Congress sits on hands as health privacy wanes

By David Pittman | Politico.com | 6/12/14 5:00 AM EDT

Everyone from legal scholars to patient privacy advocates — and even the White House — are saying the country’s landmark health privacy law is antiquated and needs to be updated.

But Congress doesn’t appear to be moving any legislation on the issue.

Backers of tougher health data privacy rules argue that much has changed in how people’s health information is collected and handled since the law governing patient records was passed in 1996. Protections added in 2009 don’t fully address the problem, they say.

The Health Insurance Portability and Accountability Act — commonly called HIPAA — largely applies to use of data by health care providers and insurance companies. But they are a smaller and smaller slice of who deals with patient information today.

For example, employee wellness programs, which are increasingly popular and hold potentially private information such as pregnancy status, don’t fall under the HIPAA umbrella. Hospital discharge data is sold by 33 states, according to the Federal Trade Commission, but only three do so in a HIPAA-compliant fashion.

“I think HIPAA does a really good job where it’s relevant,” said Kirk Nahra, a privacy and information security lawyer at Wiley Rein. “What’s happened in the last 15 years is that the space where it’s not relevant has been what’s growing.”

HIPAA governs the doctor-patient and doctor-payer relationships, but it didn’t envision the rest of the universe, and that’s where there is a need for new privacy protections, Nahra said.

Health and fitness apps — of which there are nearly 100,000 available today — are probably the biggest concern. They fall outside HIPAA and are free to collect and share information on their users.

The Privacy Rights Clearinghouse concluded last year that mobile health and fitness apps “are not particularly safe” when it comes to protecting user privacy. They found 26 percent of the free apps and 40 percent of paid apps didn’t have a privacy policy. Furthermore, 39 percent of free apps and 30 percent of paid apps sent data to a third party not disclosed by the developer.

The FTC mapped where data was being sent from 14 free health and fitness apps. One transmitted data to 18 different third parties with diet, workout, personal identifiers and other information. Fourteen third parties received consumers’ names and email addresses, and 22 received gender, location and symptom-search information.

The free use of consumer information by app makers is one reason privacy advocates are concerned that Apple is entering the game. The tech giant announced last week it would make its HealthKit part of its iOS 8 operating system, set to be released later this year.

The FTC sees all of this as a problem and is looking to Congress for help.

In a recent report on data brokers, the commission recommended Congress consider legislation to force tech companies to obtain express consent from consumers before information is collected or shared.

A White House report on big data and privacy last month noted that current policy “may not be well-suited” in the future. While health data exchanges will help realize technology’s potential, the information often is shared “in ways that might not accord with consumer expectations of the privacy of their medical data.”

“Health care leaders have voiced the need for a broader trust framework to grant all health information, regardless of its source, some level of privacy protection,” the report said.

Despite the pleas for new rules on use of consumer health information, Congress appears to be sitting on its hands. Little legislation exists, and the issue has yet to gain traction.

“The only thing that is likely to get congressional interest is for there to be a major data tragedy,” said Nicolas Terry, health law professor at Indiana University law school. “It’s very hard at the moment to see much consensus out there. Everyone says they believe in privacy. Privacy is very important. Privacy is a right. But actually moving the ball forward to protect consumers, given the massive weight of the information lobby, seems very hard.”

Congress has been working on data security and breach notification issues — especially in light of recent high-profile cases involving Target and others — with a decent chance of passing something by the end of the year.

Privacy is another issue. “There’s no consensus on broader privacy issues,” Nahra said.

Lawmakers on Capitol Hill have taken some steps to improve consumer privacy protections since HIPAA was passed. Seeing the dawn of the advent of electronic medical records, they included several provisions in the 2009 HITECH Act, including a ban on the sale of personal health information, breach notification requirements and penalties for privacy violators.

One possible source of inaction is the seemingly immovable lobbying force. Companies such as Microsoft, Google, Siemens, the Mayo Clinic, WebMD, IMS Health and IBM all spent money lobbying Congress last year on health privacy issues, according to disclosure forms.

