Physician, Upgrade Thyself

Go into almost any medical office, hospital or clinic in the United States and your records will still be handled the old-fashioned way — on paper. You can use a computer to pay your taxes, to program your TiVo or to read a message from your great-aunt, but your doctor has to practically level a forest just to examine your medical files. The cost, however, isn’t calculated in trees but in human lives: Electronic medical records would reduce the risk of medical errors and spare hospitals the expense of missing records and unnecessary treatment.

Health care providers have been dreaming about electronic records for so long that the idea has begun to seem like vaporware, a never-to-be-realized fantasy similar to flying cars and jetpacks. But there is already a clear software standard, an open-source system that’s low-cost, easy to use and readily available. It could be the key to the health care system we ought to have already.

The program, WorldVistA, is based on the Veterans Affairs Department’s electronic-records system, called VistA (short for Veterans Health Information Systems and Technology Architecture — and yes, they beat Bill Gates to the name). VistA stands as perhaps the greatest success story for government-developed information technology since the Internet itself.

Using the VistA record system, the veterans department has managed to improve nearly every benchmark of quality in health care. In a decade, the department increased its pneumonia vaccination rate among at-risk patients to 94 percent from only 29 percent. That translates into 6,000 saved lives and $40 million saved each year from fewer pneumonia hospitalizations. On a host of other benchmarks — beta blocker use, cancer screening, cholesterol screening and so on — the department outperforms the nation’s best care.

{WorldVista is simple, easy, to use, lowers costs, and improves health of veterans, but it also completely violates veterans’ legal and ethical rights to medical privacy, by exposing the medical records of veterans and their dependents to identity theft and discrimination by private corporations and future employers. These violations of privacy occur because the corporations that use, handle, and store VA patient data can sell their data.  The Amended HIPAA Privacy Rule allows any of over 4 million health-related businesses and government agencies to use
electronic medical records for any business purpose without patient consent. The author has no idea how much identifiable patient data hemorrhages out of the offices and hospitals where patients are treated and into the commercial data marketplace where it is purchased by drug companies, large employers, and insurers to discriminate against patients who have sought medical care. The elimination of medical privacy will devastate the veterans of Iraq, who have experienced mental illness and addiction as a result of war trauma. Who will hire these vets after they leave the military when their mental health records are available for commercial surveillance? ~ Dr. Deborah Peel, Patient Privacy Ri

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