What is a major concern about including patient data in federated electronic health records (EHRs)?

• A. Misinterpretation of data
• B. Inability for their provider to access the data
• C. Possibility for incorrect data to be present
• D. Privacy of their data

Answer: (D)

Privacy of patient data is the major concern in federated EHRs because data stays within multiple independent organizations and is accessed across systems rather than being stored in one central repository. This distributed setup makes it harder to consistently enforce who can see what, obtain proper patient consent, and govern data use, which increases the risk of unauthorized access, data breaches, or leakage during cross-system querying. Even with strong security measures, the many data sources and access paths complicate privacy protections and can raise concerns about secondary use or reidentification, all of which can erode patient trust and run afoul of privacy regulations like HIPAA. While data quality and accessibility are important considerations, the potential privacy exposure in a federated model tends to be the more fundamental and pervasive challenge.