Most U.S. Doctors Believe Patients Should Update Electronic Health Record, but Not Have Full Access to It, According to Accenture Eight-Country Surve

To view the full article, please visit Most U.S. Doctors Believe Patients Should Update Electronic Health Record, but Not Have Full Access to It, According to Accenture Eight-Country Survey.

According to a Harris Poll,  70% of doctors don’t “believe” patients should be able to get FULL copies of their electronic health records.

But patients have always had the right to copies of their paper medical records—it was just a hassle to get them.  HIPAA,  HITECH, and the Omnibus Privacy Rule all affirmed patients have the right to download copies of their electronic health information.

Do only 30% of doctors understand patients’ rights under the law?  MD Anderson Cancer Center has given patients FULL downloads of their electronic health records for years.

How the Insurer Knows You Just Stocked Up on Ice Cream and Beer

View the full article at How the Insurer Knows You Just Stocked Up on Ice Cream and Beer.

Your employer already has access to personal medical information such as how often you get check ups and whether you’re taking prescription mediation through your insurance carrier, but now some companies are beginning to monitor where you shop and what you eat.

Some key quotes from the article:

“…But companies also have started scrutinizing employees’ other behavior more discreetly. Blue Cross and Blue Shield of North Carolina recently began buying spending data on more than 3 million people in its employer group plans. If someone, say, purchases plus-size clothing, the health plan could flag him for potential obesity—and then call or send mailings offering weight-loss solutions.”

“Some critics worry that the methods cross the line between protective and invasive—and could lead to job discrimination. ‘It’s a slippery-slope deal,’ says Dr. Deborah Peel, founder of Patient Privacy Rights, which advocates for medical-data confidentiality. She worries employers could conceivably make other conclusions about people who load up the cart with butter and sugar.”

“Analytics firms and health insurers say they obey medical-privacy regulations, and employers never see the staff’s personal health profiles but only an aggregate picture of their health needs and expected costs. And if the targeted approach feels too intrusive, employees can ask to be placed on the wellness program’s do-not-call list.”

2012 Sets New Record for Reported Data Breaches

Please view the full report at 2012 Sets New Record for Reported Data Breaches

Everyone knows that securing data is hard, but in healthcare much is still not even encrypted. 2012 broke the record for the most data breaches.

  • -”With 2,644 incidents recorded through mid-January 2013, 2012 more than doubled the previous highest year on record (2011)”

“The latest information and research conducted by Risk Based Security suggests that organizations in all industries should be on notice that they face a very real threat from security breaches. Whether it is the constantly increasing security threats, ever-evolving IT technologies or limited security resources, data breaches and the costs related to response and mitigation are escalating quickly. Organizations today need timely and accurate analytics in order to better prioritize security spending based on their unique risks.”

Some key statistics:

“The Business sector accounted for 60.6 percent of all 2012 reported incidents, followed by Government (17.9%),Education (12.0%), and Medical (9.5%). The Business sector accounted for 84.7 percent of the number of records exposed, followed by Government (12.6%), Education (1.6%), and Medical (1.1%).”

“76.8% of reported incidents were the result of external agents or activity outside the organization with hacking accounting for 68.2% of incidents and 22.8% of exposed records in 2012. Incidents involving U.S. entities accounted for 40.7% of the incidents reported and 25.0% of the records exposed.”

Rekindling the patient ID debate

Unique patient identifiers pose enormous implications for patient control and privacy. Dr. Deborah Peel is quoted in this article explaining how detrimental UPIs will be for patient trust and safety. To view the full article, please visit Rekindling the patient ID debate.

Key Quotations:

“The idea of unique patient identifiers (UPIs) is not a concept extracted from the next dystopian novel. It could very well be reality in the not-so-distant future. The question remaining, however, is whether or not the benefits of such technology outweigh constitutional privacy and patient trust concerns.”

“Deborah Peel, MD, founder of Patient Privacy Rights, and a fierce opponent of UPIs, writes in a Jan. 23 Wall Street Journalarticle, ‘In the end, cutting out the patient will mean the erosion of patient trust. And the less we trust the system, the more patients will put health and life at risk to protect their privacy.’

Peel points to the present reality of patient health information – genetic tests, claims data and prescription records – already being sold and commercialized. ‘Universal healthcare IDs would only exacerbate such practices,’ she avers.”

