CVS imposes health penalty if workers’ body weight is not reported or they don’t quit smoking

To view the full article, please visit CVS imposes health penalty if workers’ body weight is not reported or they don’t quit smoking.

CVS has instated a very invasive new policy of charging workers a hefty $600 dollar a year fine if they do not disclose sensitive health information to the company’s benefits firm. According to the article, “Under the new policy, nearly 200,000 CVS employees who obtain health insurance through the company will have to report their weight, blood sugar, blood pressure and cholesterol to WebMD Health Services Group, which provides benefits support to CVS.” However, if employees refuse, they will be charged an extra $50 a month in health insurance costs.

Patient Privacy Rights’ Dr. Deborah Peel tells the public, “‘This is an incredibly coercive and invasive thing to ask employees to do,’…’Rising healthcare costs are killing the economy, and businesses are terrified, Now, we’re all in this terrible situation where employers are desperate to get rid of workers who have costly health conditions, like obesity and diabetes.'”

To learn more about this issue, please visit our Health Privacy Summit Website and register for the 3rd International Summit on the Future of Health Privacy.

Patient Trust in Confidentiality Affects Health Decisions

To view the full article by Pablo Valerio, please visit Enterprise Efficiency: Patient Trust in Confidentiality Affects Health Decisions

This article highlights a survey sponsored by FairWarning that looks at how “patient privacy considerations impact the actual delivery of healthcare” in the UK and US.

Key quotes from the story:

-“CIOs and healthcare providers need to ensure the best security, not only because it is the law, but because data breaches actually affect how honest a patient might be with a doctor and how quickly they will seek medical attention.”

-“It is not enough to comply with government regulations about data protection. If a data breach occurs patients are not going to check if the institution was following rules, they are going to blame their executives for allowing the breach to happen, regardless of the reasons.”

The survey, “UK: How Privacy Considerations Drive Patient Decisions and Impact Patient Care Outcomes; Trust in the confidentiality of medical records influences when, where, who and what kind of medical treatment is delivered to patients” cited in the article below compares attitudes about health information privacy in the UK and US.

Some key UK findings are:

-38.3 percent stated they have or would postpone seeking care for a sensitive medical condition due to privacy concerns

-More than half of patients stated that if they had a sensitive medical condition, they would withhold information from their care provider.

-Nearly 2 out of 5 stated they would postpone seeking care out of privacy concerns.

-45.1 percent would seek care outside of their community due to privacy concerns

-37 percent would travel… 30 miles or more, to avoid being treated at a hospital they did not trust

US vs UK patients:

-UK patients are almost twice as likely to withhold information from their care provider…if they had a poor record of protecting patient privacy.

-4 out of 10 UK patients versus nearly 3 out of 10 US patients … would put off seeking care … due to privacy concerns.

-97 percent of UK and US patients stated chief executives and healthcare providers have a legal and ethical responsibility to protect patients’ medical records from being breached.

Doctors order more X-rays, not fewer, with computer access

This excerpt is taken from Lena H. Sun’s article in the Washington Post National: Doctors order more X-rays, not fewer, with computer access.

“In the debate over the high cost of health care, federal policymakers have always claimed that one way to cut costs is for doctors to use electronic medical records and other information technology. Doing so, they say, avoids duplication and saves money.

But new research suggests that may not be the case.

Doctors who have easy computer access to results of X-rays, CT scans and MRIs are 40 to 70 percent more likely to order those kinds of tests than doctors without electronic access, according to a study to be published in the March issue of the journal Health Affairs.

“On average, this is comparing doctors who had electronic medical records and those who didn’t,” said lead author Danny McCormick, a physician and assistant professor of medicine at Harvard Medical School.

Researchers say the findings challenge a key premise of the nation’s multibillion-dollar effort to promote the widespread adoption of health information technology.

“This should give pause to those making the argument,” McCormick said. Instead of saving money, that effort could drive costs higher, he said.”

WSJ Exposes Web Tracking Truths

This story should prompt a flood of investigative reporting about the secret, highly lucrative data theft and mining industries. And health information is THE most valuable personal information of all.

“Consumer tracking is the foundation of an online advertising economy that racked up $23 billion in ad spending last year.”

The story shows that the data theft and data mining industries are selling real-time access to specific people—a FAR more intrusive practice than buying a location on a webpage:

“These profiles of individuals, constantly refreshed, are bought and sold on stock-market-like exchanges that have sprung up in the past 18 months.”

“Advertisers once primarily bought ads on specific Web pages—a car ad on a car site. Now, advertisers are paying a premium to follow people around the Internet, wherever they go, with highly specific marketing messages.”

