S.C. Medicaid patients' records go online

Medical records belonging to state Medicaid patients have gone electronic. In July, the South Carolina Health Information Exchange made 800,000 medical histories of disabled and poor residents available to physicians, clinics and hospitals.

Privacy advocates urge caution. "Medical privacy for many people is one of the most important forms of privacy," said Graham Boyd, interim executive director of the state's national office for the American Civil Liberties Union.

Here's how SCHIEx (pronounced sky-ex) works. When a Medicaid patient visits a clinic, the doctor can call up the patient's medical history through a password-protected Web portal.

Claims data already existed electronically but was not immediately available to providers, said Jeff Stensland, director of public information for the state's Medicaid agency.

The information, including prescription and treatment history, belongs to the S.C. Department of Health and Human Services and will not be housed on providers' computers. Records will be bounced to providers when they are requested.

Another safety feature is that the database is encrypted, said David Patterson, deputy chief of health and demographics with the S.C. Office of Research and Statistics, the agency that built the system. The records are decrypted only when requested by a provider.

SCHIEx is a collaboration of the Department of Health and Human Services, which paid $250,000 for the new system, the Office of Research and Statistics and several health care associations. Other partners include the S.C. Hospital Association, S.C. Primary Health Care Association, Rural Health Association and S.C. Free Clinic Association.

Stensland said, "We are very confident that it's secure."

Independent private companies have conducted security analyses and penetration tests, Patterson said.

The free Web tool was created to provide continuity in patient care, Stensland said. Allowing doctors to see histories spanning a decade can help them detect patterns or recognize treatments that aren't working and change course, he said.

South Carolina is on the forefront nationally of electronic records, the ACLU's Graham said.

Federal bills are in the pipeline inducing states to set up electronic record systems, but only a handful of states have started on their own, he said.

Graham applauded the designers of SCHIEx for including the choice allowing patients to opt out of the system. He would like to see an in-between option, whereby patients can choose to have some data in the system and restrict more sensitive information.

"This has to be done with the highest level of security," he said.

Eventually, these systems could house all patient data. "They're coming, and it's not just Medicaid," Graham said.

That reality is still distant, however.

Only about 4 percent of physicians have what's considered a fully functional electronic records system, according to a study published in July in The New England Journal of Medicine.