(May 7) By the fall of 2009, if all goes as planned, Oregon's 400,000 Medicaid recipients could be receiving a higher quality of health care through one high-tech change, according to the Department of Human Services. The agency is taking the lead on an effort to put the patients' records online.

The records would be accessible to authorized health care providers and would not be available to outside interests who seek to market or use the information in those records.

But the Health Records Bank of Oregon program for Medicaid patients is just the first part of an effort to file most Oregonians' health care records in an online database as part of compliance with the federal Health Insurance Portability and Accountability Act, commonly known as HIPAA.

Passed by Congress in 1996, HIPAA set a national standard for electronic transfers of health data. If you have some immediate concerns about that act, chances are that those involved with implementing HIPAA's goals in Oregon already know about them.

Oregon health care providers, managed care organizations, information technology experts and state administrators have been endeavoring since 2003 to resolve the barriers to establishing a secure and functional online medical records databank.

Ideally, patients would have control over those records - and over who has access to them. Patients could be informed whenever their records are accessed. That would be an improvement over the current system. Many of our medical records are on computers now, but those computers are not linked.

Corvallis' own Andrew Perry, the chief executive officer at the Corvallis Clinic, was appointed by the governor last month to the state's Health Information Infrastructure Advisory Committee, which is charged with setting up a "secure computerized health network."

Perry said the system would be accessible to patients themselves. For example, it could help them keep track of the proper name of their prescriptions. Too often, he said, patients can describe their medications only by the color of a pill. Patients who are being treated in an emergency room far from home also might receive better care if the treating physician could access their medical records to see what medications they're already taking, or to learn of any allergies they might have.

In fact, that kind of "great-in-the-absence-of-patient-competence" argument turns up a lot across the nation as medical professionals and information technology specialists work to put medical records online. But advocates of placing medical records online realize that they pose a temptation to hackers, certain marketers and others hoping to cash in on this most sensitive information. They're careful to always use the term "secured" sites. Not everyone is convinced that there is such a thing.

A 2005 report to the 73rd Legislative Assembly from the Electronic Health Records and Data Connectivity Subcommittee said 47 percent of those polled about the idea cited fear that medical information will be leaked as their reason for thinking the plan's risks outweighed its benefits. We understand that concern.

Given the high level of proprietary concern many of us have about our personal medical information, we'd hoped to be able to direct readers to a Web site where the public could gain answers to frequently asked questions about the state's ongoing efforts, and on find out how they can participate in the discussion of how best to ensure such an online medical database truly is secure and under patient control.

Ree Sailors, the governor's adviser on health policy, said that a Web site for the Health Information Infrastructure Advisory Committee is in the works, but it is not yet online, although discussions of the issue have been around since 2003.

The HIIAC group had its first meeting April 25 and plans to meet again May 29, at a time and place yet to be announced.

Greg Wenneson, project manager of the state's Division of Medical Assistance Programs, said information about the plan to put Medicaid information online already is available at www.oregon.gov/DHS/hrb-oregon. Interested persons soon will be able to see exactly where and when the group will hold its next public meeting, tentatively planned for July.

We don't doubt that providing more information to doctors more quickly ultimately could prove as convenient and valuable as debit cards have proven to be for access our finances. (Remember how concerned we were about them?)

But medical information is personal. The public will remain nervous about online storage of medical records unless its concerns are addressed candidly and completely. Providing the public a guaranteed place at the table during this process is key to assuring support.