Even Nike — maker of the popular fitness app Nike+ that’s implanted on all iPhones — disclosed lobbying on privacy issues in 2013.

Terry said consumers could incite change if they demanded it. Automobile makers lobbied hard against safety regulations in the 1960s and 1970s, but car safety is ubiquitous today because of pressure from car buyers, he said.

The FTC has the authority to halt companies’ deceptive practices if they fail to disclose certain data uses to consumers, notes Justin Brookman, director of consumer privacy at the Center for Democracy & Technology, which advocates stronger protections.

As long as the FTC and Congress remain inactive, and consumers remain passive, it’s up to Washington power brokers to point out HIPAA’s inadequacies.

“I do believe it’s time that we look beyond [HIPAA],” Karen DeSalvo, national coordinator for health IT, said at the recent Health Privacy Summit. “As this field rapidly evolves, we need to think about what additional protections might need to be in place.”

To view online:
https://www.politicopro.com/go/?id=35019

 

 

Re: The Internet is a surveillance state

In response to the CNN article by Bruce Schneier: The Internet is a surveillance state

Bruce Schneier is wrong. Privacy is not over — the public is just now learning how invasive Internet technology, tech corporations, and government really are, and that they ACT to protect and maintain the US surveillance economy. When enough citizens tell Congress and the President to stop, this privacy disaster will stop.

The public is just beginning to WAKE UP. Today is the start of privacy in the Digital Age in the US, not the end.

It’s a lie that people happily give up privacy for “targeted ads” — tech giants like Google, Facebook, etc. have PREVENTED us from having apps and tools that enable privacy (ie, our right TO control personal information online). We have NO choices because government and the data mining industry have prevented us from having meaningful choices.

Signs of intelligent life in the Universe:

  • Attend or watch the 3rd International Summit on the Future of Health Privacy (its free). The EU Data Protection Supervisor will keynote and so will the US Chief Technology Officer—-the stark differences between US and EU data protections will be discussed—register at: http://www.healthprivacysummit.org/d/vcq3vz/4W
  • SnapChat—millions of free downloads of an app that shows people want technology that gives THEM control over their data: single use of info (a picture in this case) and the ability to delete info. See: http://patientprivacyrights.org/2013/02/snapchat-and-the-erasable-future-of-social-media/
  • A recent Pew Research Center study found smartphone users are taking action to protect their privacy:
  • The default for Microsoft’s Windows 8 browser is ‘Do Not Track’
    • Microsoft’s Chief Privacy Officer Brendon Lynch said a recent company study of computer users in the United States and Europe concluded that 75 percent wanted Microsoft to turn on the Do Not Track mechanism. “Consumers want and expect strong privacy protection to be built into Microsoft products and services.”
    • See more in the New York Times article: Do Not Track? Advertisers Say ‘Don’t Tread on Us’

DONATE to help Latanya Sweeney and Patient Privacy Rights build a health data map—-we MUST prove that thousands of hidden data users are stealing, using , and selling our personal health data: http://patientprivacyrights.org/donate/

SEE Latanya describe thedataMap at: http://patientprivacyrights.org/thedatamap/
This is the beginning of privacy, the war has just begun.

Leaders in Congress Call Out TRICARE & SAIC

We congratulate the leaders in Congress, Reps Markey, Barton, DeGette, Stearns, and Andrews for calling TRICARE and SAIC on the carpet for not securing military families’ sensitive health data. See the letter here.

We hope this letter leads to Congressional oversight hearings into the industry-wide culture of disregard for the privacy of military personnel’s and all Americans’ sensitive electronic health information. The worst serial corporate abusers should be penalized and prevented from getting federal contracts. We need Congress to get to the roots of the industry-wide disregard for health privacy FAST, before millions more people are harmed, not just by medical identity theft, but by the use of health information to discriminate against them in employment, credit, and other key opportunities in life. Once health records are exposed, they can never be made private again.

