Health Freedom Watch -- January 2008

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Health Freedom Watch

(Email newsletter published by the Institute for Health Freedom)

January 2008

Contents:

 

* _Microsoft Seeks Patent for System to Remotely Monitor Office

Workers _ (mip://04e543c8/default.html#Article1)

* _Collective Care: Medical Groups, National Accrediting Agency, and

Large Employers Promote “Medical Home†Concept _

(mip://04e543c8/default.html#Article2)

* _“Wired for Health Care Quality Act†Threatens Privacy and Control

over Personal Information_ (mip://04e543c8/default.html#Article3)

 

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Microsoft Seeks Patent for System to Remotely Monitor Office Workers

 

Microsoft is seeking a U.S. patent for software that would enable employers

to monitor workers’ “productivity, physical well-being and competence,â€

the

Times of London reports. The patent application, the Times says, reveals

that:

* The “‘unique monitoring system’ … could link workers to their

computers†via wireless sensors that measure “heart rate, galvanic skin

response, EMG, brain signals, respiration rate, body temperature, movement

facial

movements, facial expressions and blood pressure.â€

* Managers could use the system “to monitor employees’ performanceâ€

according to those criteria.

* The software could also “automatically detect frustration or stress

in the user [and] offer and provide assistance accordingly.â€

* “Physical changes to an employee would be matched to an individual

psychological profile based on a worker’s weight, age and health. If the

system picked up an increase in heart rate or facial expressions suggestive of

stress or frustration, it would tell management that he needed help.â€

The Times writes, “Technology allowing constant monitoring of workers was

previously limited to pilots, firefighters and NASA astronauts. This is

believed to be the first time a company has proposed developing such software

for

mainstream workplaces.â€

Implications for Freedom and Privacy

The issue of remote monitoring of physiological indicators raises some

important ethical issues, including:

* Who would own and control the release of employees’ data collected by

employers?

* What right to privacy do individuals/employees have regarding their

physiological and other personal health data?

With the development of new employee-surveillance technologies, it’s

important for Americans to consider the need for strengthening privacy and civil

rights in the information age.

Source: “Microsoft Seeks Patent for Office 'Spy' Software,†TimesOnline,

January 16, 2008:

_http://technology.timesonline.co.uk/tol/news/tech_and_web/article3193480.ece_

(http://technology.timesonline.co.uk/tol/news/tech_and_web/article3193480.ece)

_[back to Contents]_ (mip://04e543c8/default.html#CONTENTS)

 

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Collective Care: Medical Groups, National Accrediting Agency, and Large

Employers Promote “Medical Home†Concept

 

The National Committee for Quality Assurance (NCQA), a private

not-for-profit health-care accrediting agency, along with some large employers

and medical

groups, are promoting the “medical home [concept,] … a model of care where

each patient has an ongoing relationship with a personal physician who leads

a team that takes collective responsibility for patient care†(emphasis

added). In a January 8 news release NCQA says, “The physician-led care team

is

responsible for providing all the patient’s health care needs and, when

needed,

coordinating care across the health care system…. Many large health plans, as

well as Medicare and Medicaid, are planning demonstration projects to learn

more about how [medical] practices can become medical homes and the quality

and cost advantages of doing so†(emphasis added).

This concept was defined by the American Academy of Family Physicians

(AAFP), the American Academy of Pediatrics, the American College of Physicians

(ACP), and the American Osteopathic Association (AOA). Ten elements are

associated with physician practices comprising “medical homes†(quoting the

release):

* Use of paper or electronic charting tools to organize clinical

information

* Use of data to identify important diagnoses and conditions in

practice

* Adoption and implementation of evidence-based guidelines for three

chronic conditions

* Systematic tracking of test results and identification of abnormal

results

* Referral tracking, using a paper or electronic system

* Clinical and/or service performance measurement, by physician or

across the practice

* Performance reporting, by physician or across the practice

* Active patient self-management support

* Written standards for patient access and patient communication

* Use of data to show standards for patient access and communication

are met

In the Annals of Family Medicine, AAFP president Dr. Jim King explained that

“physicians themselves cannot be recognized as medical homes; only a

physician practice can earn the designation of ‘patient-centered medical

home.’

That means a patient-centered medical home is a team effort, involving everyone

in the practice†(emphasis added). The journal reported that the Council of

State Governments adopted a resolution urging its members to establish and

fund medical-home pilot projects. “The resolution will be sent to governors

and

state legislative leaders, creating an opportunity for AAFP chapters to open

a dialog with these officials about the importance of the patient-centered

medical home model in reforming health care at the state level,†the journal

stated.

NCQA stressed that “Large employers have also embraced the patient-centered

medical home concept.†Paul Grundy, chairman of the Patient-Centered Primary

Care Collaborative and director of Healthcare, Technology and Strategic

Initiatives for IBM Global Wellbeing Services and Health Benefits, told NCQA,

“

The question isn’t whether we should implement the medical home, but how.