And, of course, sensitive health information is being stolen too:

“On Encyclopaedia Britannica Inc.’s dictionary website Merriam-Webster.com, one tracking file from Healthline Networks Inc., an ad network, scans the page a user is viewing and targets ads related to what it sees there. So, for example, a person looking up depression-related words could see Healthline ads for depression treatments on that page—and on subsequent pages viewed on other sites.”

“Healthline says it doesn’t let advertisers track users around the Internet who have viewed sensitive topics such as HIV/AIDS, sexually transmitted diseases, eating disorders and impotence. The company does let advertisers track people with bipolar disorder, overactive bladder and anxiety, according to its marketing materials.”

Ubiquitous surveillance and data theft is used to track and discriminate against every American in real time. Ads are NOT innocuous and helpful:

“We’re driving people down different lanes of the highway,” Mr. Cheyney says.

“Some financial companies are starting to use this formula to show entirely different pages to visitors, based on assumptions about their income and education levels.”

“Life-insurance site AccuquoteLife.com, a unit of Byron Udell & Associates Inc., last month tested a system showing visitors it determined to be suburban, college-educated baby-boomers a default policy of $2 million to $3 million, says Accuquote executive Sean Cheyney. A rural, working-class senior citizen might see a default policy for $250,000, he says.”

Only exposure and public outrage over the deeply invasive secret data theft and data mining industries will shut them down. And it’s important to know that the government is one of the biggest customers of these stolen data profiles.

See the Wall Street Journal Article: The Web’s New Gold Mine: Your Secrets

Re: State agency swaps babies’ blood for supplies

This is a response to the recent article in the Austin American Statesman: State agency swaps babies’ blood for supplies

Institutional Review Boards (IRBs) are NO LONGER the best solution – or even an adequate solution – for state problems (or for research) when informed consent is needed for the use of individual health information, tissue, or bloodspots. There are now effective, affordable technology solutions that enable individual families to make their own informed choices.

The state of Texas was sued because families could not individually decide how their spots were handled – whether they should be kept and how they could be used. Technology offers great solutions for those sensitive problems.

Governance of bio-banks like the NBS Program is critical as Dr. Callan points out, BUT governance cannot replace individuals’ existing rights to privacy and informed consent.

And there is no longer a need to use IRBs (typically stacked with members who have conflicts of interest) to replace individual families’ rights to make decisions about their child’s newborn bloodspots, now that technology offers much better solutions where each family can set their own preferences and be contacted for use/sale of their spots.

IRBs and privacy boards were needed in the past when the time and cost of contacting hundreds and thousands of people to ask consent for the use of their records was prohibitive, but that is no longer true thanks to technology. Millions can be contacted by email or text mail on cell phones instantly, at virtually no cost. And their responses can be addressed automatically via technology—think of online response cards when you donate money, you get an email confirming what you did. Technology can enable each family to make their own informed decisions.

There are many problems with using IRBs to replace individual informed consents. IRBs tend to be dominated by researchers and data users — people who want to use patient records or bio-specimens, rather than consumers and privacy advocates. IRBs have not focused on protecting medical record privacy — the focus has been on clinical research on the use and effectiveness of new drugs and devices that can directly harm people’s minds bodies weighing the safety of the study vs. the risk of side-effects and even death. IRBs were designed to protect people who participate in research from harm and death. So IRBs view research in patients’ records and bio-specimens as safe—as if no serious harms or risks result from these kinds of research. But research using bio-specimens or sensitive personal health information poses great risks to privacy. Personal health information, from prescriptions to DNA, are very valuable commodities that are sold and used to discriminate against patients and their children and grandchildren. Bio-specimens contain genetic information, which can be re-identified, and put families at risk for generations of discrimination.

In addition, the public does not agree that researchers should have unfettered access to their medical records. Open access to the nation’s sensitive health information is not seen as a desired public good. In fact Alan Westin’s survey for the Institute of Medicine on this subject showed that only 1% of Americans would agree to let researchers freely use their health records for any purpose. See: http://patientprivacyrights.org/media/WestinIOMSrvyRept.pdf?docID=2501

Also, the story did not highlight how deceptive ‘opt-out’ consents are. ‘Opt-out’ consent has been utterly rejected in the UK as the method of consent for transferring people’s health records to the NHS—the program had to be stopped when the public found out. ‘Opt-out’ consent was perceived by the public as deceptive, unfair, difficult to understand and enact. See: http://patientprivacyrights.org/2010/04/controversial-medical-records-database-suspended/

The proposal to ‘Save the Spots’ team including Patient Privacy Rights, the Genetic alliance, the UT LBJ School, and innovative technology corporations would have offered an online consent tool where Texas families could choose to:

  • Destroy the spot
  • store and do nothing
  • store and allow use for research, etc.
  • store and contact us for each use
  • send a copy of the test results to us for use with our doctor and our health planning

The story missed the key point about how technology can improve the informed consent process and create trust. Think about this example: you can set your preferences for how your bank pays your bills. Online banking allows you to set preferences for how something of yours ($ instead of spots or information)) is shared with whom, for what purpose. You can set up the bank to pay some bills automatically every month, others are one-time occurrences– ALL at your direction. And you can change your preferences at any time. We need dynamic, real-time patient-centric technology like that in the health care system—technology has NOT been used to assure patients rights, expectations, or convenience. I just saw a system for consent Friday where you can receive requests to use your health information on your cell phone, with the doctor’s name, and how long access is needed.

