Employees at Penn Medicine, a large hospital system in the Philadelphia area, use more than 175 mobile apps to streamline operations and improve hospital services. According to a recent article on the Technical.ly Philly blog, Penn Medicine has tapped its 32-member software development staff to create at least 75 apps to be used alongside another 100 developed by outside firms. These apps allow hospital employees to access patient records, view data from multiple databases, and communicate with one another using HIPAA-secured smartphones.


Anyone who has spent time in a hospital recently knows that the electronic health record (EHR) is here to stay. As part of its recent health reforms, the federal government made a $48 billion investment in health information technology. The Center for Medicare & Medicaid provides incentives to hospitals and doctors who “adopt, implement, upgrade or demonstrate meaningful use” of EHR technology. A well-designed EHR system can improve practitioner record-keeping, resulting in more complete information for and about patients. Instead of relying on paper charts, which are vulnerable to loss and damage, hospitals and healthcare practitioners can instead access patient information from secure databases. Patients can control who has access to their information and more easily see personalized care information, doctor’s notes, and health history.


Unfortunately, EHRs also present a number of new risks to patient privacy, risks which are compounded by mobile access. Electronic records are available to entire systems of health workers, vulnerable to cybersecurity threats, and subject to a large risk of human error. Giving access to sensitive information to more people in more places inevitably creates more opportunity for inappropriate and illegal sharing of that information. A driving force behind the push for EHRs is demand for electronic health information exchange, the sharing of health data between patients, providers, pharmacists, and other professionals. This widespread sharing increases risk, particularly in a mobile system where access is not constrained by time or place. Hundreds of new mobile EHR apps are expected to come onto the market soon and some will inevitably have better security than others. Although the Office of the National Coordinator for Health Information Technology oversees a certification program for new software, even rigorous app certification processes can overlook security flaws.


Of course, risk is not a reason to avoid new technologies. Mobile access to medical information is an obvious and inevitable next step for healthcare providers. The challenge for developers, regulators, and hospital policymakers will be to ensure that these technologies are used ethically even as they continue to expand and evolve.

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Theo Schall

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