Alaska's Electronic Medical Record System Raises Privacy Concerns

As more of Alaska's health care providers transition to electronic medical records, a health information exchange network is being lauded as better for doctors and patients, but also has its share of controversy over privacy.

The Alaska eHealth Network, a non-profit corporation, manages the exchange system, which was launched in Fairbanks in June and is quickly growing to include the Anchorage area. Rebecca Madison, the network's executive director, says hospitals often don't use the same reporting system, so it works as a translation medium to convert data into a form that each system can read.

Although most doctors have switched to an electronic system, many people are concerned about the security of their online records, according to Joshua Decker, the interim executive director of the ACLU of Alaska.

"If people's medical records are going to be online, there needs to be really robust security," Decker said. "The state needs to make sure and the companies need to make sure that those protections are in place."

Madison says Alaska eHealth's system has multiple levels of encryption and monitors to ensure the system isn't accessed illegally. The only computers that store the data belong to health care providers, although patients can also access their electronic health records at different providers after an authentication process.

"We've tried really hard to work with the highest level of security standards that are out there that are available right now," Madison said. "We ensure the record is encrypted from the time it leaves the EHR until it arrives at the other EHR."

Wary patients can choose to opt-out of the system, but they must either notify their provider who will then inform the network, or go directly to Alaska eHealth and undergo an extensive authorization process.

Decker said it would be better for patients to have to opt-in to the system and make a conscious choice about their involvement.

While the state addressed some of the ACLU's concerns, Decker said the ACLU would like the state to pass specific regulations for the system's daily functions and outline circumstances for releasing records for national security reasons.

"When private things like people's medical records are involved, it's a sensible solution to have a clear set of rules," Decker said.

The transition to electronic records began as a federal mandate under the George W. Bush administration, but the Obama administration provided funding to help providers acquire the electronic systems by 2015.

In 2009, Alaska lawmakers passed Senate Bill 133, to create a statewide health information exchange system. The bill specified that patient data could be shared for treatment or billing as well as for some statewide reporting.

Whether or not the electronic process undergoes further changes, Madison says education for providers and patients is key.

"Everybody needs to weigh the risks and benefits for themselves," Madison said. "I firmly believe that we can't avoid moving to electronic format for medical records. It's going to happen. Providers are doing it all over the state and all over the nation."