Mostashari, policy committee take critical look at CommonWell

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The ONLY way patients/the public will trust health technology systems is if THEY control ‘interoperability’—-ie if THEY control their sensitive health data. Patients have strong rights to control exactly who can collect, use, and disclose their health data. This also happens to be what the public expects and wants MOST from HIT……The public has strong legal rights to control PHI, despite our flawed HIT systems.

The story below is about an attempt by large technology vendors and the government to maintain control over the nation’s sensitive health data. Institutional/government-sanctioned models like the CommonWell Alliance violate patients’ rights to control their medical records (from diagnoses to DNA to prescription records).  Patients should be able to:

  • -choose personal email addresses as their IDs, there is no need for Institutions to choose ID’s for us—email addresses on the Internet work very well as IDs
  • -download and store their health information from electronic records systems (EHRs)–required by HIPAA since 2001, but only now becoming reality via the Blue Button+ project
  • -email their doctors using Direct secure email

Today’s systems violate 2,400 years of ethics underlying the doctor-patient relationship and the practice of Medicine: ie Hippocrates’ discovery that patients would only be able to trust physicians with deeply personal information about their bodies and minds IF the doctors never shared that information without consent. That ‘ethic’—-ie, to guard the patient’s information and act as the patient’s agent and protector is codified in the Hippocratic Oath and embodied in American law and the AMA Code of Medical Ethics. Americans have strong rights to health information privacy which HIPAA has not wiped out (HIPAA is the FLOOR, not the CEILING for our privacy rights).

The public does NOT agree that their sensitive health data should be used without consent—they expect to control health information with rare legal exceptions. See: http://patientprivacyrights.or…. HUGE majorities believe that individuals alone should decide what data they want to share with whom—not one-size-fits-all law or policies.

Nor does the public agree to use of their personal health data for “research”—whether for clinical research about diseases or by industry for commercial use of the data via the ‘research and public health loopholes’ in HIPAA. Only 1% of the public agrees to unfettered use of personal health data for research. Read more about these survey results here.

The entire healthcare system depends TOTALLY on a two-person relationship, and whether there is trust between those two people. We must look at the fact that today’s HIT systems VIOLATE that personal relationship by making it ‘public’ via the choice of health technology systems designed for data mining and surveillance. Instead we need technology designed to ensure patient control over personal health information (with rare legal exceptions). When patients cannot trust their doctors, health professionals, or the flawed technology systems they use, the consequence is many millions of patients avoid or delay of treatment and hide information. Every year many millions of Americans take actions which CAUSE BAD OUTCOMES.

Current health technologies and data exchange systems cause millions of people annually to risk their health and lives, ie the technologies we are using now cause BAD OUTCOMES.

We have to face facts and design systems that can be trusted. Patient Privacy Rights’ Trust Framework details in 75 auditable criteria what it takes to be a trusted technology or systems. See:http://patientprivacyrights.or… or download the paper at:
http://ssrn.com/abstract=22316…

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