Privacy issues pose ongoing challenge to HIEs

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The legal and ethical aspects of healthcare data sharing have long been a concern for Valita Fredland, recently named vice president and general counsel and privacy officer at the Indiana Health Information Exchange (IHIE).

"I think big data raises important ethical and legal questions that in some cases haven't yet been well addressed by regulatory frameworks," she tells "It's hard to anticipate some of the things that we're able to do with big data until we've done it. One then has to ask, 'Well, was that the right thing to do with it?'"

She points to the tension created in the federal push to share data and at the same time protect the privacy and security of that information.

"Privacy officers find themselves right in the middle of that tension," says Fredland, who holds a masters degree in clinical biomedical ethics as well as a law degree.

Creating a privacy and security framework that covers exchanged data over multiple jurisdictions will be a big issue for HIEs in the immediate future, she says.

Tracking the rights and permissions associated with various bits of data poses a particular challenge for blended databases and big data initiatives. With data coming from disparate sources, information collected on a website, for instance, might have a different privacy policy than that collected in other ways.

Organizations need a multi-faceted strategy for protecting data, Fredland says, that includes a rigorous bring-your-own-device strategy, continuous employee education, good technical security infrastructure and a clearly established security policy.

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