Nearly Half of U.S. Adults Believe They Have Little To No Control Over Personal Info Companies Gather From Them While Online

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No surprise, 80% of US adults do NOT want targeted ads. 24% think they have no control over information shared online.

How will US adults feel when they learn they have no control over sensitive electronic health information? Despite the new Omnibus Privacy Rule,  there is still no way we can stop our electronic health records from being disclosed or sold.  The only actions we can take are avoiding treatment altogether or seeking physicians who use paper records and paying for treatment ourselves. No one should be faced with such bad choices. There is no reason we should have to give up privacy to benefit from technology.

Today, the only way to prevent OUR health information from being disclosed or sold to hidden third parties is to avoid electronic health systems as much as possible. That puts us in a terrible situation, because technology could have been used to ensure our control over our health data. The stimulus billions can still be used to build trustworthy technology systems that ensure we control personal health information. Institutions, corporations, and government agencies should not control our records and should have to ask us for consent before using our them.

Quotes:

  • -”45% of U.S. adults feel that they have little (33%) or no (12%) control over the personal information companies gather while they are browsing the web or using online services such as photo sharing, travel, or gaming.”
  • -”many adults (24%) believe that they have little (19%) to no (5%) control over information that they intentionally share online”
  • -”one-in-five (20%) said that they only minimally understand (17%), or are totally confused (3%) when it comes to personal online protection”
  • -”When asked under what circumstances companies should be able to track individuals browsing the web or using online services, 60% say this should be allowed only after an individual specifically gives the company permission to do so.”
  • -”Just 20% of adults say that they want to receive personalized advertising based on their web browsing or online service use, while the large majority (80%) report that they did not wish to receive such ads.”

DNA records pose new privacy risks

To view the full article, please visit: DNA Records Pose New Privacy Risks

An article in the Boston Globe highlights the ease with which DNA records can be re-identified. According to the article, “Scientists at the Whitehead Institute for Biomedical Research showed how easily this sensitive health information could be ­revealed and possibly fall into the wrong hands. Identifying the supposedly anonymous research participants did not require fancy tools or expensive equipment: It took a single researcher with an Internet connection about three to seven hours per person.” Even truly anonymous data was not entirely safe from being re-identified. Yaniv Erlich”…decided to extend the technique to see if it would work with truly anonymous ­data. He began with 10 unidentified men whose DNA ­sequences had been analyzed and posted online as part of the federally funded 1,000 Genomes Project. The men were also part of a separate scientific study in which their family members had provided genetic samples. The samples and the donors’ relationships to one ­another were listed on a website and publicly available from a tissue repository.”

These findings are incredibly relevant because it is highly possible that “something a single researcher did in three to seven hours could easily be automated and used by companies or insurers to make predictions about a person’s risk for disease. ­Although the federal Genetic Information Nondiscrimination Act protects DNA from ­being used by health insurers and employers to discriminate against people”.

Clouds in healthcare should be viewed as ominous- Quotes from Dr. Deborah Peel

A recent article in FierceEMR written by Marla Durben Hirsch quotes Dr. Peel about the dangers of cloud technology being used in healthcare. Dr. Peel tells FierceEMR that “There’s a lot of ignorance regarding safety and privacy of these [cloud] technologies”.

Here are a few key quotes from the story:

“It’s surely no safe haven for patient information; to the contrary it is especially vulnerable to security breaches. A lot of EHR vendors that offer cloud-based EHR systems don’t take measures to keep patient data safe. Many of them don’t think they have to comply with HIPAA’s privacy and security rules, and many of their provider clients aren’t requiring their vendors to do so.” (Hirsch)

“Many providers have no idea where the vendor is hosting the providers’ patient data. It could be housed in a different state; or even outside of the country, leaving it even more vulnerable. ‘If the cloud vendor won’t tell you where the information is, walk out the door,’ Peel says.”

“Then there’s the problem of what happens to your data when your contract with the cloud vendor ends. Providers don’t pay attention to that when they sign their EHR contract, Peel warns.”

“‘The cloud can be a good place for health information if you have iron clad privacy and security protections,’ Peel says. ‘[But] people shouldn’t have to worry about their data wherever it’s held.’”

OCR Could Include Cloud Provision in Forthcoming Omnibus HIPAA Rule

The quotes below are from an article written by Alex Ruoff in the Bloomberg Health IT Law and Industry Report.