ALSO—the details about what we offered were not correct in the story—naturally we did not have the funding in hand when we went to the state. How would that be possible? We formally asked the state to agree with the plaintiffs for a delay for 90 days (easy to get from the judge, when both parties agree) so that we could seek the funding from federal and other state and national funders. Funders would not even look at our proposal UNLESS the state had agreed to work with us; ie, without the state’s agreement we could NOT DO IT. The state would not agree.

We could not have come to the state with funds for our proposal in hand—that’s why we needed the state’s formal agreement to the delay and approval to let us seek the funds to execute our proposal.

Unfortunately the story also did not explain why electronic consents can solve seemingly difficult problems, or why IRBs should no longer be used to replace individuals’ rights of consent when technology enables individuals to make their own informed choices about research.

The issue of what kind of consents we will have for the state of Texas as we move toward requiring and exchanging electronic health information is VERY CRITICAL—it is critical for lawmakers and the public to realize that innovative consent and privacy-enhancing technologies can be used to protect their rights in electronic health systems, not destroy them.

Again, you can see the Article referenced here at this link: http://patientprivacyrights.org/2010/05/state-agency-swaps-babies-blood-for-supplies/

DNA Destruction

In the weeks before state health officials destroyed more than 5 million newborn blood samples they had stored without consent, privacy advocates, parents and lawmakers reached a last-ditch accord to save them — but couldn’t convince the Department of State Health Services to sign on…

Peel said the state’s decision not to seek a non-destructive solution is a shame. She said there was national interest in “saving this treasure trove” of baby blood spots, and that she was working with researchers and lawmakers in Texas and Washington, D.C., to seek funding for a state-of-the-art research database that would allow parents to give consent electronically.

“We were going to … reach out to those 5 million families and let them know they had an alternative to having their blood spots destroyed,” Peel said.

Ethics Debate Over Blood From Newborn Safety Tests

After those tiny blood spots are tested for a list of devastating diseases, some states are storing them for years. Scientists consider the leftover samples a treasure, both to improve newborn screening and to study bigger questions, like which environmental toxins can harm a fetus’ developing heart or which genes trigger childhood cancers.

But seldom are parents asked to consent to such research — most probably do not know it occurs — raising privacy concerns that are shaking up one of public health’s most successful programs. Texas is poised to throw away blood samples from more than 5 million babies to settle a lawsuit from parents angry at what they call secret DNA warehousing. A judge recently dismissed a similar lawsuit in Minnesota.

Teen Screen Lawsuit Advances: Federal Court Affirms Family’s Right to Sue School

A federal court has given the green light to a civil rights lawsuit filed by Rutherford Institute attorneys in defense of a 15-year-old Indiana student who was subjected by school officials to a controversial mental health examination without the knowledge or consent of her parents. In ruling that the lawsuit filed on behalf of Chelsea Rhoades and her parents, Michael and Teresa Rhoades, may proceed to trial, the U.S. District Court for the Northern District of Indiana upheld the claims that the local school district deprived the Rhoades family of their federal constitutional rights to family integrity and privacy when it subjected Chelsea to the TeenScreen examination. A copy of the lawsuit is available here.

This ruling rightly recognizes that parents have an intrinsic right to control their childrens education, as well as safeguard their mental and physical well-being, stated John W. Whitehead, president of The Rutherford Institute.

Watching your figure? So’s the boss.

Think your weight is nobody’s business? Try telling that to employers.

Faced with ever-soaring health insurance costs, more employers are putting wellness programs into overdrive. They’re no longer hinting that it might be time to think about getting healthier. They’re making it part of the culture.

General Mills has made “healthy weight” a cornerstone of a wellness mission statement, launching dozens of fitness programs for workers at its Golden Valley headquarters and in its manufacturing plants. A Minneapolis marketing firm launched a “Biggest Loser”-style weight-loss contest, which morphed into workouts five hours a day for the most zealous participants. A commercial insurance agency in Minneapolis hired a chef to teach workers how to cook healthier meals. In Indianapolis, one employer proposed $30 fines for overweight workers.

