Since the beginning of digital record keeping, the field of health care has been steadily moving towards a model that facilitates greater communication between providers for the benefit of their patients. Introducing the ICD-10 codes has also helped to normalize the language of diagnosis to be more consistent across the globe.
While the benefits are easily observable, the costs are considerably more insidious. Both providers and patients are faced with serious risks as a result of globalization chiefly because of the value recordkeeping has to criminals.
One of the chief gains globalization provides our health system with is better access to records and experimental data. As new treatments become available and clinical experience begins to translate into case reports, being able to share said data is absolutely essential to maintaining an evidence-based model for care.
The convenience factor means the institutions can send records to one another with virtually no cost or delay. Where requests may once have taken days or weeks to arrive by mail, we now have instantaneous access. Said information can and is already helping to improve patient outcomes.
But as the past few years have taught us, this accessibility comes at the cost of risking major data breaches. Large hospitals aren’t the only targets either; in 2016, Southeast Eye Institute (a US based company) reported the loss of 87,000 patient records after one of their vendors was compromised.
With the cost of a single record lost reaching over $150, health care providers are being forced to shoulder even more costs than in the past. Combined with the rising cost of care as a result of liability and more expensive technology, this represents the possibility for a crisis.
It should be noted that risks in this sphere are generated not just from underprepared systems, but from policy as well. To save money, many institutions (especially private practices) allow a BYOD (Bring Your Own Device) policy to predominate.
This creates a problem because personal devices are often devoid of important security tools such as VPNs or anti-malware applications. When these devices become compromised, they become a window into private medical data ripe for the stealing.
Patients also suffer serious consequences in these scenarios. When their health records are stolen, they’re frequently resold to criminals online and used to commit various types of fraud. One of the most dangerous types is the use of insurance to receive care.
This is highly dangerous precisely because of laws concerning medical records. Once care is given, those records cannot be easily altered. In the case of fraud, procedures might be done that could endanger the victim if—when future treatment is sought—these fraudulent procedures alter the course of care based on patient history.
Take the example of a patient that comes in for a routine exam. Their history states no allergy to latex (as a result of a fraudulent procedure). Armed with this information, the doctor proceeds to trigger anaphylaxis in his or her patient with a severe latex allergy.
A less extreme example might be in the event of assumed prior surgeries. Using insurance to undergo surgery will permanently alter a patient’s records to reflect the procedure done. In some cases this may prove to be a nuisance to the victim, but it may also reduce the quality of their care.
To say that globalization efforts are entirely negative simply wouldn’t be true. Though there are serious security concerns about maintaining patient records and preventing fraud, being able to offer the same procedure based on the same evidence anywhere in the world is no small benefit.
Bringing the health care system onto a global platform affords doctors access to the latest data even before seeing it published in some major publication such as The Lancet. For illnesses that currently have few or no known effective treatments, this is the ideal.
The primary risk is the possibility of spreading poor or inaccurate information. Although the best available care is most certainly based on published evidence, not all published evidence is necessarily the best treatment available.
Consider spinal fusion therapy. Despite its wide utilization, very little evidence actually supports its effectiveness. The studies published actually suggest in large part that other, more conservative forms of care are more effective.
Yet globalization is creating a false impression of effectiveness in countries with low utilization as a result of the high utilization in other countries. The threat here is in the financial sphere as well as the health care sphere because patients can suffer twofold; unnecessary treatments and burdensome costs.
Regardless of the risks, globalization is marching forward mostly unopposed. As providers, it will be up to you to mitigate the risks while extracting as many benefits as possible. Remember that convenience rarely comes without a cost.
The hope is that the cost will just be vigilance.
About the Author: Cassie, is a health care advocate and technology specialist that writes about the challenges faced by businesses and providers becoming progressively more digital. Her work also focuses on current and emerging tech that can be used to make our lives healthier and safer.