DoD does WHAT?

It is fascinating that the DoD clearly believes it owns and can use the personal health information of 12 million active duty military personnel for whatever purpose it decides. In this case, the DoD is paying a for-profit corporation to do research on active duty military personnel without their consent.

Maybe when you join the military you lose all privacy and Constitutional rights. I don’t know, I’m not a lawyer. If so, that is a steep price to pay to serve your country: losing all health privacy for yourself and your relatives forever. Do those who join the armed forces know they are signing up to become medical guinea pigs? Do they really understand the consequences for their futures and their families futures?

Many questions abound:

• Are the electronic records adequately secured? What a rich target: 12 million health records! What if enemies hack the privately held data base to learn about key military leaders?

• Will Phase Forward continue to use and sell the records for other purposes as HIPAA authorizes? Other data management corporations (such as Thomson Medstat) the government pays to perform fraud and waste audits obtain millions of health records that they later aggregate and sell to employers without anyone’s consent.

• Furthermore–this is clearly medical research without informed consent. That is simply unethical and illegal. The US signed the Declaration of Helsinki after WW II because Nazis did human research without consent. Back then America recognized the need for informed consent before research takes place. Today, the codes of research and medical ethics still require patients to give informed consent before personal records can be used or disclosed. Why is this project not being done with informed consent when new ‘smart’ electronic consent tools could make it easy, cheap, and fast to obtain informed consent and explain all the risks and consequences?

Review this article from the Washington Post’s Government Inc. Blog for more information:
Data Mining for DoD Health

Rescue plan renews health IT privacy debate

The multi-billion-dollar economic stimulus plan renews patient privacy issue debate.

The plan to add health information technology to the multibillion-dollar economic stimulus package legislators are developing has renewed the debate over how to protect patient privacy in a nationwide health IT system.

In offering advice to lawmakers, advocates are staking out familiar territory: One side argues that health IT often speeds information sharing into the wrong hands, while the other says overly tough privacy protections could negate the benefits of health IT.

Privacy rights defender Dr. Deborah Peel recently warned that the proposed economic stimulus package risks giving more power to companies that want to exploit health information for their own gain.

“Giving for-profit corporations…a blank check for health IT paves the way to establish a goldmine of information that can be used to increase profits [and] promote expensive — not necessarily more effective — drugs, devices and treatment,” Peel said this week.

Opposing privacy views aired in letters to Congress

“No privacy, no peace” could be a slogan we’ll hear a lot during the 111th Congress when it convenes next year.

Members of both houses of Congress have already received a letter from a healthcare coalition warning legislators who are considering information technology booster bills against deviating from the status quo of current privacy rules and laws. Meanwhile, a privacy rights organization sent an opposing letter to House and Senate leaders asking them to insist on the restoration of privacy protections they say were eroded under the Bush administration.

Mary Grealy, president of the Washington-based Healthcare Leadership Council and the Confidentiality Coalition it organized, sent her letter warning that “we are extremely worried that some privacy provisions that have been proposed would have a negative impact on the quality and safety of our healthcare system and counteract the positive benefits of HIT and any economic stimulus effect.” The letter was addressed to House Speaker Nancy Pelosi (D-Calif.) and Senate President Harry Reid (D-Nev.) and copied to all members of Congress. Healthcare Leadership Council members include leaders of many of the major pharmaceutical manufacturers, as well as pharmacy benefits management companies, payers and a few providers.

Connecting The Medical Dots

Congress is considering adding money for health information technology to January’s stimulus package.

Doing so could spur a critical mass of the nation’s doctors to finally enter the information age, but unless the funds are tied to standards for the interoperability of health IT systems, the expenditure could do more harm than good.

Before lawmakers act, they need to think: If stimulus money supports a proliferation of systems that can’t exchange information, we will only be replacing paper-based silos of medical information with more expensive, computer-based silos that are barely more useful. Critical information will remain trapped in proprietary systems, unable to get to where it’s needed.

Health IT systems produce value when they are interoperable. When they’re not, doctors who invest in electronic health records cannot share information with each other or add lab results to your file or send electronic prescriptions to your pharmacist. They would have to use handwritten prescriptions and paper files in addition to their electronic files.

Electronic Records Are Key to Health-Care Reform

BusinessWeek reader William Yasnoff says Obama must make electronic medical records a top priority in his economic stimulus plan.