These

standards clearly assess and identify effective medical homes.â€

Founded in 1990, NCQA’s mission is to improve the quality of health care and

elevate this issue to the top of the national agenda.

Sources:

* “NCQA Program to Evaluate Patient-Centered Medical Homes,†National

Committee for Quality Assurance press release, January 8, 2008:

_http://web.ncqa.org/tabid/641/Default.aspx_

(http://web.ncqa.org/tabid/641/Default.aspx)

 

* “Medical Home Gains Prominence with AAFP Oversight,†Annals of

Family Medicine, January/February 2008:

_http://www.annfammed.org/cgi/content/full/6/1/90_

(http://www.annfammed.org/cgi/content/full/6/1/90)

 

_[back to Contents]_ (mip://04e543c8/default.html#CONTENTS)

 

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“Wired for Health Care Quality Act†Threatens Privacy and Control over

Personal Information

 

Given the federal government’s ambitious plans for establishing a national

electronic medical-records system, everyone should keep a close watch on the

Wired for Health Care Quality Act. Senate bill 1693 would foster a nationwide

interoperable health information-technology (IT) system while purportedly

aiming to improve the quality and lower the costs of health care. The political

strategy of combining a popular idea (improvement in medical care) and an

unpopular idea (the anti-privacy national database) in a single bill appears to

be at work here.

Many members of Congress and staffers who don’t understand the anti-privacy

features of the current federal “privacy†regulations won’t fully see

through the misleading promises of S. 1693. The first page of the Senate

report

states, “The bill enhances the use of health information technology to

improve

health care quality, while protecting the privacy and security of health

information†(emphasis added). The bill also includes a section (Sec. 3013)

titled “Ensuring Privacy and Security,†which says an operator of an

electronic

health database would be deemed a “covered entity†under the privacy

regulations. This means such an operator would be permitted to share patient

information with over 600,000 other covered entities (such as insurers) without

consent, as permitted under the privacy regulations.

 

Thus the bill actually would destroy patient privacy by facilitating the

electronic exchange under the misleading promise that privacy will be

protected.

The Institute for Health Freedom has been stressing since 1999 that the

privacy regulations do NOT ensure true patient privacy because they permit the

release of personal health information—without patients’ consent—for

purposes

related to treatment, payment, and health-care management.

What can you do to protect your health privacy and inform Congress about

proposed health IT legislation and how it could destroy health privacy? Inform

your representatives and staff about the federal medical-privacy rule and its

true impact on patient privacy. Educate them by doing the following:

* Ask if they have actually read the full text of the privacy

regulations as published in the Code of Federal Regulations.

* If they have not, ask them to do so to become fully informed about

the anti-privacy features.

* Make an appointment with your members of Congress and their staff

(either in Washington, D.C., or at their local office near your home) to inform

them about how the privacy regulations destroy patient privacy (by

eliminating patient consent and therefore control over the flow of electronic

records).

* Share and circulate information from pro-health privacy groups that

advocate health-privacy rights, including the Institute for Health Freedom

(_www.ForHealthFreedom.org_ (http://www.forhealthfreedom/) ), Citizens’

Council

on Health Care (_www.cchconline.org_ (http://www.cchconline.org/) ), and

Patient Privacy Rights (_www.patientprivacyrights.org_

(http://www.patientprivacyrights.org/) ).

Note: Senators Hillary Clinton and Barack Obama are both co-sponsors of the

Wired for Health Care Quality Act (S. 1693). Perhaps they are especially in

need of education regarding the privacy regulations.

Sources:

* “HHS Enterprise Information Technology Tactical Plan (Draft): FY 2006

– FY 2010â€: _http://www.hhs.gov/ocio/plans/itstrategicplan.html_

(http://www.hhs.gov/ocio/plans/tacticalplanvol2.html)

* “Wired for Health Care Quality Care Actâ€, Senate Report 110-187,

110th Congress, 1st Session (report to accompany S. 1693), October 1, 2007 (pp.

1-2 and p 52). :

_http://thomas.loc.gov/cgi-bin/cpquery/R?cp110:FLD010:@1(sr187)_

(http://thomas.loc.gov/cgi-bin/cpquery/R?cp110:FLD010:@1(sr187)) :

 

_[back to Contents]_ (mip://04e543c8/default.html#CONTENTS)

 

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Health Freedom Watch is a monthly email newsletter published by the

_Institute for Health Freedom_ (http://www.forhealthfreedom.org/) (IHF), a

national

nonprofit, educational organization whose mission is to bring the issues of

personal health freedom to the forefront of the American health-policy debate.

IHF monitors and reports on national policies that affect citizens' freedom

to choose their health-care treatments and providers, and to maintain their

health privacy—including genetic privacy. IHF is not affiliated with any

other

organization. © Institute for Health Freedom.