What is Snowden’s Impact on Health IT?

To view the full article, please visit What is Snowden’s Impact on Health IT?

This is a highly interesting article about the effect of Edward Snowden’s actions on health IT. In the interview with PPR’s own Dr. Deborah Peel, the issues of privacy that our government is currently facing can also be applied to the healthcare industry. As Dr. Peel aptly states, “The Department of Health and Human Services claims its actions are justified to lower healthcare costs. These are obviously very different agencies collecting different kinds of very sensitive personal information, but both set up hidden, extremely intrusive surveillance systems that violate privacy rights and destroy trust in government.”

A key argument that Dr. Peel makes is “The benefits of technology can be reaped in all sectors of our economy without the harms if we restore/update our laws to assure privacy of personally identifiable information in electronic systems. Our ethics, principles, and fundamental rights should be applied to the uses of technology.”

What is Snowden’s Impact on Health IT?

This article expounds upon the implications of Edward Snowden’s actions for the Health IT industry.

Key quotes:

Deborah Peel, MD, founder of Patient Privacy Rights, says there are many parallels between the Snowden controversy and the U.S. healthcare system.

According to Peel, the NSA has one million people with top security clearance to 300 million people’s data. The U.S. healthcare system has hundreds of millions of people — none with top security clearances, and the majority with inadequate basic training in security or privacy — who can access millions of patients’ most sensitive health records. Further, we don’t know how many millions of employees of BAs, subcontractors, vendors and government agencies have access to the nation’s health data, she added.

“Corporations and their employees that steal or sell Americans’ health data for ‘research’ or ‘public health’ uses or for ‘data analytics’ without patients’ consent or knowledge are rewarded with millions in profits; they don’t have to flee the country to avoid jail or charges of espionage,” she said.

“The NSA justifies its actions using the war on terror,” Peel added. “The Department of Health and Human Services claims its actions are justified to lower healthcare costs. These are obviously very different agencies collecting different kinds of very sensitive personal information, but both set up hidden, extremely intrusive surveillance systems that violate privacy rights and destroy trust in government.”

“The benefits of technology can be reaped in all sectors of our economy without the harms if we restore/update our laws to assure privacy of personally identifiable information in electronic systems. Our ethics, principles, and fundamental rights should be applied to the uses of technology,” Peel says.

Privacy Hawk: Put Patients at Center of Health Information Exchange (Quotes Dr. Peel)

“If healthcare organizations truly want to protect patient privacy and earn public trust regarding electronic health records (EHRs), they need to let go of the notion that institutions control individual data and look for technology that lets patients take charge of information flow…”

Key quotes from the article:

  • -“Many commercial EHRs started as systems to improve the operational side of healthcare and increase reimbursement, not to improve clinical care”
  • -“‘We’re stuck with these frankly primitive and privacy-disruptive systems that need to be fixed,’ Peel said at WTN Media’s 11th annual Digital Health Conference.”
  • -To Peel, last week’s revelations that the National Security Agency has been tracking phone calls and e-mails of virtually every American for at least six years shined a light on an issue that long has been prevalent in the healthcare industry.
  • -“‘In healthcare we actually have a total surveillance economy, too,’ said Peel, an Austin, Texas, psychiatrist.”
  • “‘We don’t actually know where our health data goes. We have no chain of custody, much less control over our health information,’ she said. Having personal information get out could lead to ‘health discrimination’ in employment or insurance coverage for patients with mental health disorders, sexually transmitted diseases or cancer, Peel added, and the threat of a breach often leads to care avoidance.”

The Verizon order, the NSA, and what call records might reveal about psychiatric patients

The NSA knows we are sick because we phone doctors’ offices.

As a mental health professional, Dissent Doe explains in her blog (below) how revealing phone call metadata is:

“Because my phone is used mainly for calls to and from patients and clients, can the NSA figure out who my patients are?  And could they, with just a query or bit of analysis, figure out when my patients were going into crisis or periods of symptom worsening?  I suspect that they can. And because I am nationally and internationally known as an expert on a particular disorder, could the government also deduce the diagnosis or diagnoses of my patients or their family members? Probably.”

