Locking down privacy

Deborah Peel, MD, is the founder of Patient Privacy Rights (PPR), a national not-for-profit watchdog coalition. As a physician, she was inspired to adopt privacy as her mission in 1993 after an unnerving proposal from President Bill Clinton called for every patient encounter in America to be recorded in an electronic data-base. She was intimately familiar with the anxiety related to privacy in her own psychiatric-services practice, but the broad reach of electronic health records posed an imminent threat she just couldn't ignore.

From the very first week she began in practice, patients offered to pay for treatment out of pocket if she would agree to conceal their visits from insurance plans. A Distinguished Fellow of the American Psychiatric Assn., Dr. Peel says she didn't learn about the tremendous task of managing privacy from medical school; she learned it from her patients. Each patient has an individual expectation for how his or her privacy must be maintained, and most want extremely granular control of how health data is used, not a collective policy.