It’s clear by now that COVID-19 has impacted our world in a serious way. Without warning, the world had to abandon their normal lives and shelter in place. The closure of society as we knew it brought a barrier to accessing in-person health services. Without preparation, everyone had to shift to a digital world that may not have been prepared for it.
As healthcare was forced to become more digital, health professionals turned to any available platform. The sense of urgency led everyone to trust the readily available platforms with their most private health data. These platforms included FaceTime, Zoom, and Skype. Suddenly, the privacy we once expected and demanded seemed to no longer be paramount. We just needed a doctor, now.
However, are health professionals spending enough time thinking about the privacy concerns associated with telehealth? Let’s consider Zoom. The popularity of Zoom rose rapidly when the pandemic began. A major problem that arose with Zoom was called “Zoombombing” in which an uninvited third party could join your Zoom call, breaching your privacy and potentially causing serious disturbances in your meeting. Other concerns arose regarding the lack of end-to-end encryption for Zoom’s unpaid version. After some criticism, Zoom has announced it will include end-to-end encryption for the unpaid version. Only after advocacy and criticism did the platform consider implementing this change.
In a real clinic, you expect privacy and trust that you have it because you can see the four walls enclosing the examination room and the door that closes behind your doctor when she enters. In the digital health realm, we don’t have these same tangible walls and doors ensuring us that our privacy is being protected. Instead, we need to rely on our healthcare providers to be using platforms that are compliant with the various health information laws.
In North America, digital health platforms generally must be PIPEDA- and HIPAA-compliant. Zoom does provide a version for healthcare which is compliant with both North American privacy laws but this requires the health provider to pay for this service. Unfortunately, small, independent healthcare providers might choose to use the more readily available programs due to the cost of the services and lack of knowledge of privacy laws.
In some regions, non-profit, governmental organizations have control over telehealth. In Ontario, a network called the Ontario Telemedicine Network (OTN) has been established which provides low cost, PHIPA-compliant video conferencing software to increase access to virtual health. Though members need to pay a fee, it is less than half the cost per month of Zoom for Healthcare. This type of platform enhances patient privacy by making compliant software more accessible to healthcare providers. With enhanced privacy comes more trust and the shift to digital health may just be the future of medicine.
The digital health shift is a positive one. If Zoom taught us anything it is that advocacy will encourage providers of telehealth to increase their privacy protection for their consumers. The distrust that consumers have toward telehealth was swiftly eliminated with the urgent need for telehealth services. We need to ensure this new trust in digital health delivery isn’t eroded by breaches of privacy. As consumers, we can continue to criticize the providers and make our voices known to the government, pressuring providers to comply with the privacy requirements and digital health regulations.