Re: Top 100 – Under Their Influence

This is in response to the article in Modern Healthcare By Andis Robeznieks: “Under their influence, Washington insiders hold sway over our ’100 Most Influential’ ranking, but real change seems to be coming from elsewhere.”

“The Politics of Privacy” is one of four key areas in Modern Healthcare’s story about the “100 Most Influential People in Healthcare” in 2011. Privacy was highlighted because the expectation to control personal health data is a truly bipartisan, trans-partisan issue.

The historic first-ever summit on the future of health privacy co-sponsored by Patient Privacy Rights (PPR) and the UT LBJ School in June was highlighted (see www.healthprivacysummit.org to watch videos of the sessions).

The story recognizes the crucial importance of PPR’s leadership on building patients’ rights to control use of the most sensitive personal information into the healthcare system up front, so patients will use and trust health IT systems and data exchanges.

Unfortunately, many of the new consumer privacy protections the Obama Administration supported in the stimulus bill (HITECH) are being implemented by federal agencies in ways that do not comply with HITECH and other existing federal regulations.

If industry and key government rule makers continue to ignore the American people’s expectations for control over the use of sensitive personal health data, the stimulus billions will be wasted on systems that can’t be trusted and the tremendous potential benefits health IT can bring to treatment and research may never be realized.

Privacy desires ignored

For psychiatrist Deborah Peel, maybe patient privacy and patient consent aren’t identical twins, but they’re sure close relatives.

Not surprisingly, a recent Zogby International poll commissioned by Peel’s not-for-profit Patient Privacy Rights Foundation, Austin, Texas, focuses on patient consent and its relationship to privacy—a unity the federal government has chosen to either ignore or deny.

The 2,000 adult poll respondents reached by Zogby via the Internet put great store in their right to privacy. They cling to the quaint notion that they should be asked before their electronic health records are sent skittering off to unknown users for unknown purposes. See full poll results here.

Silly them.

HHS rulemakers wrote away a key right to privacy eight years ago.

An HHS revision to the Health Insurance Portability and Accountability Act privacy rule in 2002 stripped away one of the broader authorities giving patients the right to control the flow of their medical information. HHS rulemakers did it by eliminating the right of consent. They took a stringent privacy protection rule and transformed it into a disclosure rule.

There are a lot of bright folks who have warned HHS that this privacy issue broadly—and this HIPAA privacy rule revision, specifically—are going to explode on the healthcare industry. One of the more insistent voices has been Peel’s, but she by no means alone.

Majority of Americans want personal control of health information

It’s hard to get Americans to agree on much these days, but overwhelming majorities seem to want control over their own electronic health information.

A poll from Dr. Deborah Peel’s Patient Privacy Rights Foundation and Zogby International found that 97 percent of the more than 2,000 U.S. adults surveyed believe that hospitals, physicians, laboratories and IT vendors should not be allowed to sell or share “sensitive health information” without consent. Ninety-eight percent are opposed to health insurance companies marketing personal health information, according to the survey.

See full poll results here.

Americans Want to Control Their Health Information

Health privacy watchdog Patient Privacy Rights and Zogby International surveyed 2,000 people, and found that almost all object to doctors, hospitals, and insurance companies sharing or selling their information without their consent. An overwhelming majority also wants to decide not only which companies and government agencies can access their electronic health records, but which individuals.

See the Survey Results

Hospitals and doctors are currently busy implementing the first stage of requirements under the HITECH Act, which calls for providing patients within the next two years with an electronic copy of their physical, test results, and medications. Ultimately, patients should be able to access their electronic health record online.

Poll: Huge majorities want control over health info

AUSTIN, TX – Patient Privacy Rights, the health privacy watchdog, has enlisted the help of Zogby International to conduct an online survey of more than 2,000 adults to identify their views on privacy, access to health information, and healthcare IT. The results were overwhelmingly in favor of individual choice and control over personal health information.

View the full poll results here.

Ninety-seven percent of Americans believe that doctors, hospitals, labs and health technology systems should not be allowed to share or sell their sensitive health information without consent.

The poll also found strong opposition to insurance companies gaining access to electronic health records without permission. Ninety-eight percent of respondents opposed payers sharing or selling health information without consent.

“No matter how you look at it, Americans want to control their own private health information,” said Deborah Peel, MD, founder of Patient Privacy Rights. “We asked the question, ‘If you have health records in electronic systems, do YOU want to decide which companies and government agencies can see and use your sensitive data?’ Ninety-three percent said ‘Yes!’”…

…The group advocates a ‘one-stop shop’ website where consumers can set up consent directives or rules to guide the use and disclosure of all or part of their electronic health information; if a request to use or sell health data is not covered by privacy rules, they can be ‘pinged’ via cell phone or e-mailed for informed consent.

Patient Privacy Rights calls this solution the “Do Not Disclose” list – similar to the national “Do Not Call” list. If a patient’s name is on the list, any organization that holds his or her sensitive health information, from prescriptions to DNA, must first explain how that information will be used before being granted permission.

