Privacy concerns remain the key obstacle in the widespread adoption of electronic health records in the U.S., according to researchers from the North Carolina State University.

The paper, "Privacy and Security in the Implementation of Health Information Technology (Electronic Health Records): U.S. and EU Compared," outlines steps that could be taken to boost privacy and promote the use of EHRs.

"Electronic health records could reduce costs in the U.S. by an estimated $80 to 100 billion each year," says David Baumer, head of the business management department at NC State and co-author of the paper. "Using electronic records allows the healthcare system to operate more efficiently, minimizes duplicative testing, et cetera. But you can only get those cost reductions if everyone, or nearly everyone, makes use of the records, from healthcare providers to pharmacies to insurance companies."

Researchers say that a lack of public support related to privacy concerns has hindered EHR progress. Baumer says the concerns are not entirely unwarranted. For example, there is some evidence showing that EHRs can facilitate identity theft. But EHRs have become prevalent in the European Union, which has significantly more stringent privacy protections and whose citizens feel more comfortable with the EHR concept.

"We are moving in the right direction in regard to putting better privacy protections in place, but we have a long way to go," Baumer says. And that lack of privacy protection is hindering the adoption of EHRs. "For example, approximately 50 percent of people in the U.S. have EHRs, but doctors will have to check for paper records until EHRs are so widespread that checking for paper records is no longer considered due diligence." By way of comparison, approximately 95 percent of people in Holland have EHRs.

Researchers included a list of technical and legal recommendations that could make EHRs more viable in the U.S. For example, the paper calls for the introduction of civil penalties if people share information inappropriately or with inappropriate parties.

"Incorporating EHRs into our healthcare system is important," says Baumer. "The Obama administration's health plan relies on EHR savings as part of its effort to be revenue neutral. And more privacy protections are needed to make those savings a reality."

The paper, which will be available in the Boston University Journal of Science and Technology Law, was co-authored by Janine Hiller and Matthew McMullen of Virginia Tech and Wade Chumney of Georgia Tech.