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Two years ago, Naugatuck Valley Radiology Associates implemented a new radiology information system with multiple bells and whistles. The system, from Los Angeles-based MedInformatix, facilitates sharing reports, images and schedules across the 18-physician practice's multiple sites in central Connecticut. It also integrates with the group's claims clearinghouse, enabling electronic submission of claims emanating from 80,000-plus annual patient visits. But there's one aspect of the technology the practice is delaying-the patient portal. "There are many different mindsets on what it can and should do," explains Paul Masotta, executive director. "Patients want access through the Web site, and we could provide information. But it is difficult due to privacy and difficult to say what the portal will look like. There are all these HIPAA rules we have to keep in mind."

Across the industry, providers are balancing the need for patient connectivity with concerns over exposing data. Rather than rushing into opening up patient records online, or enabling electronic patient-physician communication, they are taking a more cautious approach, analyzing the legal implications of consumer connectivity and any unintended risk it might cause.

It's the kind of caution that can cause industry outsiders to wince. "Health care organizations are entrenched in the old ways of doing things," says Amy Cueva, founder of Mad*Pow, a design firm based in Portsmouth, N.H. that has worked with multiple payers in making online services more consumer-friendly. Federal privacy laws, she contends, are making many in the industry gun-shy of technological innovation. "I understand HIPAA, but there is a wide world of data that consumers need access to. They just don't know how to connect the dots. Health care organizations should not make their systems so secure they discourage adoption. HIPAA is scaring people from innovation."

Health care executives point to a disconnect between the federal privacy law and actual consumer behavior. Patient-centric Web sites continue to sprout up, notes Stephen Rosenthal, vice president for network management at Montefiore Medical Center, New York. "Patients review doctors online and reveal information about their own health. The Internet is becoming a highway of very intimate dialogue among people with serious concerns."