It is well-known in the healthcare industry and by privacy advocates that about 80% of healthcare providers and the health IT corporations that manage health information have ignored federal laws requiring encryption and data security protection for years. Obviously, head-in-the-sand approaches to data security simply don’t make sense. Clearly it’s cheaper and easier for corporations to ignore the law and common sense than it is to protect our most sensitive personal information, from diagnoses to DNA.

The fact that SAIC has continued to get billions in funds from the federal government despite repeated breaches of sensitive health information shows also that the federal process of awarding, monitoring and auditing, and assuring performance of billion-dollar contracts needs investigation.

Providers, healthcare organizations, and technology companies that do not use state-of-the-art data security for health information should not be allowed to work in the healthcare field. If you are unwilling to protect patient data, you don’t belong in healthcare.

We also strongly support the proposal to make sure that victims of health data breaches receive effective state-of-the-art remediation. Victims should be able to use new technology that enables them to monitor all health insurance claims before they are submitted, so they can prevent the fraud and prevent other people’s health data from being added to their health records.

House to Defense Top Doc: What’s Up With TRICARE Theft?

Four members of the House Energy and Commerce Committee and one member of the House Armed Services Committee want some answers from Dr. Jonathan Woodson, the Pentagon’s top medical official, about how the Defense Department handled the September theft of computer tapes containing the records of 4.9 million TRICARE beneficiaries from the car of an SAIC employee in San Antonio, Texas. Woodson is the assistant secretary of Defense for health affairs and director of the TRICARE Management Activity, which was responsible for the data.

Woodson has been mum on this debacle since it unfolded, and in fact gave a speech in San Antonio the week after the theft was reported and, as far as I can determine, never addressed the issue…

…Last month, TRICARE directed SAIC to offer credit monitoring services to patients whose information was stored on the stolen tapes. Dr. Deborah Peel, founder of Patient Privacy Rights, an advocacy group based in Austin, Texas, says this does nothing to insure the safety of health care information on those tapes.

Peel, who sent me the Congressional letter to Woodson, said those patients should also be provided with new technology that allows them to monitor all health insurance claims before they are submitted, so they can prevent fraud as well as other people’s health data from being added to their health records.

See Patient Privacy Rights’ Press Release

Resolution of Disapproval in Supreme Court Decision in Sorrell v. IMS Health Case

Lawmaker, author of health privacy protections in economic recovery act, declares privacy rights of doctors, patients should trump commercial interests

WASHINGTON, D.C. – On Friday July 8, 2011, Congressman Edward J. Markey (D-Mass.), co-chairman of the Congressional Bi-Partisan Privacy Caucus and senior member of the House Energy and Commerce Committee, introduced H.Res. 343, a resolution expressing disapproval of the recent Supreme Court decision in Sorrell v. IMS Health. In its decision, the Court struck down a Vermont state law that banned the sale of doctors’ drug prescriptions records if the records are used for commercial purposes without the doctors’ permission.

Rep. Markey’s resolution states that the Court erred in applying free speech protections to a Vermont law that lawfully regulated a purely commercial interest. Before the Vermont law was enacted, data-mining companies would purchase information about doctors’ prescription drug information from pharmacies and then resell the data to pharmaceutical companies. The pharmaceutical companies could use the information – without the doctors’ consent – for the commercial purpose of targeting their sales messages and marketing more expensive, brand-name drugs to physicians.

“In this case, the Supreme Court tipped the scales of justice in favor of big drug companies at the expense of patients and their doctors,” said Rep. Markey. “The privacy of the doctor-patient relationship should outweigh the ability of pharmaceutical companies to mine data simply so they can market expensive drugs to providers and reap huge profits. States should be able to regulate pharmaceutical companies in a way that protects the privacy of their residents and prevents pharmaceutical companies from having undue influence on doctors’ prescribing habits.”

