By Greg Scandlen, Heartland Institute Healthcare Expert
The ACLU put out a video illustrating what could happen when privacy is violated. Unfortunately, this strikes a little to close to the bone to be entirely comical, especially in these days when employers are actively firing people who smoke, who are overweight, who don't exercise, or who have dependents who do any of those things.
My Heartland colleague Maureen Martin read the "HITECH" bill (the health IT provisions in the stimulus package) and came away pretty concerned from a civil libertarian point of view. She writes, "Despite supposedly heightened privacy provisions, the details of HITECH are chilling. These, of course, are the very details most members of Congress didn't bother reading before voting for the bill."
She goes on, "Health information is anything to do with 'the past, present, or future physical or mental health or condition of an individual.' It includes information known to 'healthcare providers.' Health information is not just what our doctors and nurses know but also information from any source that is known to our employers, schools and universities, which are now all defined as healthcare providers."
And, she says, although people with access to your records are "sworn to secrecy," there are few consequences to violations. "If the disclosure is accidental or unintentional, nothing happens. Those whose disclosures are willful may face prosecution for fines from $10,000 to $100,000. But there are two reasons why this consequence is lame. First, crimes involving specific intent are notoriously difficult to prove. Second, there are no funds for more government prosecutors, who will likely view many privacy violations as too trivial to bother with, even if they are a big deal to the individual involved."
Ms. Martin is one of the finest attorneys I know. If she is worried, I am worried.
Writing in USAToday, Mimi Hall notes the pros and cons of health IT. She cites one medical practice that has gone all-digital and the physicians love it. It turns out this "seven-doctor practice went digital when it was bought by MedStar Health, so the doctors didn't have to pay for the switch."
She says, "The federal government plans to set up regional centers, staffed by 'geek squads,' to help offices get their systems up and running, and those who don't take steps to go digital will face graduated penalties beginning in 2015."
But, "Questions about the effort are being raised by health care experts. Avalere Health, a research company for government and industry, released a study last month showing that it will cost the average doctor or small medical practice about $124,000 to upgrade to computers over the period that the government incentives are offered, 2011-15. Those incentives, the study said, would add up to $44,000 per office at best."
Hall quotes Jonathan Oberlander, a University of North Carolina School of Medicine professor, as saying, "There's not much reason to believe that this is going to save significant amounts of money."
The article concludes, "Without proper protections, health IT could end up harming patients, says Ashley Katz of the group Patient Privacy Rights. If patients don't feel certain their records are protected from employers, creditors and marketers, they may not tell their doctors the truth about certain conditions or behaviors, she says."
Healthcare IT News reports consumer demand for health IT is strong. It cites the Deloitte study (cited above) in saying, "While only 9 percent of consumers surveyed have an electronic personal health record, 42 percent are interested in establishing PHRs connected online to their physicians. Fifty-five percent want the ability to communicate with their doctor via e-mail to exchange health information and get answers to questions. Fifty-seven percent reported they'd be interested in scheduling appointments, buying prescriptions and completing other transactions online if their information is protected."
But, "Despite strong consumer demand, many are still concerned about the privacy and security of their medical information. Nearly four in 10 consumers surveyed (38 percent) are very concerned about the privacy and security of personal health information."