identifiable medical information without their consent. though google claimed that their process was legal in obtaining the information, there was concern between researchers on this claim. efforts to protect health information with the lack of help from the department of health and human services there is a conflict of interest that has been made clear. some wish to place individual betterment as more important, while others focus more on external benefits from outside sources. the issues that occur when there are problems between the two groups are also not adequately solved which leads to controversial laws and effects. individual interests take precedence over the benefits of society as a whole and are often viewed as selfish and for the gain of capital value. if the government does not make any more future changes to the current legislation, countless organizations and people will have access to individual medical information. in 1999, the gramm-leach-billey act (glba) addressed the insurance privacy debate regarding medical privacy. yet, there were many issues with the implementation. one issue was that there were inconsistent regulation requirements within the different states due to preexisting laws. secondly, it was difficult to combine the pre-existing laws with the new framework. and thirdly, in order for the federal government to implement these new rules, they needed state legislature to pass it. glba aimed to regulate financial institutions so that corporations could not affect people's insurance. because of the difficulty of the implementation of the glba, state legislatures are able to interpret the laws themselves and create initiatives to protect the medical privacy. when states are creating their own independent legislature, they create standards that understand the impact of the legislation. if they stray from the standard laws, they must be valid and fair. the new legislation must protect the rights of businesses and allow them to continue to function despite federally regulated competition. patients gain benefits from these new services and standards through the flow of information that is considerate with medical privacy expectations. these regulations should focus more on the consumer versus the benefits and political exploitation. many times, regulations are for the personal gain of the corporation, therefore, state legislatures be wary of this and try to prevent it to the best of their abilities. medical privacy is not a new issue within the insurance industry, yet the problems regarding exploitation continue to reoccur; there is more focus on taking advantage of the business environment for personal gain. in 2001, president george w. bush passed additional regulations to hipaa in order to better protect the privacy of individual medical information. these new regulations were supposed to safeguard health information privacy by creating extensive solutions for the privacy of patients. the new regulation goals included being notified once an individual's information is inspected, amend any medical records, and request communication opportunities to discuss information disclosure. however, there are exceptions to when the disclosure of phi can be inspected. this includes specific conditions among law enforcement, judicial and administrative proceedings, parents, significant others, public health, health research, and commercial marketing. these aspects of lack of privacy have caused an alarming number of gaps within privacy measures. ultimately, there is still an issue on how to ensure privacy securities; in response, the government has created new regulations that makes trade offs between an individual's privacy and public benefit. these new regulations, however, still cover individually identifiable health information - any data that contains information unique to an individual. however, non-identifiable data is not covered as the government claims it will cause minimal damage to a person's privacy. it also covers all health care organizations and covers businesses as well. additionally, under new hipaa additions, the state legislation is more protective than national laws because it created more obligations for organizations to follow. ultimately, the new rules called for expansive requirements that created better safety measures for individuals. yet, there are still ways that businesses and healthcare organizations can be exempt from disclosure rules for all individuals. thus, the hhs needs to find more ways to balance personal and public trade offs within medical laws. this creates a need for extra government intervention to enforce legislation and new standards to decrease the number of threats against an individual's privacy of health data. effects of changing medical privacy laws physician-patient relationshipes patients want to be able to share medical information with their physicians, yet they worry about potential privacy breaches that can occur when they release financial and confidential medical information. in order to ensure better protection, the government has created frameworks for keeping information confidential - this includes being transparent about procedures, disclosure and protection of information, and monitoring of these new rules to ensure that people's information. effects of technological advances recently physicians and patients have started to use email as an additional communication tool for treatment and medical interactions. this way of communication is not “new”, but its effects on doctor patient relationships has created new questions regarding legal, moral, and financial problems. the american medical informatics association has characterized medical emails as way to communicate “medical advice, treatment, and information exchanged professionally”; yet, the “spontaneity, permanence, and information power characterizing” role is significant because of its unknown affects. however, the use of emails allows for increased access, immediate aid, and increased interactions between patients and doctors. there are many benefits and negative aspects of using emails; doctors feel a new sense of negative responsibility to respond to emails outside of the office, but also find benefits with facilitating rapid responses to patient's questions. additionally, the use of email between physicians and their patients will continue to grow because of the increasing use of the internet. with the internet, patients are able to ask for medical advice and treatment, yet issues regarding confidentiality and legal issues come up. ultimately, emails between a physician and patient are supposed to be used as a supplement for face to face interactions, not for casual messages. if used properly, physicians could use emails as a way to supplement interactions and provide more medical aid to those who need it immediately. traditional beliefs on doctor-patient relationship although