Dissenting in the Supreme Court’s 6-3 decision, Justice Stephen Breyer wrote that the Vermont state law in question “adversely affects expression in one, and only one way. It deprives pharmaceutical and data-mining companies of data…that could help pharmaceutical companies create better sales messages.” The dissent, which was joined by Justices Ruth Bader Ginsburg and Elena Kagan, stated that the Vermont statute is a “lawful governmental effort to regulate a commercial enterprise…The far stricter, specially ‘heightened’ First Amendment standards that the majority would apply to this instance of commercial regulation are out of place here.”

Dr. Deborah Peel, a national health privacy expert and founder of the non-profit Patient Privacy Rights, praised the Markey resolution. “With a Supreme Court that stands up for the interests of pharmaceutical companies, it’s reassuring to know that Congressman Markey is looking out for patients and doctors who value the privacy of their prescription drug information.”

Text of the resolution can be found HERE.

Re: Web site helps people profit from information collected about them

See the new story in the Washington Post by Thomas Heath: Web site helps people profit from information collected about them

A new technology called “Personal” allows people to control some their personal information and monetize it themselves.   A technology like “Personal” could give us control over our personal health data, which is constantly being “monetized” today without our consent and sold for uses that have nothing to do with improving our health.

“Personal” is betting that data we enter about ourselves and our product preferences will be very attractive to corporations that want to know us and/or sell to us. Today corporations use and sell whatever information they can scavenge about us online.

Similarly, sensitive health data that we control and release will be FAR more valuable to our doctors, researchers, and marketers because we have checked it for accuracy and completeness.  No one has quite the same motivation to ensure the accuracy and completeness of our health data as we do: it’s literally a matter of life and death.

Here is the business model “Personal” uses:

  • “if you mon­etize your data (Personal doesn’t like the word “sell”) through commercial activities with companies that want to buy it. Personal wants to be your “agent,” collecting a 10 percent fee on the compensation you receive each time you monetize your data.
  • EXAMPLE:  “So if I were a user of Personal, I could fill in the data fields in my “gem” on travel preferences for my trip to Stockholm this summer. I would release the information to Stockholm hotels, which could compete for my business based on my preferences for a clubby hotel bar, delicious breakfasts, a king-size bed and access to running trails. If a hotel gave me a discount or cash payment, Personal would collect a 10 percent fee.”

JUST LIKE in today’s electronic healthcare systems where we are powerless to stop the theft and sale of health data, “Personal can’t stop companies and others from scavenging data by tracking your online activities. It does, however, “give you the tools to monetize your data, but only if you want to,” Green said.”

“Personal’s” model of individual control over personal data could work very well with sensitive health data—–giving us choices, like NOT selling anything at all. But, Granny could sell some of her health information to afford her medications.  Or Dad could sell some of his data for research to afford treatment.

At a time when healthcare is not affordable for so many people, why should hospitals, pharmacies, doctors, labs, health IT and HIE vendors, prescription data mining corporations, insurers, transcription companies, data warehouses, states like Texas, digital devices, cell phone corporations and innumerable others be able to sell and “monetize” health data, instead of patients?

Many are concerned that if patients can monetize their data, poor and vulnerable people will give up privacy for money and the rich won’t need to. But how moral is the current system where corporations secretly profit from health information about the poor and rich alike?

To date, federal and state laws designed to prevent the sale of our protected health information have not been implemented or enforced. Congress and the states intended to stop the sales of health data without consent, but industry lobbies have effectively prevented the laws from working.

When was the last time your pharmacy asked if they could sell your prescription details? All US pharmacies sell everyone’s prescription records every night. See: http://patientprivacyrights.org/consumers/campaign-for-perscription-privacy/

Who is tracking YOU?

On the Internet ALL your health searches about scary and stigmatizing illnesses, all searches or purchases of books on health, and all searches or purchases of medications and devices are tracked and sold.

It is impossible to search for health information privately via Google, etc.

Health websites take massive advantage of Americans’ powerful expectations that ALL healthcare providers put their interests and their privacy first—expectations which come from the traditional doctor-patient relationship and the ethics that have governed Medicine for 2,400 years (derived from the Hippocratic Oath).

