The increasing use of electronic information in clinical clerkships has sparked a debate among medical educators and students: does tracking patients’ progress via their electronic health records for the purpose of medical training infringe upon patient privacy rights?
Gregory E. Brisson, MD, ’94 GME, assistant professor of Clinical Medicine-General Internal Medicine and Geriatrics, and colleagues addressed this ethical issue in an article recently published in Academic Medicine.
According to the article, tracking a patient’s progress via their electronic health records has the potential to compromise that patient’s autonomy, their control over the collection and use of data about themselves, and may even increase their anxiety and reluctance to seek care.
He hopes the article will create awareness for medical students to understand the ethical responsibilities of tracking patients, and to make the issue transparent for patients.
“As medical students are increasingly using electronic health records in their clerkships, it is a topic that should be addressed and hasn’t been, primarily because the widespread use of electronic health records is so new,” he said. “The goal of the paper is twofold: one, to address the ethical issues surrounding this issue so students may be able to use the EHR in education, and two, to respect the privacy and autonomy of the patient.”
In the paper, Dr. Brisson and his coauthors present both sides of the argument, discuss how to balance the ethical conflict, and propose a solution that would allow medical students restricted access to records. The article also emphasizes the need for national guidelines on tracking patients.
Dr. Brisson concludes that the benefits of tracking outweigh potential harms and educators should seek opportunities to use this new technology to improve medical training. “Tracking patient records allows students to self-educate by auditing their diagnoses to see if they were right,” he noted.
“Tracking in the electronic health records offers potential to turn any patient interaction into a longitudinal learning experience,” Dr. Brisson said. “Longitudinal access allows students to observe the history of disease in way not previously possible, even if patients switch between different physicians and locations.”
Dr. Brisson and his team plan to develop formal guidelines based in ethics and existing law and eventually incorporate the guidelines into medical student training and patient education, so patients will understand how their records are being used.
“By raising awareness of this issue among patients, students and educators, we can come together and find the best uses for electronic health records in medical education so everyone can feel comfortable,” he said.