many people believe that the technological changes are the reason for fear of sharing medical privacy, there is a theory that states that institutional ideals between doctors and their patients have created the fear of sharing medical privacy information. although levels of confidentiality are changing, individuals often feel the need to share more information with their doctors in order to get diagnosed correctly. because of this, people are concerned with how much information their physicians have. this information could be transferred to other third party companies. however, there is a call for smaller emphasis on sharing and confidentiality in order to rid patients from their fears of information breaching. there is a common belief that the confidentiality of one's information also only protects the doctors and not the patients, therefore there is a negative stigma towards revealing too much information. thus it causes patients to not share vital information relevant to their illnesses. medical privacy standards and laws by country australia – ehealth on july 1, 2012, the australian government launched the personally controlled electronic health record (pcehr) (ehealth) system. the full implementation incorporates an electronic summary prepared by nominated healthcare providers along with consumer-provided notes. further, the summary will include information on the individual's allergies, adverse reactions, medications, immunizations, diagnoses, and treatments. the consumer notes will operate as a personal medical diary that only the individual can view and edit. the opt-in system gives people the option to choose whether to register for the ehealth record or not. as of january 2016, the commonwealth department of health changed the name pcehr to my health record. privacy – governance the personally controlled electronic health records act 2012 and privacy act 1988 governs how ehealth record information is managed and protected. the pcehr system operator abides by the information privacy principles in the privacy act 1988 (commonwealth) as well as any applicable state or territory privacy laws. a privacy statement sets out the application of the collection of personal information by the system operator. the statement includes an explanation of the types of personal information collected, what the information is used for, and how the information is stored. the statement covers measures in place to protect personal information from misuse, loss, unauthorized access, modification, and disclosure. privacy – security measures security measures include audit trails so that patients can see who has accessed their medical records along with the time the records were accessed. other measures include the use of encryption as well as secure logins and passwords. patient records are identified using an individual health identifier (ihi), assigned by medicare, the ihi service provider. privacy – issues a 2012 nationwide survey in australia assessed privacy concerns on patients' health care decisions, which could impact patient care. results listed that 49.1% of australian patients stated they have withheld or would withhold information from their health care provider based on privacy concerns. how does consent impact privacy? one concern is that personal control of the ehealth record via consent does not guarantee the protection of privacy. it is argued that a narrow definition, 'permission' or 'agreement', does not provide protection for privacy and is not well represented in australian legislation. the pcehr allows clinicians to assume consent by consumer participation in the system; however, the needs of the consumer may not be met. critics argue that the broader definition of 'informed consent' is required, as it encompasses the provision of relevant information by the healthcare practitioner, and understanding of that information by the patient. is it legitimate to use personal information for public purposes? data from the pcehr is to be predominantly used in patient healthcare, but other uses are possible, for policy, research, audit and public health purposes. the concern is that in the case of research, what is allowed goes beyond existing privacy legislation. what are ‘illegitimate’ uses of health information? the involvement of pharmaceutical companies is viewed as potentially problematic. if they are perceived by the public to be more concerned with profit than public health, public acceptance of their use of pcehrs could be challenged. also perceived as problematic, is the potential for parties other than health care practitioners, such as insurance companies, employers, police or the government, to use information in a way which could result in discrimination or disadvantage. what are the potential implications of unwanted disclosure of patient information? information 'leakage' is seen as having the potential to discourage both patient and clinician from participating in the system. critics argue the pcehr initiative can only work, if a safe, effective continuum of care within a trusting patient/clinician relationship is established. if patients lose trust in the confidentiality of their ehealth information, they may withhold sensitive information from their health care providers. clinicians may be reluctant to participate in a system where they are uncertain about the completeness of the information. are there sufficient safeguards for the protection of patient information? security experts have questioned the registration process, where those registering only have to provide a medicare card number, and names and birth dates of family members to verify their identity. concerns have also been raised by some stakeholders, about the inherent complexities of the limited access features. they warn that access to pcehr record content, may involve transfer of information to a local system, where pcehr access controls would no longer apply. canada the privacy of patient information is protected at both the federal level and provincial level in canada. the health information legislation established the rules that must be followed for the collection, use, disclosure and protection of health information by healthcare workers known as "custodians". these custodians have been defined to include almost all healthcare professionals (including all physicians, nurses, chiropractors, operators of ambulances and operators of nursing homes). in addition to the regulatory bodies of specific healthcare workers, the provincial privacy commissions are central to the protection of patient information. turkey the privacy of patient information is guaranteed by articles 78 and 100 of legal code 5510. on the other hand, the social security institution (sgk), which regulates and administers state-sponsored social security / insurance benefits, sells patient information after allegedly anonymizing the data, confirmed on october 25, 2014.