The tortuous path of the HIPAA privacy provision

“Whatever, in connection with my professional practice, or not in connection with it, I may see or hear in the lives of men which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.” –Oath of Hippocrates From the very beginning, when the privacy rule of the Health Insurance Portability and Accountability Act was first released by HHS in the waning days of the Clinton administration in late 2000, the Hippocratic Oath has taken a back seat to national security, many observers contend.
HIPAA was passed in 1996 with some privacy penalty provisions in place, but Congress gave itself a three-year grace period to come back and flesh out the law with specific privacy legislation. That never happened. Instead, legislative foot-dragging triggered a HIPAA provision that said if Congress failed to act on privacy within three years of passage, HHS was given the authority to write the privacy rule itself. Even that first issue of an HHS-written HIPAA privacy rule allowed disclosures of medical records for national security requests, but since then, the Justice Department and HHS, the key federal agency pushing healthcare information technology, have teamed up to seriously weaken the HIPAA privacy rule while Congress and the Bush administration have sought to expand government access to health records for national security reasons, according to lawyers and privacy advocates.
That doesn’t mean the Justice Department or HHS are implicated in illegally exposing medical records to surveillance, but it does mean the relaxation of the rule makes it easier for government surveillance agencies to obtain healthcare data from commercial sources, those sources say.
… “The (RTI) fraud-and-abuse report was the absolute worst, giving everything over to private industry,” says Deborah Peel, an Austin, Texas, psychiatrist and the founder of the not-for-profit Patient Privacy Rights Foundation.
Peel says individuals have an ancient right to health information privacy, first recorded in the Hippocratic Oath, but also protected by the U.S. Constitution, federal, state and common laws.
But in recent years, Peel says, the government has engaged in “a concerted effort to gut and eliminate an individual’s control over digital information. It’s absolutely a systemic pattern. Over and over again, you see document after document coming out of ONCHIT and HHS, and they want to open up healthcare records for data mining. There is never a decision for privacy. They want back doors into everything. Someone is directing this because it’s not happening by accident.”

New lawsuit challenges mandatory premarital testing

CAIRO: Mandatory premarital medical testing is an inherently flawed and potentially counter-productive policy that contravenes basic rights, the Egyptian Initiative for Personal Rights (EIPR) argued in a new lawsuit filed yesterday before Egypt’s Court of Administrative Justice.

The case challenges the new policy, adopted last summer, requiring all citizens wishing to marry to submit to a comprehensive and mandatory medical examination as a prerequisite for registering their marriage.

Mandatory testing, the plaintiffs argue, violates the protection afforded by Egypt’s Constitution and international human rights treaties for the rights to privacy and personal autonomy and imposes an excessive limitation on the right to marry and start a family.

Vital Signs: Examining Our Health Data

Ever wonder who sorts through all the data that powers your all-knowing health insurance company? Samuel A. McKinney did. McKinney was surprised to find a concerned letter from Blue Cross Blue Shield in his mailbox wondering why he had stopped taking his medication: Immediately consult a physician about your medication if it’s too expensive or causing side effects, the insurer advised. Trouble was, he had just filled the prescription.
So, he called and discovered that Resolution Health, a Columbia-based health analytics firm, was helping insurers keep closer tabs their members. Armed with a massive databases — medical and pharmacy claims, lab reports, provider reports and other statistics — Resolution analyzes personal health information. More than 1,000 computer algorithms dissect the data for millions of members, scanning for ways to cut costs, eliminate conflicting medications and avoid lapses in treatment.
When a problems are identified, letters, much like this one, are sent out to patients such as McKinney and their doctors.
As it turns out, Blue Cross wasn’t informed that McKinney, a retiree who lives in Salem, Ohio, gets his drugs through a military pension program.
McKinney forgave the oversight.

Microsoft et al to employ IT in ‘ground-breaking’ genetics research

SAN DIEGO – Microsoft, Scripps Health, Affymetrix and Navigenics will launch what the companies say is ground-breaking research to evaluate the impact of personal genetic testing on the health and psyche of a patient. The study will offer genetic scans to up to 10,000 employees, family and friends of Scripps Health system and will measure changes in participants’ behaviors over a 20-year period.

Researchers will use healthcare IT to study genetic variations linked to many diseases. “The study will afford researchers the opportunity to better understand ways to prevent, diagnose and treat disease,”according toMicrosoft officials. “This project represents the largest single opportunity to date for modern genetics to move outside the laboratory and directly to consumers,” saidKevin King, president of Affymetrix. The study follows heated presidential election debates over how to reduce the costs of healthcare through better use of preventive care. It also comes as physicians and stakeholders continue to wrangle over the value and timing of using genetic information to treat patients.