“Deborah Peel, founder of Patient Privacy Rights, said few providers understand how HIPAA rules apply to cloud computing. This is a growing concern among consumer groups, she said, as small health practices are turning to cloud computing to manage their electronic health information. Cloud computing solutions are seen as ideal for small health practices as they do not require additional staff to manage information systems, Peel said.
Cloud computing for health care requires the storage of protected health information in the cloud—a shared electronic environment—typically managed outside the health care organization accessing or generating the data (see previous article).
Little is known about the security of data managed by cloud service providers, Nicolas Terry, co-director of the Hall Center for Law and Health at Indiana University, said. Many privacy advocates are concerned that cloud storage, because it often stores information on the internet, is not properly secured, Terry said. He pointed to the April 17 agreement between Phoenix Cardiac Surgery and HHS in which the surgery practice agreed to pay $100,000 to settle allegations it violated HIPAA Security Rules (see previous article).
Phoenix was using a cloud-based application to maintain protected health information that was available on the internet and had no privacy and security controls.

Demands for Guidance

Peel’s group, in the Dec. 19 letter, called for guidance “that highlights the lessons learned from the Phoenix Cardiac Surgery case while making clear that HIPAA does not prevent providers from moving to the cloud.”

Peel’s letter asked for:
• technical safeguards for cloud computing solutions, such as risk assessments of and auditing controls for cloud-based health information technologies;
• security standards that establish the use and disclosure of individually identifiable information stored on clouds; and
• requirements for cloud solution providers and covered entities to enter into a business associate agreement outlining the terms of use for health information managed by the cloud provider.”

Vast cache of Kaiser patient details was kept in private home

The excerpt below is from the LA Times article Vast cashe of Kaiser patient details was kept in private home by Chad Terhune. This shows both the negligence of Kaiser in caring for their patients, but also the lack of privacy and security that is frequently found in electronic health records.

“Federal and state officials are investigating whether healthcare giant Kaiser Permanente violated patient privacy in its work with an Indio couple who stored nearly 300,000 confidential hospital records for the company.

The California Department of Public Health has already determined that Kaiser “failed to safeguard all patients’ medical records” at one Southern California hospital by giving files to Stephan and Liza Dean for about seven months without a contract. The couple’s document storage firm kept those patient records at a warehouse in Indio that they shared with another man’s party rental business and his Ford Mustang until 2010.

Until this week, the Deans also had emails from Kaiser and other files listing thousands of patients’ names, Social Security numbers, dates of birth and treatment information stored on their home computers.

The state agency said it was awaiting more information from Kaiser on its “plan of correction” before considering any penalties.

Officials at the U.S. Department of Health and Human Services began looking into Kaiser’s conduct last year after receiving a complaint from the Deans about the healthcare provider’s handling of patient data, letters from the agency show. Kaiser said it hadn’t been contacted by federal regulators, and a Health and Human Services spokesman declined to comment.”

Patient privacy group (PPR) asks HHS for HIPAA cloud guidance

Government HealthIT recently wrote an article about Dr. Peel’s of Patient Privacy Rights’ letter to the HHS Office for Civil Rights pushing for security guidelines, standards, and enforcements for cloud technology being used in healthcare.

Here are a few key points highlighted in the article:

“Issuing guidance to strengthen and clarify cloud-based protections for data security and privacy will help assure patients (that) sensitive health data they share with their physicians and other health care professionals will be protected,” Peel said.

“Cloud-computing is proving to be valuable, Peel said, but the nation’s transition to electronic health records will be slowed ‘if patients do not have assurances that their personal medical information will always have comprehensive and meaningful security and privacy protections.’”

“Patient Privacy Rights, a group founded in 2006, is encouraging HHS to adopt guidelines that highlight ‘the lessons learned from the Phoenix Cardiac Surgery case while making it clear that HIPAA does not prevent providers from moving to the cloud as long as it is done responsibly and in compliance with the law.’”

“In general, Peel said, cloud providers and the healthcare industry at large could benefit from guidance and education on the application of federal privacy and security rules in the cloud. ‘HHS and HIPAA guidance in this area, to date, is limited,’ Peel said, recommending the National Institute of Standards and Technology’s cloud privacy guidelines as a baseline.”