Fear of Data Theft Blunts Public Acceptance of EHRs

August 24, 2012 — Worries about the security of personal information continue to blunt public acceptance of electronic health record (EHR) systems now used by more than half of the nation's office-based physicians, according to a survey conducted by Harris Interactive for Xerox.

Sixty-three percent of Americans fear that a computer hacker will steal their personal data, down just 1 percentage point from 2010. Not much else in public opinion has changed over the last 2 years. Roughly half of Americans still say that they are concerned that their digitized health data could be lost, damaged, or corrupted. And one half continue to worry that a power outage or computer crash could prevent a physician from accessing their chart.

Overall, the percentage of Americans with some kind of EHR anxiety rose from 83% to 85% over this time frame, according to the survey, which was published last month.

Americans also have some positive things to say about EHRs. Sixty-eight percent expect the technology to improve the quality of the treatment they receive, and 60% believe EHRs will reduce the overall cost of care. However, when it comes to the rubber-meets-the-road question of "I want my medical records to be digital," only 26% of Americans say "yes," down a percentage point from 2010. In terms of a global assessment, only 40% agree that digital records mean better, more efficient care. That was the same response in 2010.

The survey conducted by Harris Interactive for Xerox is just one snapshot of public opinion, and other surveys suggest that patients view EHRs with more enthusiasm. A Harris Poll published in February — this one for the National Partnership for Women & Families — found that 75% of Americans whose medical records are paper ones want their physicians to digitize. Among those Americans whose physicians use EHRs, 73% say the software enhances the overall quality of service.

However, even this otherwise positive survey uncovered a deep strain of EHR-phobia. Almost 60% of Americans with digital charts predict that widespread adoption of the technology will lead to more personal information being stolen or lost, according to the survey conducted for the National Partnership for Women & Families. This belief also was held by 66% of Americans still in the paper-chart world.

Large Data Breaches Since September 2009 Have Affected 21 Million

It is not as if Americans are worried about an imaginary problem. They see a constant stream of news headlines about medical-practice laptops stolen from cars, or hospital computers broken into by hackers.

The US Department of Health & Human Services (HHS) tracks these cyber crimes. Healthcare providers, insurers, and their business associates are required under the 2009 economic stimulus legislation to report data breaches each year to the Office for Civil Rights in HHS. Breaches affecting 500 or more individuals, however, must be reported within 2 months. Some incidents involve paper records, but the headline makers — some topping 1 million individuals — are typically digital in nature.

Since September 2009, HHS has received reports of 489 data breaches in the 500-plus category that add up to 21 million people. That translates into about 14 large breaches per month, or about 3 per week, over this roughly 36-month period. It is unknown how many of the affected individuals eventually became victims of identity theft.