The current worldwide financial crisis is transforming the problem of rising U.S. health-care costs into a dire threat to our entire economy, making health-care reform an increasingly urgent priority. Any potential approach to restructuring health care must include universal electronic medical records so that both patient care and policy decisions are fully informed. In his weekly address to the nation on Dec. 6, President-elect Barack Obama made a commitment to this goal as part of his economic recovery plan. But what exactly needs to be done to achieve this?…

Privacy First

Just as you control the funds in your checking account, you would retain sole authority over access to any portion of your medical records in a health record bank. Normally, you would make the complete records available to your own doctors and to health-care personnel treating you in an emergency. You would have access to your records yourself (including the ability to add information if you wished) and would be able to see exactly who else has accessed your records and when. With your permission, your information could be aggregated with others’ data into anonymized reports for public health officials, medical researchers, and policymakers.

Kennedy confident HIT bill will pass early in 2009

Rep. Patrick Kennedy (D- RI), co-chairman of the 21st Century Health Care Caucus, on Wednesday said he is optimistic that legislation would be passed early next year that would enable providers to more easily adopt comprehensive electronic health records.

“I think all of us have waited a long time for an opportunity to finally see great progress take place on health information technology,” Kennedy said at a news conference on Capitol Hill.  “And everybody knows that this coming legislative session offers really the most promising opportunity for us to see that progress take place.”

There is little doubt among lawmakers and policy shapers in Washington that broad health reform initiatives will get heard in 2009, and each has jockeyed to get their pet causes in play.  Already President-elect Barack Obama has proven to be a champion of health IT, hinting strongly that provisions aimed at speeding adoption would be included in a mixed bag of programs meant to goose the economy.

Data Mining For DOD Health

Contracts naturally come in all sizes, shapes and flavors. Here’s one that’s just plain fascinating.
“U.S. Department of Defense Chooses Phase Forward to Support FDA-Sponsored Drug Safety Initiative.”
That’s the headline of a press release from a drug industry firm called Phase Forward. The contract involves an effort to use powerful data mining software to examine the medical records of some 12 million people, a company spokesman told us.
The stated aim is to improve the safety of prescription drugs through “rapid evaluation of DoD healthcare data on Army active duty personnel, their family members and retirees to determine which potential safety ‘signals’ merit a more thorough investigation through an epidemiological study.

Thieves Winning Online War, Maybe Even in Your Computer

Internet security is broken, and nobody seems to know quite how to fix it.

Despite the efforts of the computer security industry and a half-decade struggle by Microsoft to protect its Windows operating system, malicious software is spreading faster than ever. The so-called malware surreptitiously takes over a PC and then uses that computer to spread more malware to other machines exponentially. Computer scientists and security researchers acknowledge they cannot get ahead of the onslaught.

As more business and social life has moved onto the Web, criminals thriving on an underground economy of credit card thefts, bank fraud and other scams rob computer users of an estimated $100 billion a year, according to a conservative estimate by the Organization for Security and Cooperation in Europe. A Russian company that sells fake antivirus software that actually takes over a computer pays its illicit distributors as much as $5 million a year.

State health IT, privacy legislation on the rise: report

State legislators introduced more than 370 bills to boost healthcare information technology over an 18-month period in 2007 and 2008, with more than a third passing, according to a report released by the National Conference of State Legislatures.

The volume of IT legislation introduced was three times higher than in a similar period from 2005 to 2006, the NCSL reported.

Meanwhile, six states passed what the NCSL described as “comprehensive measures aimed at protecting patient privacy while facilitating the exchange of health data.” In a news release accompanying the 54-page report, state Sen. Richard Moore, a Massachusetts Democrat and vice president of the organization, called the wave of bills “a healthcare IT revolution.” Federal and state governments “are moving toward a seamless, integrated system of information sharing ranging from patient medical records to insurance claims to filling a patient’s drug prescription,” said Moore, who serves as chairman of the Massachusetts Senate Health Care Financing Committee.

The Push to Build an Electronic Health System

In response to the NYTimes front page article “Thieves Winning Online War, Maybe Even in Your Computer”, Dr. Peel points out the dangers of an Electronic Health System lacking security and privacy.

There is a real disconnect between the ease of hacking home computers and the federal push to build a national electronic health system.

Health-related information technology systems pose a tremendous new and unrecognized threat to the privacy of personal information.

Cubbyhole databases and encryption are not widely used, authentication and identity-proofing are terrible, and hospitals allow thousands of employees to see hundreds of thousands of patient records.