EHRs don’t save Texas doc time, money or paper

I can’t stand it any longer! This nonsense that electronic health records will save money must stop! We have a six-man orthopedic group in Lubbock, Texas, and have had one company for six years and were ill advised to switch to another this year. Both are nothing special, don’t save time, don’t save money, don’t save paper, are not safer for patients.

My God, who are the idiots who have convinced our legislators that these systems will somehow save money? Improve patient safety? Hogwash! Try to update a longstanding patient’s profile in your computer … see how long it takes you, how slowed down your office will be. I just read that there are only 50 practices using our current company in the U.S. I know why—the system has huge flaws, like not being able to fax batched documents. Where are the efficiencies? For $250,000, I could have hired more staff, funded my pension and taken a hell of a vacation. Somebody please stop this misinformation.

CMS, e-health group push e-Rx with meeting, guide

The e-Health Initiative released its A Clinician’s Guide to Electronic Prescribing at a Boston e-prescribing conference sponsored by the CMS.
The guide, clearly aimed at boosting the use of e-prescribing, was introduced Tuesday at the daylong conference, which was promoted by the CMS with full-page ads in the New York Times and Wall Street Journal. The guide differentiates between “stand-alone” e-prescribing software systems, that can either be purchased and loaded onto and then run off of a prescriber’s own computer system, and Internet-based systems where the software is accessed through a Web browser and the service is paid for through monthly fees.

Microsoft Joins Study to Gauge Impact of Genetic Testing

Microsoft is co-sponsoring a study to see if people who undergo genetic testing to identify their risk for developing certain diseases actually change their behavior to mitigate that risk.
San Diego-based research lab Scripps Translational Science Institute (STSI), the study’s main sponsor, will offer genetic scans to up to 10,000 employees, family members and friends of Scripps Health that provide a detailed analysis of their risk for more than 20 health conditions. Scripps Health is a US$2 billion nonprofit community health system also based in San Diego.
The conditions — including diabetes, obesity, heart attack and some forms of cancer — are ones that can be changed or prevented by people’s lifestyle choices. Scripps will then track changes in the participants’ behaviors over 20 years to see if people who learn they are at risk for certain diseases or conditions will actually take preventative measures to avoid them, Microsoft said.

Healthcare IT leaders kick off government’s e-prescribing drive

With the first phase of Medicare’s mandate for e-prescribing rolling out in January, healthcare IT leaders, led by Health and Human Services Secretary Michael Leavitt, gathered Tuesday in Boston to jumpstart the initiative.

“One of the beauties of the system is that it will reduce the number of medical mistakes … and tragic results,” Leavittsaid at the National E-prescribing Conference.

“We know it saves lives, we know it saves money, and it’s time to implement it.”

Leavitt tied the nation’s current economic crisis to the rising costs of healthcare and noted that going electronic with prescriptions helps provide cost-savings for patients, doctors and the entire healthcare system.

“It’s an economic imperative in this country,” he said.

The changing face of AHIC

It is a tale of three committees: one fading into history, a second forming to take its place and a proposed third that might supplant the first and render the second moot.
On Nov. 12, members of the American Health Information Community are scheduled to gather for their 25th and, perhaps, final meeting. AHIC, which was created in 2005 by HHS Secretary Mike Leavitt to advise him on healthcare information technology policy, is being converted into a privately run and managed not-for-profit group called AHIC Successor.
But the new AHIC may be overshadowed next year by a proposed new federal oversight committee that has the backing of powerful lawmaker Rep. Pete Stark (D-Calif.), a move opposed by the Healthcare Information and Management Systems Society.

Calif. hospitals face penalties for privacy violations

California hospitals will face tougher penalties for patient privacy breaches and must do more to inform state regulators of such lapses, according to two new laws signed earlier this week by Gov. Arnold Schwarzenegger.

The state will create the Office of Health Information Integrity within the California Health & Human Services Agency, and appoint a director to assess penalties against individuals who violate patient privacy, with fines up to $250,000. Monies from the penalties will be used to support healthcare quality-improvement projects. The director can also recommend to state and federal licensing authorities further regulatory action.

Another new law sets fines for hospitals that fail to protect patients’ information of up to $250,000. The law also raises fines for serious medical errors in hospitals from $25,000 to up to $125,000 per