Saturday, February 01, 2014

Should Medical Records be Released to the Public Online?


With the adoption of electronic medical records and the advent of CRISP, Maryland's centralized collection of health information (it's an opt-out, if you haven't, you're in it, and if you opt out, they still get your info, they just don't release it), I'm coming to accept that there is no medical privacy.  Before you get distressed, the system does not include physician notes -- it's tests per the labs, medications per the pharmacies, radiology reports, and perhaps hospital discharge notes.  I'm  not aware of any psychiatrists who are feeding information into the system, but if you're in Maryland and you're filling a prescription for a psychotropic, or getting a lithium level done, it goes into the system.  Most doctors still can't access it, and the Emergency Rooms says the information is invaluable,  in situations where people don't know what medications they take or what tests they've had, the information can be lifesaving.  I, personally, wish that the system included patient consent, and some type of first-visit access grant, such as a ATM card with a PIN number, so that patients could be certain that only the people treating them have access to their records.  Among the thousands of authorized users, misuse of the information is limited only by the honor system, and the fear of repercussions if caught. 

With that as a prelude, The VA has posted the medical records of the Navy Yard Shooter on line, with the names of the doctors redacted.  The VA or AP did not feel inspired to redact the shooter/patient's name in the statement that was made in their release statement, but I have redacted it for our blog in abiding by our Shrink Rap policy to not use the names of mass murderers for fear that the publicity they receive creates a reason to commit such atrocities.

"The Veterans Affairs Department agreed that the public interest in the mass killing outweighed [the Navy Shooters’] privacy rights in keeping his treatment records secret after his death."
The shooter is dead, his actions destroyed the lives of many, the tragedy is obvious. But is "public interest" (meaning 'curiosity')  a reason to reason to forgo the usual ethical requirements established by the AMA  before scanning someone's medical/psychiatric records onto a public website and releasing them to the Associated Press? What do you think? Perhaps the public has a right to know, but perhaps a summary? Where is the precise line for public interest versus personal health privacy?  What other lines might be drawn?