Perhaps the most dramatic move here can be found at Treasure Island Resort & Casino, where employees and their spouses are now required to take a medical exam at work to qualify for employer-sponsored insurance. Included in the screening: a body mass index reading used to determine the cardiovascular disease risk created by excess body weight. If that number is too high, workers at the Red Wing casino will be encouraged to hit the exercise mat.

The American workplace is packing on the pounds. Two-thirds of Americans are overweight or obese, double the rate of a generation ago, according to the Centers for Disease Control and Prevention.

As we get fatter, diseases rooted in obesity are driving up health care costs. Obesity costs corporate America an estimated $13 billion a year in additional health insurance expenses, sick leave, life insurance and disability insurance, according to the National Business Group on Health.

Health care costs remain volatile. Double-digit percentage increases of a few years ago moderated as employers passed along more of the bill to workers. But costs are expected to spike 9 percent this year, up from a 5.3 percent increase in 2007, reports Hewitt Associates, a benefits consulting firm.

Alarmed employers are now focused on changing the demand for health care. For a growing number, that means using the workplace to preach the benefits of eating better, eating less and exercising more.

“Employers are trying to take steps to make sure they can afford to offer health insurance,” said Adam Jensen, an attorney with Virchow Krause, a firm that’s working with employers to reinvent wellness programs.

NOT SO FAST

Workers are skeptical. A national survey of 30,000 employees by Hewitt Associates shows that just 12 percent think their employers should be telling them how to stay healthy.

That skepticism was evident at Treasure Island earlier this year when workers received letters explaining that medical screenings would be required to sign up for health insurance. After employees were told that a full blood panel would be required, rumors swirled that the company could conduct genetic screenings.

Is There a Heart Attack In Your Future?

What are the chances that you will get heart disease, or Alzheimer’s? Or that you’ll get fat? New genetic tests will soon be available to offer people answers to these questions and more, assessing their risk for a range of conditions based on a sample of saliva.
It’s one of the promises of the genetics revolution: Putting personalized medical information directly into the hands of individuals so they can make informed choices about their health. Yet despite the potential, there are several reasons people might not yet embrace such tests — including skepticism about their scientific soundness, steep prices and insurance and privacy issues.
Indeed, many genetic experts believe predictive gene-based tests aren’t ready for wide use. Besides questions about accuracy, there is also the issue of how useful the answers will be. There’s no evidence, many physicians say, that people will act on such information to lead healthier lives. Little is known about the interplay of genetic and nongenetic factors such as diet, exercise, smoking and pollution that also affect a person’s risk for disease. And few doctors are well-versed in how to interpret genetic tests or what to tell patients based on the results.
One such test is set to be announced today by Navigenics Inc. of Redwood Shores, Calif. Called Health Compass, the test will be available starting early next year and will be offered directly to consumers via the Internet — circumventing the traditional doctor-patient relationship. The company believes people will want to take the $2,500 test when they’re healthy, and then make lifestyle and other changes to avoid or delay disease. Results, which will be posted on a Web site that customers access with a password, will tell consumers their risk for more than 20 conditions, including diabetes, obesity, prostate cancer and glaucoma. Consumers would learn how their risk compares with the general population’s, and what strategies they can follow to possibly reduce their chances of developing it.
“When you’re reading your genetic risk and you realize that you might get this disease, that’s when it’s real and relevant,” says Mari Baker, chief executive of the San Francisco-based start-up. For consumers, the test will say, “What I might get and what I might start doing today so I don’t get it in the future.”
Another company, 23andme Inc. of Mountain View, Calif., is working on a similar direct-to-consumer test that outsiders say will provide gene-based ancestry and health-related information. The company isn’t providing details until it is ready to launch the product, possibly by the end of the year.
These tests are part of a larger rush to capitalize on the growing body of genetic information that has been emerging since scientists finished mapping the human genome. Silicon Valley venture-capital firms Kleiner, Perkins, Caufield & Byers and Sequoia Capital are among Navigenics’ backer, while biotech giant Genentech Inc. and Google Inc. are among those financing 23andme.
{“Don’t ever get a genetic test unless you use an alias. It is simply not safe—although state laws and medical ethics say that your test results cannot be disclosed without your consent, in reality there is no way any of us can control our personal electronic health information. The electronic healthcare system is NOT set up to ensure that we control all access to our health information. And there is no federal law to stop employers or insurers from using genetic data to discriminate against you and your children and relatives. The vast majority of electronic health systems in use today everywhere in America are set up to facilitate the data mining and theft of our health records. Even companies that offer genetic tests directly to consumers cannot be trusted. Many sell the data to other users, sometimes they say the data is aggregated, sometimes not. Aggregated data can easily be re-identified. There is NO WAY to tell which companies sell your genetic data and which do not, because using your personal health information for business purposes without your consent is legal under the gutted misnamed HIPAA Privacy Rule.” ~Dr. Deborah Peel, Patient Privacy Rights}