Robert Gellman, a privacy and information policy consultant based in Washington, D.C., has prepared a report for the The World Privacy Forum — a non-profit public interest research and consumer education group — on why personal health records (PHRs) could threaten privacy. Possible privacy consequences outlined in the report include:

• Health records in a PHR may lose their privileged status.
• PHR records can be more easily subpoenaed by a third party than health records covered under HIPAA.
• Identifiable health information may leak out of a PHR into the marketing system or to commercial data brokers.
• In some cases, the information in a non-HIPAA covered PHR may be sold, rented, or otherwise shared.
• It may be easier for consumers to accidentally or casually authorize the sharing of records in a PHR.
• Consumers may think they have more control over the disclosure of PHR records than they actually do.
• The linkage of PHR records from different sources may be embarrassing, cause family problems, or have other unexpected consequences.
• Privacy protections offered by PHR vendors may be weaker than consumers expect and may be subject to change without notice or consumer consent.

Gellman concludes that,

While PHRs may have some laudable goals, they also are a tempting target for companies or others that want to evade whatever privacy protections remain in the health care system in order to make a profit. Whether the benefits of PHRs are sufficient to overcome the real dangers to privacy remains to be seen. It is something that each potential user of a PHR must consider before enrolling. Any consumer worried about the privacy of personal health information should proceed with great caution before agreeing to sign up for a PHR, particularly those operating outside of HIPAA.