The Right to Obtain Restrictions Under the HIPAA/HITECH Rule: A Return to the Ethical Practice of Medicine

To view the full article, please visit: The Right to Obtain Restrictions Under the HIPAA/HITECH Rule: A Return to the Ethical Practice of Medicine.

Great explanation of how industry has fought to influence those in government that write the ‘rules’ for how federal law works in practice. The key industry tactic is to complain that complying with the law is too costly or impossible or would take too much time. For reasons we don’t understand, the government agency that writes the ‘rules’ takes the side of industry rather than defending patients.

Re: Health Industry Under-Prepared to Protect Patient Privacy, Says PwC Report

In response to the Security Week article: Health Industry Under-Prepared to Protect Patient Privacy, Says PwC Report

The US is facing an unprecedented privacy crisis. The healthcare industry is extremely negligent about protecting data security and privacy (patient consent). At the same time 3/4 of the healthcare industry further risks patient privacy by selling or intending to sell data for secondary uses. Data theft and sales are driven in large part because, “Digitized health data is becoming one of the most highly valued assets in the health industry.”

  • Sixty-one percent of pharmaceutical and life sciences companies, 40 percent of health insurers, and 38 percent or providers currently share information externally. Of those organizations that share data externally, only two in five pharmaceutical and life sciences companies (43 percent) and one in four insurers (25 percent) and providers (26 percent) have identified contractual, policy or legal restrictions on how the data can be used.
  • Most corporations using patient data lack an effective consent process, “Only 17 percent of providers, 19 percent of payers and 22 percent of pharmaceutical/life sciences companies have a process in place to manage patients’ consent for how their information can be used.”

It’s a double whammy—not only is sensitive health information at high risk of misuse, sale, and breach INSIDE healthcare organizations, it’s also sold to OUTSIDE organizations that lack effective security and privacy measures.

  • “Nearly three quarters (74 percent) of healthcare organizations surveyed said they already do or intend to seek secondary uses for health data; however, less than half have addressed or are in the process of addressing related privacy and security issues.”

PriceWaterhouseCoopers surveyed 600 executives from US hospitals and physician organizations, health insurers, and pharmaceutical and life sciences companies. Data security and privacy practices were abysmal despite new enforcement efforts by the Administration, and despite hundreds of major data breaches compromising the privacy of millions of Americans.

Why aren’t Congress and the public outraged that the privacy and security of health information is so bad? If the banking industry operated like this there would be MAJOR oversight hearings and new laws.

The idea that today’s electronic healthcare systems and data exchanges safeguard health data is simply wrong. Clearly federal and state oversight and penalties for failure to protect the most sensitive personal data on earth need to be increased.

Re: David Cameron ready to put chunks of NHS up for sale, says Labour

The British Prime Minister proposes opening up and selling the health information of British citizens, ie copying the US model of data sales because he sees it’s worth tens-hundreds of billions in annual revenue to those in the US selling data. For at least the past decade, US industry has been violating Americans’ expectations and strong rights to health privacy by selling and using sensitive patient health information without consent, and without public awareness, much less, debate.

See more here: David Cameron ready to put chunks of NHS up for sale, says Labour

Key quotes:

  • Prime Minister “[Cameron] sees no limit on the involvement of the private sector and says he wants it to be a ‘fantastic business’. In his desperation to develop a credible industrial strategy, he seems willing to put large chunks of our NHS up for sale.”
  • Roger Gross, from the pressure group Patient Concern, said that allowing private firms access to NHS data would mean “the death of patient confidentiality”.
  • “We understand GP surgeries will have the right to refuse to release their patients’ records, but whether patients will ever be told what is happening, let alone have the choice to protect their privacy, is still unclear,” Gross said.

Re: HIPAA Auditor Involved in Own Data Breach

OCR’s contractor, KPMG, breached the privacy of 4,500 patient records when an employee lost an unencrypted flash drive.

You can read the full story at Health Leaders Media, “HIPAA Auditor Involved in Own Data Breach.”

KPMG absolved itself of doing any harm:

  • “KPMG believes that it is possible that the patient data was deleted from the flash drive prior to the time when it was lost,”
  • “KPMG has also concluded that there is no reason to believe that the information on the flash drive was actually accessed by any unauthorized person.”

Then KPMG prescribed its own remedy:

  • “KPMG has told us the company is implementing measures to avoid similar incidents in the future, including additional training and the use of improved encryption for its flash drives.”

Why didn’t OCR investigate and penalize KPMG? Instead, OCR doubled down and awarded KPMG a $9.2 million contract for HITECH-required HIPAA audits.

This does little to inspire consumer confidence in OCR, which has a long history of not penalizing industry for data security breaches.

Time for Congressional oversight?

Mostashari mindful of HIT stakeholder tension

WASHINGTON – At the Health IT Policy Committee meeting Wednesday morning, Farzad Mostashari, MD, the new national coordinator for health information technology, said he will listen attentively to stakeholder interests and is aware of the tensions among them. However, his first objective will be the public interest.

In addition to his national coordinator role, Mostashari will serve as chair of the HIT Policy Committee, an advisory group to the Office of the National Coordinator for Health Information Technology (ONC), which meets once amonth. Like his predecessor, David Blumenthal, MD, his leadership of this committee, in particular, will provide a catalyst for much of the activity the government plans for health IT.

“David is a tough act to follow,” Mostashari said, in some of his first public comments following his appointment last Friday. He added that Blumenthal had a broad range of support and unique skills that helped to move the federal HIT agenda to the next level.

“I’m not David Blumenthal, but I will do my best and will continue down the path he has set,” Mostashari said.

Healthcare moving to Cloud Computing

Joe Conn looks more deeply into the problems of ‘cloud’ computing for the storage, exchange, and analysis of health data. See his article in Modern Healthcare: ‘Healthcare is slow to change’ to cloud environment

Today there is not yet a trusted organization to certify the privacy of electronic health records systems, whether on servers or in clouds.

Until the privacy of health data can be assured first with trusted security certification and then with a separate stringent privacy certification (proving that patients control the use and disclosure of their sensitive records) Americans will not trust that their data is safe.

Proof that consumers control personal data in clouds will be essential for trust in health IT.

So far all we have are promises of security and privacy. We won’t trust without verification .