Privacy Digest

Health IT: Not Too Fast - Out of Control: "I've come to think of the whole effort to create a national standard for the exchange of health care data as misguided at best, a looming patient privacy disaster at worst.

Last year, the House of Representatives passed a bill (HR 4157) aimed at promoting a national health IT network, but it died in the Senate and has not been reintroduced in 2007 so far. States are showing an interest as well. In 2005 and 2006, 24 states passed 36 bills calling for Health IT use to improve health care, while 10 state governors passed executive orders to that effect, according to eHealth Initiatives' Third Annual Survey of Health Information Exchange at the State, Regional and Community Levels.

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Foremost is that the matter of health records, let alone the concept of health IT, means different things to different people. For example, to a hospital, a 'health information system' encompasses admissions, insurance records, treatment records, billing records and much more. Integrating these, at a local level, is an IT management headache in and of itself.

Then there are 'medical records,' which is something of a misnomer because they have little to do with actual patient treatment. But since they record patient diagnostics and courses of treatment, they are crucial to billing and insurance claims. It's these types of documents that pass back and forth from physicians to insurance companies. These records can be a nightmare of paperwork by themselves, as different insurance companies may demand the same billing data be formatted and presented in different ways.

Then there are 'clinical records,' the actual case history of a patient. Integration, unification and portability of theses records is considered the Holy Grail of health IT. Its greatest benefit is also its greatest drawback: it would centralize every detail about an individual's health history in one place - be it on a wallet-sized card or on a distant server housed with millions of other such records. Wherever it is, the vision calls for it to be network-enabled and the government must take some hand in it. Beyond that, the vision turns murky. Ask who will own the information, how it will be networked, who will have access and on what terms, and you get dozens of answers, accompanied by justifications and rationalizations.

And it's here, on the networking aspect, where ALEC's principles, and much of the debate, fall short. What's needed is something to the effect of: 'These ease with which electronic information can be replicated and shared requires necessary policies to assure the protection and privacy of consumer data.'

The trouble is, a statement like this may be antithetical to the whole notion of an interoperable health IT network, especially for clinical records. Wiser minds than I have put it, 'you can have an open method of sharing information or you can have a high threshold of privacy, but you can't have both.'

Much is made of the supposition that a health care IT network would lower costs, improve the quality of care and, overall, make the U.S. health care system more efficient.

Efficient for whom? What do we get from a standardized national network for the wider ability to exchange of medical data on consumers?"

(Read Original Article - Via Out of Control.)