Two Dartmouth professors are part of a team of researchers who received a $15 million grant from the U.S. Department of Health and Human Services to investigate the security of health information technology a field that can encompass electronic health records to smart phones that can monitor brain waves.
Computer science professor David Kotz and sociology professor Denise Anthony will participate in the Strategic Healthcare Information Technology Advanced Research Projects program, a $60 million initiative by the HHS to promote better understanding of health care information technology.
Policymakers and doctors have long pushed for the introduction of electronic information technology in the medical field, which still relies almost entirely on paper records, Kotz said in an interview with The Dartmouth. Kotz added that electronic health records could be sent between different hospitals making them easily accessible to medical staff and health care organizations as an example of the potential benefits of this type of technology.
"Many people believe health care will be more efficient if there were more readily available information [on patients] in multiple hospitals," Kotz said. "With electronic records, if you got into a car crash, broke your leg and went to a random hospital, they could, in theory, pull up your hometown medical records and learn what they needed to learn from it."
A doctor typically has to rely on a paper chart to review portions of the patient's medical history, Kotz said.
"Everybody patients, physicians, nurses and policymakers all recognize that if you're in an accident and you show up in the emergency room, electronic records would give the best care possible," Anthony said in an interview.
Many electronic devices are already being used to monitor the health of patients, Kotz said.
"Mobile computing portable devices like smart phones, iPods [and] iPads will measure blood pressure, or pulse, or brain waves and it's getting to the point where you could actually walk around in these devices that measure health continuously," Kotz said
He warned, however, that security risks could accompany the use of these technologies. Unless safeguards are initiated with information technology, patient information can potentially be viewed, manipulated or deleted, he said.
Health care is delivered and organized in ways that may make the introduction of information technology more difficult, Anthony said, adding that information technology could drastically transform how doctors and specialists are compensated for their work.
"A specialist won't get paid for just reading test results [sent through electronic records] or for evaluating you in a visit," Anthony said. "They really get paid for doing the test, seeing you based on the test. And that's the way, for many historical reasons, health care has been financed in the United States."
Anthony also described privacy issues related to health care information technology, adding that patients and doctors conceptualize privacy in surprisingly different ways. Patients are concerned about the security of private information regarding illnesses, past injuries and disorders, Anthony said. Doctors, however, are concerned about having a patient's full medical history.
"These two perceptions of what privacy means don't match up," Anthony said. "So we have to ask, How are we going to make policies and have the technology itself operate in a way that fits the perceptions of all the different stakeholders?'"
Security of health information technology is one of the four areas of concern examined by the SHARP initiative. Other areas include patient-centered cognitive support, secure information-exchange networks and the secure secondary use of electronic health records for research purposes, according to the HHS website.
Anthony and Kotz are part of a team of researchers participating in SHARP, led by computer science professor Carol Gunter of the Information Trust Institute. Other researchers are affiliated with Carnegie Mellon University, Harvard Medical School, Johns Hopkins University, New York University, Northwestern Memorial Hospital, Stanford University, University of California at Berkley, University of Massachusetts at Amherst, University of Washington and Vanderbilt University.
