Tracking patients in an EHR improves education, but safeguards needed

It’s ethical for medical students to tap into EHRs to track former patients, but safeguards are needed to protect patient privacy and ensure such work is restricted to research purposes, according to a study published in Academic Medicine.

Medical students utilize EHRs in clerkships, and as part of training often track former patients for educational purposes for a defined period of time after they have left one's direct care.

Researchers from Northwestern University’s Feinberg School of Medicine critically analyzed ethical considerations surrounding this practice. For example, they found that it could compromise patient autonomy as well as their control over their own health information. Also, patients may be reluctant to seek care from institutions allowing this practice.

However, given its benefit to society and the advancement of healthcare, tracking patients is supported by the principle of distributive justice. But it must be done only with defined limits to safeguard patient autonomy, including obtaining permission from patients, having legitimate educational intent and self-restricting review of records to those essential for training, according to the study.

The authors conclude that there is a need for national guidelines on tracking patients in an ethically appropriate manner.