"I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know." (1) This excerpt from the modern Hippocratic Oath to which every doctor swears by; it was set to ensure that each patient’s information and condition is kept private.
The communal spaces of a clinic pharmacy or hospital often don't mirror the tenet for medical privacy. For example, standing in line waiting to ask the pharmacist a personal question can be an embarrassing and even traumatizing ordeal as complete strangers stand within earshot. For many patients, simply having to divulge personal health information (PHI) can be an uncomfortable occurrence in itself. Couple this fear with the security and privacy risks inherent to anything of a personal nature, particularly one’s own medical information. Being sick today or even going in for an annual exam or wellness visit connotes a hesitancy on patients who are all to wary of things like identity theft.
Having access to a healthcare provider online is less stressful and more practical for many patients. "People are often more comfortable talking to a computer than they are to a doctor," said Dr. Delbanco, a professor of medicine at the Harvard Medical School and the lead author of an article on doctors and e-mail in the current New England Journal of Medicine(2). However, the convenience of emailing your doctor or clinic to ask your provider questions brings up risks.As the digital and healthcare worlds advance their symbiotic relationship into the 21st. Century new threats to personal health information have also emerged in recent years.
Did you email your question to the correct person at your clinic? Did they reply to the email directly or use contact information in their electronic medical record database? In a 2005 study 70% of Americans are concerned that personal health information could be disclosed as a result of weak data security(3). With each technological advance, both the medical field and patients must be aware of the severity of improper use of public health information (PHI). According to the Heath Privacy Project, a patient's rights information site, one in five patients are victims of improper disclosure (4).
In spite of all these risks, patients continue to utilize email and the internet in order to seek out answers to various health queries. Some visit sites such as WebMD's Symptom Checker to find why they’re left leg is swollen, while others simply spend time at sites such as the American Diabetes Association that are strictly devoted to specific health issues. Patients often research and want to ask questions about their conditions after clinics are closed.
"It's a matter of both convenience and comfort level," Dr. Delbanco, an advocate for the continued relationship of email, the internet and medicine says. "In the office, a doctor sits there in a white coat exuding authority, which can be scary. There's evidence that people tend to be more open in front of a computer, especially with tricky stuff like alcohol or sexual behaviors." (5)
Online behavior shows that not only patients but many within the medical field want to take accessing medical information a step further. Both medical providers and patients wish to use the internet as a tool in their personal healthcare communications. "The internet will increasingly change patients' expectations of the clinicians, so that physicians will routinely need to offer services like e-messaging, instant messaging, video conferencing and other online services," according to Dr. Daniel Z. Sands, a primary care internist and Assistant Professor of Medicine at Harvard Medical School (6).
Trends in patient internet use show that now is the opportune time for both patient and doctor to achieve a cooperative symbiosis within the digital ether. The digital medical office is a true possibility, but measures need to be put into place to protect patients' private health information and a clinic’s electronic medical records.
The internet has changed where and how patients seek the help of doctors and medical providers. The e-medical caregiver can converse with his or her patients in a wide array of online communications tools, continuing the symbiotic relationship between doctor and patient. The Hippocratic Oath's tenets of treatment, respect and privacy can be upheld as long as electronic security is also a priority to clinicians.
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End Notes:1.) Louis Lasagna, "Hippocratic Oath, Modern Version," Academic Dean of the School of Medicine at Tufts University, 1964. reprinted on "Nova Online, Survivor MD," http://www.pbs.org/wgbh/nova/doctors/oath_modern.html
2.) Anahad O'Connor, "Take Two Aspirin, E-Mail Me Tomorrow," The New York Times, Section F; Column 5; Health & Fitness; Pg. 7. LexisNexis 30 September 2005.
3.) "Majority of Americans Have Privacy Concerns about Electronic Medical Record System," Health Privacy Project (www.heathprivacy.org): http://www.healthprivacy.org/info-url_nocat2303/info-url_nocat_show.htm?doc_id=263085
4.) Health Privacy Project "Homepage Animation" http://www.healthprivacy.org. 29 September 2005.
5.) Anahad O'Connor, "Take Two Aspirin, E-Mail Me Tomorrow," The New York Times, Section F; Column 5; Health & Fitness; Pg. 7. LexisNexis 30 September 2005.
6.) Dr. Daniel Z. Sands quoted in: Susannah Fox, Janna Quinney, Lee Rainie, "The Future of the Internet," Pew Internet and American Life Project, Published 4 January, 2005. 4.
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The HIPAA article, "The Hippocratic Oath Upheld PHI, Your Personal Health Information Kept Private" was a collaboration between Marilee Venieags and Roman Martinez. Ms. Veniegas is an alumni of the University of Washington. She joined the Marketing team at Essential Security Software, Inc. in 2005. She also serves as one of the ESS site editors for I Want My ESS! a stolen work and SMB resource site. Mr. Martinez is currently a senior in the UW Communications Deptartment he has also worked in PR and radio.