providers has become the focus of intense national interest in the US , following recent legislation and moves to offer cash incentives for those who switch to the system.
The responses showed widespread support for the use of HIE, even though only just over half were actually using electronic health records.
Most (86%) said that HIE would improve the quality of care and seven out of 10 thought that it would cut costs. Three out of four (76%) felt that it would also save time.
But 16% said they were "very concerned" about potential breaches of privacy, while a further 55% were "somewhat concerned."
The authors note that the responses indicate a lower level of concern than that expressed by UK doctors, but suggest that this might change if more extensive breaches than hitherto take place.
But despite their overall enthusiasm, doctors were not willing to stump up the suggested US$150 monthly fee, and nearly half were unwilling to pay anything at all.
A second study reported in JAMIA, suggests that mental health professionals had some significant concerns about the privacy and security of data on electronic health records.
Of 56 responding psychiatrists, psychologists, nurses, and therapists - out of 120 who were sent the surveys - based at one academic medical center, most (81%) felt that the system permitted the preservation of "open therapeutic communications." Most also felt that electronic records were clearer and more complete than paper versions, although not necessarily more factual.
But when it came to privacy, almost two thirds (63%) were less willing to record highly confidential information to an electronic record than they would be to a paper record.
And more than eight out of 10 (83%) said that if they were to become a patient, they would not want their own mental health records to be routinely accessed by other providers.
The authors point out that previously published surveys of patients/consumers have reflected a lack of confidence in watertight security, and that people with mental health issues already face stigmatisation.
While the narrative data of patients' life histories and experiences inform clinical decision making in psychiatric care, security breaches lay them open to potential misuse or misinterpretation, they say.
Uptake of electronic health records has been slower than anticipated, they add. And they conclude: "Designers of future systems will need to enhance electronic file security and simultaneously maintain legitimate accessibility in order to preserve confidence in psychiatric and other [electronic health record] systems."
"The ramifications of data security cover more than the psychiatric domain, implying a need for considerable reflection," they say.