Critics Blast Electronic Med Records Plan

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http://www.newsmax.com/archives/articles/2005/1/16/210352.shtml

 

 

Critics Blast Electronic Med Records Plan

 

Jon E. Dougherty, NewsMax.com

Monday, Jan. 17, 2005

 

Soon your private medical record could become part of

a nationwide electronic database accessible by

bureaucrats.

 

The Department of Health and Human Resources (HHS)

will shortly implement a new medical database system

known as the National Health Information Network

(NHIN).

 

To be administered by the HHS, the Information Network

will be part of a longstanding plan to implement

changes to the nation's health care system, in part to

lower costs, reduce fraud, and increase efficiency.

 

The plan also would include creation of Electronic

Health Records, or EHRs, so that a patient's medical

information can be shared quickly and seamlessly with

doctors, insurance companies and government health

care providers.

 

With a few key strokes – government bureaucrats will

know everything about you personal medical history.

 

" The NHIN could be developed and operated in many ways

… It could be highly decentralized or somewhat

centrally brokered. It could be a nationwide service,

a collection of regional services or a set of tools

that share common components, " said the department, in

a statement outlining the system's goals and

objectives.

 

But opponents say EHRs represent a major violation of

a patient's privacy, mostly because records would not

only be accessible to health care providers without

patient consent but any number of other people and

organizations up and down the line. That would include

universities conducting research, medical students,

and bureaucrats at every level, from entry-level data

processors to registration clerks at medical clinics

and even high level political officials.

 

Not only can sensitive medical information be viewed

inappropriately, if a record contains erroneous

information a patient could spend countless hours

trying to correct his record as it made its way around

the medical community.

 

Finally, say critics, patients who encounter problems

with their physician such as a personality conflict,

misdiagnosis or malpractice situation could have that

conflict put into their records from the physician's

standpoint (patient non-compliant and difficult;

threatened to sue) and, even if the problem was

legitimate, that would make it more difficult for them

to find other physicians willing to treat them.

 

And there are other questions. Personal medical

histories include sometimes embarrassing details of

one’s lives, sexual activities, and other matters that

in the hands of corrupt officials could be used for

blackmail or other nefarious purposes.

 

Now What?

 

The EHRs are just the final nail in the coffin of

medical privacy, say opponents who have long fought

for rules preventing wholesale dissemination of health

records.

 

Since 1996, when Congress and the Clinton

administration passed the Health Insurance Portability

and Accountability Act, or HIPAA, patient advocacy

groups have been battling federal rules the government

says enhances medical privacy but which critics claim

does just the opposite.

 

Specifically, they say that privacy concerns are being

sacrificed to accommodate government agencies,

bureaucrats and big business interests who stand to

gain through the electronic standardization of medical

records.

 

" Does the new Federal Medical Privacy Rule, which goes

into effect on April 14, 2003, strengthen or diminish

individuals’ control over the flow of their personal

health information? " says an analysis by the Institute

for Health Freedom.

 

" The federal government and many health-care industry

representatives claim the new rule enhances Americans

medical privacy protections, " says the organization.

" But privacy advocates and consumer groups point out

that the Rule actually eliminates individuals' freedom

to give or withhold consent regarding the release of

their personal health information to many persons for

many purposes. "

 

Adds Robin Kaigh, a New York lawyer who has tracked

medical privacy since the passage of HIPAA: government

rules covering medical privacy, as well as the

implementation of the EHRs, will destroy any remaining

vestige of health care confidentiality.

 

When that happens, she points out, it will be against

the wishes of most Americans. A recent Gallup survey

conducted for the Institute for Health Freedom cited

by Kaigh in a speech Nov. 18 before the National

Committee on Vital and Health Statistics Subcommittee

on Privacy and Confidentiality showed a large majority

of Americans " don't want their medical information

shared with anyone other than the doctor they shared

that information with, " including any other doctors,

without their consent.

 

In addition, the poll showed 92 percent opposed giving

government agencies access, while 84 percent opposed

giving insurance companies access without prior

consent.

 

Additionally, Kaigh says there are security concerns

with computerized records. Even with a host of

technological safeguards available for information

technology (IT) systems, no system is a hundred

percent safe from hackers, therefore it should be up

to the patient, not the federal government to decide

if he is willing to undertake that risk.