There is a huge national media response to the NSA spying on Americans’ cell phone calls, but the media does NOT report on the far worse systemic corporate and government spying on the nation’s electronic health records.

The US healthcare system is engineered for hidden corporate and government surveillance of personal data about the minds and bodies of all 300 million Americans –from prescriptions to diagnoses to DNA—it’s all collected and sold.

The US media simply repeats industry and government talking points about the benefits of electronic health systems without reporting on the massive harms:

  • -Millions of patients/year avoid early diagnosis and treatment of cancer, depression, and sexually transmitted diseases because they know that information will not be private (see citations and statistics in:http://patientprivacyrights.org/wp-content/uploads/2010/08/The-Case-for-Informed-Consent.pdf)
  • -1/8 people hide health information because they know that information will not be private
  • -Should we use technology that causes millions to suffer bad outcomes?

2013 is a critical year: every state will share your health data with hundreds-thousands more hidden users via Health Information Exchanges (HIEs).

  • -Many states to not allow you to ‘opt-out’ of HIEs that exchange your health data.
  • -Most states do not allow you to prevent your most sensitive health information from being exchanged.
  • -So far, not one state gives patients control over data exchange.

SIGN PPR’s petition and say “no” to data exchange without your consent at: http://patientprivacyrights.org/2013/06/sign-the-petition-for-patient-controlled-exchange-of-health-information/

We need trustworthy technologies that put patients back in control of the use, disclosure, and sale of their sensitive health data.

  • -Patients have always controlled who could see and use paper medical records.
  • -Now institutions (corporations and government) control who can see and use the nation’s electronic health records.

Great existing technologies can fix badly designed electronic health systems, but we need new laws that require privacy-protective technologies are built into all electronic systems that handle health data.

Sign the Petition for Patient-Controlled Exchange of Health Information

Sign the petition asking Congress to put you in control of exchanging your sensitive health data via Health Data Exchanges (HIEs)!

Sign the petition here.

By the end of the year, every state must have one or more Health Information Exchange (HIEs) so your health data can be transferred to other doctors, the state, the federal government, insurers, technology companies, researchers, commercial users, and many other institutions.

Today those institutions and organizations decide when and to whom to transfer your health data—not you.

KEY PRINCIPLES FOR DATA EXCHANGE USING HIEs:

• You should control whether or not your health information is exchanged.

• You should have full access to electronic copies of all your health information.

• You should know what information the HIE exchanges, stores or collects, with whom your data is shared, and the purpose for using it.

View and sign the petition asking Congress to strengthen the law so Americans can trust electronic health systems and data exchanges.

Leader of Hospital Identity Theft Ring Sentenced

It’s impossible to stop the tsunami of fraud, ID theft, and medical ID theft until we rebuild US health IT systems to prevent open access to millions of patient records by thousands of hospital and insurance company employees.
Systems should be re-built to allow ONLY those few people who are directly involved with a patient’s treatment to access their health records.

  • ·         ONLY those who carry out the orders of the patient’s physician should be able to access that patient’s electronic health records
  • ·         the other hundreds or thousands of hospital system employees and staff members should not be physically or technically able to access that patient’s records
  • ·         When a patient is admitted, one physician is in charge of diagnosis and treatment.
  • ·         All people the attending physician orders to treat the patient (nurses, consultants, respiratory therapists, etc, etc) work for that physician, the “captain of the ship”

Health data cannot possibly be protected when thousands of people have access to millions of patient records.  Employees of the hundreds of separate health technologies used by every hospital also have open access to millions of patient records.
The more people have access to sensitive personal health data, the easier it is to steal, sell, misuse it.

Employees’ unhealthy habits have growing effect on their insurance premiums

The story below concludes that “Employees now contribute 42 percent more for health care than they did five years ago.”   Just because employees are stuck paying higher healthcare bills doesn’t necessarily mean they are causing costs to increase.

If employees were driving up healthcare costs, then using financial penalties to force them to undergo intrusive health screenings and join wellness programs might make sense.

But employees aren’t causing the high costs of healthcare in the US.  Time magazine concluded that healthcare corporations, such as hospitals and the pharmaceutical industry, outpatient procedures, and lobbying costs are the main culprits.

