Electronic medical records may have merit….

…..but they are not secure. Get used to the idea though. Starting with the fact that your records haven’t been as private as you may have thought.

Those privacy notices you sign in doctors’ offices do not actually give you any control over your personal data; they merely describe how the data will be used and disclosed.

Good time for that reminder. Because it’s going to be more available before long.

In a January 2009 speech, President Barack Obama said that his administration wants every American to have an electronic health record by 2014, and last year’s stimulus bill allocated over $36 billion to build electronic record systems. Meanwhile, the Senate health-care bill just approved by the House of Representatives on Sunday requires certain kinds of research and reporting to be done using electronic health records. Electronic records, Mr. Obama said in his 2009 speech, “will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests [and] save lives by reducing the deadly but preventable medical errors that pervade our health-care system.”

Sounds good, right? Not to Americans concerned about their most private personal health matters.

When patients realize they can’t control who sees their electronic health records, they will be far less likely to tell their doctors about drinking problems, feelings of depression, sexual problems, or exposure to sexually transmitted diseases. In 2005, a California Healthcare Foundation poll found that one in eight Americans avoided seeing a regular doctor, asked a doctor to alter a diagnosis, paid privately for a test, or avoided tests altogether due to privacy concerns…

Electronic record systems that don’t put patients in control of data or have inadequate security create huge opportunities for the theft, misuse and sale of personal health information. The public is aware of these problems.

Which is only one of the more minor reasons the newly passed legislation is so overwhelmingly unpopular with the American people.

Privacy has been essential to the ethical practice of medicine since the time of Hippocrates in fifth century B.C. The success of health-care reform and electronic record systems requires the same foundation of informed consent patients have always had with paper records systems. But if we squander billions on a health-care system no one trusts, millions will seek treatment outside the system or not at all. The resulting data, filled with errors and omissions, will be worth less than the paper it isn’t written on.