 

NHIN Goals

 

HHS says there are four main purposes for the national

network. They are:

 

# To inform clinical practices of a patient's medical

history (via EHRs);

 

# " Interconnect clinicians so that they can exchange

health information using advanced and secure

electronic communication; "

 

# " Personalize care with consumer-based health records

and better information for consumers, " and;

 

# " Improve public health through advanced

bio-surveillance methods and streamlined data

collection for quality measurement and research. "

 

Such a system " could be overseen by public

organizations, by private organizations, or by

public-private consortia, " says HHS. But " regardless

of how it is developed, overseen or operated, there is

a compelling public interest for a NHIN to exist. "

 

To that end, InformationWeek reports, 11 members of a

congressionally mandated federal commission were

convened this week in Washington, D.C., " to create a

plan for every American to get electronic health

records… "

 

And in an effort to placate privacy advocates and

critics, HHS says there are no plans to create a

so-called " centralized database " of medical records on

the federal level. But if a network of computers all

transfer and exchange patient records, that is roughly

the equivalent of a centralized database one could

argue.

 

Done Deal?

 

President Bush has said he wants all Americans to have

electronic medical records by 2014, but early efforts

to accomplish this may be plagued with problems.

 

Earlier this week speakers at the first meeting of the

Commission on Systemic Interoperability, which is

charged with implementing the EHRs, said while some

hospitals and doctors are already using electronic

records, others are not because they fear standards

eventually adopted for the industry won't match up to

current software.

 

" Without widespread adoption, the cost of electronic

health record technology remains high, and smaller

hospitals and practices are hesitant to use the

technology until the cost goes down and the industry

has interoperability standards, " IDG News Service

reported.

 

Though consumers have until January 18 to contact HHS

and provide feedback on whether they support or oppose

the system, the department already appears poised to

implement EHRs.

 

" As the nation embarks on the widespread deployment of

EHRs, a variety of concomitant challenges and barriers

must be addressed, " says the agency's Office of the

National Coordinator for Health Information

Technology, on its Web site.

 

Congress is also sounding an anticipatory note. In a

letter to the interoperability commission this week,

lawmakers wrote, " Your work will be critical to making

the vision for health IT a reality, so we urge you to

keep practical application in mind as you develop

recommendation and draft your report. We also

encourage you to work with due urgency to take

advantage of the opportunity that lies before us this

year. "

 

Critics say the government isn't interested in hearing

from Americans who are opposed to the system. They say

it appears as if right now Washington has made up its

mind about implementing EHRs, and now are just working

out details to implement the plan.

 

Deaf Ears

 

Opponents to the administration's EHR plan worry they

are running out of time, unless Americans en masse

voice their disapproval and soon to the HHS. To

underscore the urgency of their plea, they point to

the fact that the U.S. Supreme Court has already

refused to hear some challenges to the government's

medical privacy rule and other provisions.

 

Brought by the South Carolina Medical Association,

that group sought to have the privacy rules under

HIPAA ruled unconstitutional. The high court's refusal

to hear the case meant a lower court's ruling

upholding the rule as legal stands, " affirming that

the Congress acted within its constitutional authority

when it delegated the writing of the Rule to the

Department of Health and Human Services, " said an

analysis by the Electronic Privacy and Information

Center, an advocacy group (Editor's note: The lower

court's ruling comes from the 4th U.S. Court of

Appeals, No. 02-2001, April 25, 2003).

 

The Oath of Hippocrates, from the 4th century B.C.,

which all physicians must take, says, " Whatsoever

things I see or hear concerning the life of men, in my

attendance on the sick or even apart there from, which

ought not be noised abroad, I will keep silence

thereon, counting such things to be as sacred

secrets. "

 

Privacy advocates worry too many physicians are

forgetting this oath in favor of political and

economic expediency and the demands of a Big-brother

government that is acting without regard to the

privacy needs of its citizens.

 

" A true medical privacy rule would require patient

consent before others could access medical records,

not eliminate such consent, " says Kaigh.

 

Editor’s Note: You can contact the HHS and voice your

concern over the new NHIN plan. Let them know if you

agree with your medical records becoming part of a

national database. Go Here Now!

 

 

 

 

 

 

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