Compelled authorizations for disclosure of health records: magnitude and implications

Each year individuals are required to execute authorizations for the release of health records as a condition of employment, applying for various types of insurance, and submitting claims for benefits. Generally, there are no restrictions on the scope of information released to these compelled authorizations, and the development a nationwide system of interoperable electronic health records will increase the amount of health information released. Unless some limitations are imposed, health records generated today will be maintained indefinitely and might become the old, possibly irrelevant, and highly sensitive information about which individuals are deeply concerned. To allow for limited disclosures, legislation must be enacted to restrict the scope of disclosures to the information needed by the third-party user. A fast, cheap, and easy method to limit these disclosures is the second element. Third, there must be a public realization of the extent and consequences of compelled disclosures and a willingness to accept the political and economic costs of limiting these disclosures.