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On the adoption of personal health records: some problematic issues for patient empowerment

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Abstract

The development of electronic personal health records by independent vendors and national health systems is understood to empower patients and create a new kind of consumerism in healthcare. With more personal health information (PHI) at hand, active participation in the management of health and rational purchasing of healthcare services will be possible. Healthcare systems will also be able to contain costs and achieve sustainability. Based on a careful examination of the literature, we argue that many of the declared benefits of this technology are rather unattainable. As the boundaries between the public and private healthcare sectors become blurred and as employers struggle to reduce health insurance expenses, this proclaimed ‘consumer empowerment in healthcare’ is an attempt to introduce a technology and a business model for centralising all relevant PHI to render them economic. We reflect on the consequences for the ‘empowered’ user and we suggest that this new market device has to separate and individually address sufficiently issues of privacy, confidentiality and security before it can claim a place in the digital healthcare ecosystem.

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Notes

  1. From the late 1970s, a public administration reform agenda, loosely termed New Public Management (NPM), introduced private sector styles of professional management in Western public sectors (Hood 1991), including accountability, results, greater competition and efficiency (Gray and Jenkins 1993).

  2. See http://aushealthit.blogspot.gr/2014/03/senate-estimates-february-26-2014.html.

  3. This market is predicted to increase by 33 % in revenue from 2010 to 2015, reaching $414.8 million (Frost and Sullivan 2011).

  4. Google discontinued its PHR service early in 2012, but it has now returned and received HIPAA compliance for its Google Apps (see support.google.com/a/answer/3407054).

  5. See www.hscic.gov.uk/dles.

  6. See www.ehi.co.uk/news/EHI/9261/hes-data-handled-in-google-cloud.

  7. See truven.com/Your-Healthcare-Focus/Employer.

  8. See news.microsoft.com/2011/12/07/ge-microsoft-to-launch-joint-venture-aimed-at-global-healthcare-system-transformation/).

  9. See www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/wellpoint-agreement.html.

  10. See www.dossia.org.

  11. See ‘Lidl Germany boss fired over spying scandal’ (www.thelocal.de/20090406/18487) and ‘German rail firm admits spying on employees' health records’ (www.dw.de/german-rail-firm-admits-spying-on-employees-health-records/a-4543036-1).

  12. See www.ncsl.org/research/telecommunications-and-information-technology/employer-access-to-social-media-passwords-2013.aspx.

  13. See bigthink.com/videos/judge-richard-posner-privacy.

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  1. Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, Nottingham, UK

    Paraskevas Vezyridis & Stephen Timmons

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  1. Paraskevas Vezyridis
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Correspondence to Paraskevas Vezyridis.

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Vezyridis, P., Timmons, S. On the adoption of personal health records: some problematic issues for patient empowerment. Ethics Inf Technol 17, 113–124 (2015). https://doi.org/10.1007/s10676-015-9365-x

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