Privacy advocates are battling moves in Congress to create an electronic network so physicians can obtain the medical histories of patients no matter where they are in the country.
The Department of Health and Human Services says that almost $87 billion could be saved each year if physicians were able to retrieve medical records easily. Proponents of such networks say that giving doctors the ability to retrieve standardized records electronically would avoid duplicative medical tests, reduce errors in prescribing medicine and give physicians a complete history of patients who fall sick while on vacation or on business trips.
But opponents say the plan will result in wider distribution of the most sensitive and personal records ever compiled on Americans, without adequate privacy protections and without giving patients the right to refuse to have records included in the system.
Marc Rotenberg, executive director of the Electronic Privacy Information Center, a Washington group that monitors electronic privacy issues, said there has to be stronger protections of electronic medical records given the epidemic of identity theft from computer data banks this year.
“We must not allow the most sensitive records that exist – our medical records – to go online without adequate privacy safeguards,” he said.
Scott Wallace, chairman of the Commission on Systemic Inoperability, a federal panel that examined the issue this year, accused privacy groups of scaremongering.
Wallace said that medical records stored electronically will actually be more secure than is the case with the current system, in which doctors have files of paper records stored in their offices.
“You have no idea who is looking at your paper records,” he said. Wallace said there is an electronic trail kept identifying each person who opens up an electronic record, which increases the confidentiality of medical records.
Wallace drew a parallel to the U.S. banking system, which has shifted from a paper-based system over the last decade to electronic banking. “Are there downsides and risks? There absolutely are. But like the banking system, they can be addressed and dealt with,” he said.
The federal commission last month issued a report that contended an electronic network would reduce the 98,000 U.S. deaths from medical errors each year by providing physicians with more information about a patient’s history and drug interactions. Information collected by the network could also help authorities track a disease or quickly spot patterns associated with terrorist attacks.
Rep. Nancy Johnson, R-Conn., introduced legislation in the House last month to set up a national system of electronic records and electronic prescriptions. Under terms of the measure, the federal rules would override any state privacy laws – a move Johnson said includes strong privacy protections.
Some experts caution that Americans are concerned that the government is already collecting too much information on them.
New York City’s health commissioner, Thomas Friedan, sparked a debate earlier this year by proposing that the city intervene in the medical care of New Yorkers by gathering medical test results from laboratories in order to identify those at risk for developing diabetes.
Nationally, the disease costs an estimated $5 billion a year to treat. Friedan’s aim is to ensure that those at risk for developing diabetes be notified and encouraged to take drugs to stay healthy.
James Pyles, a Washington attorney who represents health-care groups concerned with privacy, said Friedan’s plan may be well-meaning, but it’s not a government responsibility.
Pyles said some Americans are already declining to seek medical care because they are concerned that their privacy will be invaded.
“There’s a long tradition in this country beginning with the Bill of Rights that law-abiding citizens have a right to be left alone,” he said. He said there are also obvious health benefits for every male over 40 getting prostate tests, but there’s no government responsibility to order men to get them.
Pyles warned that establishing a government database of individual medical data would only result in people resorting to a “black market” of physicians, who would agree to treat them for embarrassing or work-disabling diseases without entering the information into a database. And with medicine about to enter the genetic age, Pyles noted, many people are concerned that information on their genetic makeup could affect the lives of their children or grandchildren.
An underground system of medicine “would be an ironic result, and an unintended result,” he said.
Although many Americans are unaware of it, federal rules that went into effect in 2003 permit physicians to share medical histories with insurers and their business associates without notifying the patients.
(Contact Lance Gay at GayL@SHNS.com. Distributed by Scripps Howard News Service,http://www.shns.com/)