A culture of confidentiality
PwC's research found considerable concern for the "knowledgeable insider." On average, improper use of personal health information by an internal party was the leading privacy/security issue experienced by healthcare organizations over the last two years. Because of lack of awareness or training, breaches can result easily and with greater probability from mishandling of paper documents, people talking in the elevator, or comments made via social media channels. In addition, risks of data breaches and the complexity of consent agreements rises when information is shared with business associates, the source of more than half of reported health data breaches affecting more than 11 million people since 2009.

PwC's survey found:
 

• More than half of healthcare organizations allow access to social networking while at work; less than half have a policy covering the use of social media outside of work.
• Less than half (37 percent) of health organizations surveyed incorporate approved uses of mobile devices and social media as part of company privacy training.
• Only 58 percent of providers and 41 percent of health insurers say they include the appropriate use of electronic health records (EHR) as part of employee privacy training.
• Only 36 percent of health organizations perform a pre-contract assessment of their business associates such as business partners and vendors, and just 26 percent conduct post-contract compliance assessments.

Opportunities and risks
Digitized health data is becoming one of the most highly valued assets in the health industry, and, according to PwC, all kinds of organizations are now converging around the shared use of the information to enable new care delivery models such as accountable care organizations, outcomes-based reimbursement and the advance of wellness, preventive and personalized care.

Organizations also are discovering the potential in secondary uses of the information beyond treating patients, such as in clinical studies, post-market surveillance of drugs and the development of new products and services to better understand patient health and behaviors. Yet PwC found that while many organizations are sharing information, the complexity of consent further increases and few organizations have established proper restrictions and consent agreements to control proper access. PwC's research found that:

• Only 17 percent of providers, 19 percent of payers and 22 percent of pharmaceutical/life sciences companies have a process in place to manage patients' consent for how their information can be used.
• Nearly three quarters (74 percent) of healthcare organizations surveyed said they already do or intend to seek secondary uses for health data; however, less than half have addressed or are in the process of addressing related privacy and security issues.
• Sixty-one percent of pharmaceutical and life sciences companies, 40 percent of health insurers and 38 percent of providers currently share information externally. Of those organizations that share data externally, only two in five pharmaceutical and life sciences companies (43 percent) and one in four insurers (25 percent) and providers (26 percent) have identified contractual, policy or legal restrictions on how the data can be used.

A new approach
PwC's research found that the recent increase in breach enforcement actions have prompted health organizations to focus more on privacy and security, and that there is growing recognition of privacy and security compliance as central to maintaining a trusted brand.

"To protect patient trust and their own brand reputation, organizations need to go beyond minimum regulatory requirements and adopt an integrated approach that combines privacy, security and compliance within a culture where all employees see themselves as champions of confidentiality and where privacy is part of the patient experience," said Peter Harries, principal and co-leader, Health Information Privacy and Security Practice, PwC.

Organizations with integrated approaches to privacy and security say they have realized the benefits, including a significant increase in data security and a slight decrease in the number of privacy/security issues, depending on the extent of their integration. PwC found that health insurers were more likely than providers and pharmaceutical/life sciences companies to have integrated their approach to a great extent.

A full copy of PwC's report can be found here.