The Privacy Disparity Hiding Inside Health Interoperability

Healthcare interoperability is usually framed as pure progress: a patient's record arrives before they do, giving emergency physicians and specialists faster, better-informed context. But Hannah Galvin, MD, chief health information officer at Tufts Medicine, argues that the same default-to-share design carries a hidden cost, according to Becker's Hospital Review.

For patients whose records include behavioral health treatment, substance use history, reproductive care, gender identity, or HIV status, automatic data exchange can mean that information surfaces in places they never intended. The result, Galvin says, is that some patients avoid care entirely rather than risk exposure. A capability that improves outcomes for the majority becomes a reason for a vulnerable minority to stay away.

The practical challenge is that most exchange frameworks were built to move data broadly, not to honor granular patient consent at the level of a single sensitive diagnosis. Closing that gap means giving patients real control over what gets shared, with whom, and when, not just sharing more.