Time magazine’s issue titled “Bitter Pill, why medical bills are killing us” identified several factors in high US healthcare costs:

The article below quotes the National Business Group on Health (NBGH), a lobbying group with assests of $18,772,047 in 2011. The NBGH blames employees for rising healthcare costs, instead of its many healthcare corporation members.

  • -URL for NBGH members: https://www.businessgrouphealth.org/join/members.cfm
  • -Blaming employees allows the NBGH to defend using coercive, intrusive wellness programs even for employees with complex, hard-to-manage illnesses, that wellness programs don’t help:
    • -See “Wellness Incentives In The Workplace: Cost Savings Through Cost Shifting To Unhealthy Workers” By Jill R. Horwitz, Brenna D. Kelly, and John E. DiNardo. Health Affairs, 32, no.3 (2013):468-476; doi: 10.1377/hlthaff.2012.0683; http://content.healthaffairs.org/content/32/3/468.full.html

Meanwhile screening companies, labs, and wellness programs collect sensitive employee health information and control its use, disclosure, and sale.

  • -There is no ‘chain of custody’ for health data so employees have no way to know who sees their health information.
  • -The US has NO data map to track the thousands of hidden companies that collect, use, or sell Americans’ personal health information.
  • -Corporations that collect employees’ health information treat it as a corporate asset, not as sensitive personal information that patients have strong rights to control.
  • -So it’s impossible to verify whether the NBGH lobbyist’s statement that “few employers would risk intentionally misusing such information” is true or false.

Blaming people who are sick for the high costs of their medical care instead of the corporations that overcharge is a really neat trick. It also provides a rationale for coercing employees to enter wellness programs and violating their rights to health privacy.

Unfortunately, simply “blaming the victims” won’t solve escalating healthcare costs.  We have to look broadly at individuals, the entire healthcare system, the food-chain, and larger cultural factors to identify and deal with all the real causes.

A new CVS wellness program raises privacy concerns

From the Thomson Reuters News & Insight article by Anna Louie Sussman, “A new CVS wellness program raises privacy concerns

(Reuters) – When nationwide pharmacy chain CVS Caremark Corp announced last week that its employees must submit to a medical exam or pay a $600 annual fine, some critics raised privacy concerns…

Under the CVS exam, which is free, tests will measure an employee’s weight, body fat, blood pressure, glucose levels and other health indicators. Workers who smoke must enroll in an addiction program by next year.

“They draw blood, that’s data collection. You have to go through a screening, that’s data collection. You have to call WebMD’s center, that’s data collection. People’s sensitive health data is being used for commercial purposes,” said Dr. Deborah Peel, founder of the advocacy organization Patient Privacy Rights.

Dr. Peel on America Weekend with Paul Harris

PPR Founder and Chair, Dr. Deborah Peel, was featured on yet another radio station discussing the CVS Caremark wellness program which violates their employees right to privacy.

To listen to the full podcast, visit Paul Harris Online.

You can view more about the CVS program here.

The Immortal Life of Henrietta Lacks, the Sequel

This is an amazing article written by Rebekah Skloot, author of ‘The Immortal Life of Henrietta Lacks’, demanding consent and trust.

Rebecca is right—-the only way Americans will trust researchers is when they are treated with respect and their rights of consent for use of genomes and genetic information is restored.

The public does not yet realize that they have no control over ALL sensitive health information in electronic systems. We have NO idea how many hundreds of data mining and research corporations are collecting and using our blood and body parts. We ALSO have no control over our sensitive health information in electronic systems violating hundreds of years of privacy rights.

This week the many stories about CVS showed employers can force employees to take blood tests, health screenings, and be forced into “wellness” programs–all of which REQUIRE collection of sensitive health information—which employees cannot control.

We have NO map of who collects and uses personal health data—Henrietta Lacks family was NEVER asked for consent to use her genome.

Contribute to build a map to track the thousands of hidden users of health data at: www.localhost:8888/pprold

Attend or watch the 3rd International summit on the Future of Health Privacy (free). Register at: www.healthprivacysummit.org