Coalition Urges HHS To Restore Patient Control Over Access to Health Data NOW

On Monday, September 13th 2010, the Coalition for Patient Privacy sent in comments to HHS regarding Modifications to the HIPAA Privacy, Security, and Enforcement Rules Under the HITECH Act. Ensuring Americans’ control over health information is critical for quality health care and the success of health information technology (HIT). The Coalition applauds the efforts of the Department of Health and Human Services (HHS) to revise HIPAA. However, the Coalition also urges HHS to require use of robust electronic consent and segmentation tools to assure compliance with the consumer privacy and security protections in HITECH and existing rights in state and federal law and medical ethics.

View the proposed modifications to HIPAA
View the Full Comments from the Coalition for Patient Privacy
View the Press Release

Insecurities Plague Electronic Health Care

Information security and privacy in the healthcare sector is an issue of growing importance but much remains to be done to address the various issues raised by healthcare consumers regarding privacy and security and the providers’ perspective of regulatory compliance.

Writing in the International Journal of Internet and Enterprise Management, Ajit Appari and Eric Johnson of Dartmouth College, Hanover, New Hampshire, USA, explain that the adoption of digital patient records, increased regulation, provider consolidation and the increasing need for information exchange between patients, providers and payers, all point towards the need for better information security. Without it patient privacy could be seriously compromised at great cost to individuals and to the standing of the healthcare industry.

HHS proposes stronger privacy protections under HIPAA

Proposed changes to the HIPAA privacy regulations would expand patients’ rights to access their information and restrict certain types of disclosures of protected health information to health plans, according to InformationWeek.

“We want to make sure it is possible for patients to have maximal control over PHI,” national health IT coordinator Dr. David Blumenthal said at an HHS press conference. The statement–and the proposal itself–thrilled healthcare privacy hawk Dr. Deborah Peel. Her organization, the Patient Privacy Rights Foundation, put out a statement strongly in favor of the changes, saying that the proposed rule “signaled a clear policy change in the Obama administration, strengthening consumer rights to health privacy.”

To learn more:
- read the proposed rule issued by HHS on July 8
- read this Computerworld article via Businessweek
- take a look at CMIO’s article
- read the InformationWeek story
- see this AHIMA press release
- check out this statement from the Patient Privacy Rights Foundation, which includes a video of the HHS press conference

PPR impressed with HHS’ privacy approach

Secretary of Health and Human Services (HHS), the Director of the Office of Civil Rights (OCR), and the National Coordinator for HIT all made very strong, pro-privacy statements at the press conference today announcing the Notice of Proposed Rulemaking (NPRM) titled: 45 CFR Parts 160 and 164, RIN: 0991-AB57, Modifications to the HIPAA Privacy, Security, and Enforcement Rules under the Health Information Technology for Economic and Clinical Health Act.

Signaling a major shift in direction for the Administration and HHS’ Secretary Sebelius said “It’s important to understand this announcement of the NPRM…. is part of an Administration-wide commitment to make sure no one has access to your personal information unless you want them to.”

Patient Privacy Rights heartily congratulates the Administration and Sec. Sebelius for this new pro-privacy, patient-centered approach to personal health information (PHI).

We applaud Secretary Sebelius’ clear acknowledgment that health IT systems should empower patients to control PHI. Putting patients in control of PHI is the only route to prevent wasting billions in stimulus funds on HIT systems that destroy privacy and to stop the theft, misuse, and sale of PHI in today’s primitive HIT systems and data exchanges.

During her remarks, OCR Director Verdugo said, “the benefits of HIT will only be fully realized if health information is kept private and secure at all times.”

And finally Dr. Blumenthal stated, “we want to make sure it is possible for patients to have maximal control over PHI.” He also referred to the Consumer Choices Technology Hearing last week, which demonstrated consent tools that enable patients to control the use and disclosure of their health information from EHRs and for HIE.

Hopefully the NPRM actually gives Americans the control over access to personal information Secretary Sebelius said the Administration is committed to. We are analyzing the 234 page Notice of Proposed Rulemaking (NPRM), and will post our comments on the NPRM as soon as we can.

Below see the Press Conference announcing the Proposed Rule.

HHS pitches new patient privacy safeguards

A new rule proposed today would add substantial protections to the Health Insurance Portability and Accountability Act (HIPAA) for individuals who want to make sure their personal health information remains private and under their control, something that’s considered vital to the eventual success of electronic health record deployments.

Health and Human Services Secretary Kathleen Sebelius acknowledged as much in announcing the rule, saying that, while health IT will help to move the American health system forward, “the privacy and security of personal health data is at the core of all of our work.”

The proposed rule, which will be open to a 60-day comment period starting July 14, takes various routes to providing patient control…

…First reactions to the proposal were generally positive. Deborah Peel, founder and chair of the Patient Privacy Rights organization and an often fierce critic of the government’s record on privacy rights, said she was impressed with Sibelius’s remarks.

“We applaud her for recognizing that HHS should build what the public expects: health IT systems that empower patient control over personal health information,” she said.

HHS’ Health Privacy Site