Americans are not yet ready to believe that every aspect of healthcare in the US is profit-driven, rather than driven by the ethical codes all health professionals swear to at graduation: the promises to “do no harm” and to “guard their secrets”.

Americans are not yet ready to believe that Wall Street has taken over Medicine—and that instead of guaranteeing the strong health privacy rights Americans have under the law, Wall Street erases our rights to ensure shareholder profits.

From Sharing Music to Sharing Medical Records

Scientific American gets it. Do you? View story here.

Dr. Eric Johnson’s latest study is out. Our job is to inform the public and Congress, who are continually being falsely reassured that health IT systems are secure and private by spinmeisters for the insurance, hospital, drug, Health IT, and health data mining industries.

Industry’s blatant false promises of security and privacy are something we have been urging FTC to investigate (as false and deceptive trade practices) and the new Administration should understand to ensure that the stimulus funds are not spent on primitive health technologies with abysmal security and no consumer control over PHI. We need ‘smart’ health IT, ‘smart’ human processes, and we need the health care industry to step up and use them, so we have trusted electronic systems and don’t waste the stimulus billions.

See Dr. Johnson’s paper here.

The research examined samples of health-care data disclosures and search activity in peer-to-peer file sharing networks of the top 10 publicly traded health care firms (using Fortune Magazine’s list) over a two-week period. More than 500 hospitals were represented in the 10 organizations. 3,328 files were collected for the study.

•”data losses in the healthcare sector continue at a dizzying pace”
•”Far worse than losing a laptop or storage device with patient data (Robenstein 2008), inadvertent disclosures on P2P networks allow many criminals access to the information, each with different levels of sophistication and ability to exploit the information.”
•”Many of the documents were leaked by patients themselves. For example we found several patient-generated spreadsheets containing details of medical treatments and costs–likely for tax purposes.”
•”we found a hospital-generated spreadsheet of personally identifiable information on recently-hired employees including social security numbers, contact information, job category, etc”
•”For a hospital system, we found two spreadsheet data bases that contained detailed information on over 20,000 patients including socials security numbers, contact information, and insurance information.”
•”For a mental health center, we found patient psychiatric evaluations.”

Where is the mainstream and trade journal reporting on this???

Military health forum envisions clinical analytics — by Peter Buxbaum

David Winn is right, when you sign up for the military, you have to do whatever they say.

The problem is that the Administration and the federal government has the same thing in mind for every American–no control over access to PHI.

The payers think they own our PHI and should be able to do whatever they want with it–even though it’s both illegal and unethical. That is why industry is pressing Congress to pass an HIT bill without consumer control over access to PHI. BUT—people will lie or not participate in electronic health systems if their data is used without consent—which means we will never get the kind of research we want because the data analyzed will be incomplete and flawed.

Americans just want to be asked for consent for research and be sure that HIT systems are safe and secure.

View Full Article

The Health Record Paparazzi is Above the Law and In Bed With Congress

We learned today that all of us are a bit like George Clooney: the Health Record Paparazzi loves a celebrity, but it loves the average American just as well. Instead of intrusive cameras flashing and TMZ taping our every move, we have insurers, employers, hospitals, doctors, pharmacies, drug companies, marketers, creditors and banks digging around for our most personal, intimate information.

HIPAA protects no one, including movie stars. The HIPAA regulations were changed by a Bush appointee that defy the ancient doctor-patient promise that when a patient goes to their doctor, whatever they share will be kept private. No one can make that guarantee anymore. To see the fine print visit Patient Privacy Rights.

Over 4 million individuals and businesses can see and use our health records, without consent and over objections. HIPAA is so broad it is hard to imagine who doesn’t have a legal right to your most personal details.

The Health Record Paparazzi can be stopped — but only by an act of Congress. Right now, Congress is working on legislation that will open up your health records even more. Everyone will have control over your health information except the patient.

We must have federal legislation that guarantees our right to control our most personal information and requires meaningful, enforceable penalties for everyone who shares our information without consent.