Between You and Your Doctor?

April 13, 2000

By Joanne Kabak
drkoop.com Health News

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One of the biggest fears around expanded use of the Internet is the issue of privacy. If you put your medical record online, get a prescription filled, have a lab report sent out or have a discussion with your doctor, who else has access to that data?

If it hasn't affected you yet, just wait, said Doug Hastings, senior member in the national health law practice of Epstein Becker & Green in Washington, D.C. To date, much of the healthcare role online has been in information content. You have symptoms, you look them up on the Web to see what information is out there. Or you join a chat room to hear what others have to say.

But deeper levels of connectivity are growing, and those may well include connections with your HMO. "Healthcare plans are being connected to their patients and physicians are being connected to each other, their patients, and to health plans. It's all in the works," Hastings said.

There's never been anything like this before, and, by its very nature, it invites a response.

"What you're going to have is this explosion of regulatory and legislative thinking about what should we do to make sure the 'good' of the Internet is really good. It's going to be a challenge for all of us, to try to do our job well so that the regulations are appropriate, but to allow the good to come out and to not create obstacles," Hastings said.

To get the benefits of the Internet, information has to be communicated electronically. Then you get into issues of consent -- who should receive material and what can they do with it? Just how much latitude are patients willing to give to others about the transmittal of their data online?

In the 1996 federal Health Insurance Portability Act, Hastings said there were requirements that there be regulations guaranteeing patient privacy in electronic data. He said the government just put out proposed regulations on this in the fall, and so far they've had 55,000 comments.

As the questions mount, "there are no long-term answers yet," Hastings said. "It's constantly evolving. Healthcare is viewed both as a commodity, and as a social value and a social good, and that makes the nature of its regulation different."

With the kind of revolutionary change that the Internet brings, the reality of what's possible keeps changing. What is becoming clear is that privacy is an issue and there is the need for strong ethics and appropriate protections.

At the same time that many do not want more government regulation, they also don't want sub-par medical care coming over the Internet. But at least one thing seems certain. "Things are moving so quickly," Hastings said.

Joanne Kabak is an established free-lance writer. She has an MBA and specializes in health and business-related articles. She lives in Connecticut with her husband and two daughters.

• Medem (Peer-reviewed medical information)
• Epstein Becker & Green
• Jacobs & Associates
• American Pharmaceutical Association