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The Times They Are A-Changin’

Bob Dylan

Come gather ’round people
Wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You’ll be drenched to the bone.
If your time to you
Is worth savin’
Then you better start swimmin’
Or you’ll sink like a stone
For the times they are a-changin’.

…………..

Copyright © 1963; renewed 1991 Special Rider Music

One of main barrier for widespread use of Personal Health Record has been privacy.Many potential users of PHR are concerned about Privacy of their health information.
People fear that online use of PHR will result in loss of privacy and can have potential serious ill-effects.While some of these concerns are justified as Health is an intensively personal subject although it is a Universal right.

But what does privacy mean in 21st Century.We need to look in what others mean by privacy.

Privacy no longer can mean anonymity, says Donald Kerr, the principal deputy director of national intelligence. Instead, it should mean that government and businesses properly safeguard people’s private communications and financial information.

Millions of people in this country _ particularly young people _ already have surrendered anonymity to social networking sites such as MySpace and Facebook, and to Internet commerce. These sites reveal to the public, government and corporations what was once closely guarded information, like personal statistics and credit card numbers.

“Those two generations younger than we are have a very different idea of what is essential privacy, what they would wish to protect about their lives and affairs. And so, it’s not for us to inflict one size fits all,” said Kerr, 68. “Protecting anonymity isn’t a fight that can be won. Anyone that’s typed in their name on Google understands that.”

“Our job now is to engage in a productive debate, which focuses on privacy as a component of appropriate levels of security and public safety,” Kerr said. “I think all of us have to really take stock of what we already are willing to give up, in terms of anonymity, but (also) what safeguards we want in place to be sure that giving that doesn’t empty our bank account or do something equally bad elsewhere.”

Kurt Opsahl, a senior staff lawyer with the Electronic Frontier Foundation, an advocacy group that defends online free speech, privacy and intellectual property rights, said Kerr’s argument ignores both privacy laws and American history.

“Anonymity has been important since the Federalist Papers were written under pseudonyms,” Opsahl said. “The government has tremendous power: the police power, the ability to arrest, to detain, to take away rights. Tying together that someone has spoken out on an issue with their identity is a far more dangerous thing if it is the government that is trying to tie it together.”

Opsahl also said Kerr ignores the distinction between sacrificing protection from an intrusive government and voluntarily disclosing information in exchange for a service.

Additional Info

But as the debate over privacy continues.Personal health record privacy issues also needs to be carefully assessed in these changing times.

In a recent Wall Street Journal Online/Harris Interactive Healthcare Poll:

One key concept is that patients would have control over an Internet-based medical record and they would decide with whom and when to share that information. But, as when banking or shopping first went online, there have been issues of privacy concerns regarding healthcare data as well. As things become more common though, these concerns tend to wane, evidenced by a 10-point drop this year (from 61% in 2006 to 51%) in those who say electronic records make it difficult to ensure privacy. When it comes to other online medical services, three-fourths of adults feel that patients should be able to schedule an appointment with their physician via email or the Internet (77%) and communicate with their physician via email (75%). These online applications are big first steps in overcoming privacy concerns.

More adults (60%) feel that the benefits outweigh the privacy risks than those who do not (40%). Majorities agree that electronic medical records could reduce healthcare costs (55%), decrease medical errors (63%), and reduce redundant tests (67%) – similar to 2006 results. Even more (74%) believe that patients could receive better care if doctors and researchers were able to share information more easily.

Personal Health Record are now definitively a part of the lexicon of modern health care.

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Why is that despite the presence or more than 200 vendors of PHR products only less than 5 % of the consumers in North America use any PHR.

The main reasons are:

1.Lack of privacy policy

2.Lack of communication between providers and users

3.Lack of education about benefits of PHR.

In the first generation model of PHRs,

Vendors have had a hard time selling the idea of a personal medical diary to healthy consumers who see their doctors maybe once or twice a year. In addition to privacy and security concerns, patients are staying away because the PHRs on the market aren’t doing much to entice them, analysts say. The industry also has failed to come up with a convincing argument for why doctors should encourage their use.

But ,now with the growth of Web 2.0 technology,PHR can developed with next generation models,
Vendors are reaching out to health plans and employers in hopes of encouraging PHR use through incentives. And expanded data sets make the records more useful to physicians.
as PHR vendors add functionalities such as secure e-mailing and online scheduling, more people will create PHRs.

Also the lack of consensus definition about what exactly is PHR is hampering widespread use.Many of the consumers and also vendors assume that PHR ane EHR are one and the same product.While in some aspects they deal with your health record,but in reality they are two different entities all together.

PHR are individually controlled record of your health either in electronic or paper based format.While EHR are your health records controlled by the Hospital or medical center,

The future:

But while there is great hope for the future of PHRs, it remains to be seen what role they will play in transforming health care, even if they gain widespread acceptance among patients.

Many physicians and also patients are still skeptical about the potential benefits of PHR,they feel that it may not deliver the results as projected.Only time will tell,when internet came around in the nineties many thought it was also a passing fad,but today it is part of our life.

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