April 27, 2011
1:17 pm
Yesterday, the Supreme Court heard the case of Sorrell v. IMS Health Care which concerns a Vermont law that bans the voluntary exchange of a physician’s prescribing history. (The Healthcare Leadership Council signed an amicus brief in this case, advocating that the Vermont law be invalidated. We joined a number of individuals and organizations, including the Associated Press, the U.S. Chamber of Commerce and two former HHS Secretaries in doing so.) This could have been an opportunity to illuminate the often-confusing issue of patient privacy laws for the public but, unfortunately, some of what I’ve heard has done just the opposite.
Vermont Public Radio did an interview yesterday with the state’s attorney general regarding his defense of the law restricting information exchange. (You can hear the interview here.) He compared the release of a physician’s prescribing history to allowing someone to paw through your tax returns. I’ll admit that if I heard that and didn’t know better, I’d be petitioning the Supreme Court to strengthen the Vermont law instead of striking it down. But, nowhere in the interview did the attorney general mention the fact that the medical information at the heart of the Sorrell case is all de-identified. There is no use of names, addresses or any other data that could be used to identify an individual. So, instead of taking the opportunity to help the public better understand how de-identified health data can be used to improve healthcare quality and advance medical research, we see the use of scare tactics that are not grounded in fact.
On a more positive front, the tenor of the questioning by the Supreme Court Justices yesterday seemed to indicate they are leaning toward striking down the Vermont law which, as we said in our amicus brief, “makes it harder, not easier for healthcare professionals to identify and reduce the substantial variations that exist in the delivery of healthcare services and the considerable health disparities that affect the lives of many Americans.”
April 04, 2011
1:58 pm
Last week, my organization, the Healthcare Leadership Council, joined with two distinguished healthcare leaders, Dr. Louis W. Sullivan and Tommy Thompson, both former secretaries of the Department of Health and Human Services, in filing a ‘friend of the court’ brief with the U.S. Supreme Court. We did so because of the critical nature of medical information and the importance of keeping databases accurate, up-to-date and accessible to medical professionals.
The case in question is Sorrell v. IMS Health and it concerns a Vermont law that bans the commercial use of de-identified patient data that is part of a physician’s prescribing history. It’s the kind of law that plays to the kneejerk instinct to keep patient information in a sealed and inaccessible lockbox, but the ramifications of this approach to quality healthcare are quite severe.
What’s important to note here is that the Vermont law really isn’t protecting anybody. The patient data in question is already de-identified. Anyone making use of this information won’t see patient names. Furthermore, there are already rigorous federal and state regulations in effect to protect against wrongful use of medical information.
The downside of the Vermont law is that barring all commercial use of such data also stops the flow of resources that is used to maintain current, accurate databases and to create new analytical tools that enable the use of data for health system improvements.
Secretaries Sullivan and Thompson and the HLC are far from alone in holding this point of view. Over 50 organizations and individuals, including the U.S. Chamber of Commerce and the Associated Press, have also filed amicus briefs to invalidate Vermont’s statute.
March 25, 2010
4:02 pm
The op-ed piece by Deborah Peel, who heads the Coalition for Patient Privacy, that appeared in The Wall Street Journal this week received an inordinate amount of attention. That’s because Matt Drudge of the popular Drudge Report website seized upon the Journal’s headline, “Your Medical Records Aren’t Secure” and listed it among several other stories critical of President Obama’s healthcare plan.
But Dr. Peel’s op-ed wasn’t criticizing the President. The targets of her op-ed included hospitals, pharmacies, employers and a litany of others who are out to plunder our personal medical records for financial gain. And, she alleges, these violations of confidentiality are even easier and more likely when health records are maintained electronically instead of on paper. She insists that the answer lies in giving patients the responsibility to decide what information they choose to share with medical professionals and what to keep secret.
Dr. Peel’s logic train goes off the tracks rather quickly. First of all, it’s simply not true that electronic records are less secure than paper ones. In her op-ed, she chooses to not acknowledge the role HIPAA privacy laws have played in keeping health information confidential. She ignores the new laws adopted earlier this year that strongly encourage encryption of electronic data and that impose new criminal and civil penalties for privacy violations. And you would never know from the op-ed in the Journal that hospitals, insurers and physicians throughout the country have taken extraordinary steps to safeguard patient data.
So we can see that any privacy “crisis” is overblown. The greater problem lies in the proposed solutions.
Giving patients the responsibility to decide which portions of their medical records should be open to healthcare professionals is, at best, unreasonable and, at worst, potentially deadly. It is highly unlikely that a patient without a medical background can make a sound decision on what information a physician might need to provide quality treatment.
But an even greater potential harm lies in the society-wide impact of ill-advised patient consent proposals. Enabling system-wide picking and choosing of what data enters the flow of essential information will have an impact on the many beneficial actions that are dependent upon information collection and analysis, such as:
• Reporting and tracking incidences of disease for public health purposes
• Monitoring the quality and safety of medical products
• Carrying out product recalls
• Medical research into lifesaving cures and treatments.
Our health system has dual objectives in this regard. We need to protect patient confidentiality while, at the same time, preserving the vital flow of information that protects, extends and saves lives. Some, as Dr. Peel’s op-ed demonstrates, lose sight of the need to maintain that balance. The fact is, though, that you should never have to choose between privacy and excellent healthcare, and we don’t have to.
April 24, 2009
8:29 am
According to those in the know on such things, there is a new blog created every half-second. That means 175,000 new blogs are finding a home on the Internet every single day. That’s a staggering figure for those of us who struggle to find time to get through the entire newspaper in the morning.
Given this abundance of information on the Web, one needs a pretty compelling rationale to erect another dwelling in this already-crowded community.
Then again, there are few subjects as important as healthcare or, more specifically, better understanding the state of our nation’s healthcare system and its future.
That’s not to say there is a scarcity of interesting and insightful voices bringing provocative perspectives on health issues to the blogosphere. Anyone who wants to add both breadth and depth to their understanding of today’s key health policy debates should add sites like the National Journal Health Blog or Disruptive Women in Health Care to their must-read list.
The niche we want to create for Prognosis is the nexus at which policy meets practice. The organization I head, the Healthcare Leadership Council, has a membership that includes many of the nation’s premier hospitals, academic health centers, innovative pharmaceutical and medical device companies, health insurers, pharmacies and health care services companies.
We’re going to discuss policy on this blog, but we’re also going to make readers more aware of the innovations taking place in healthcare delivery, financing and technology, and how health policy and healthcare practices affect one another. As Congress tackles the tough issues of how we pay for and deliver healthcare while expanding access to every American, let’s have a robust discussion as to the real-world impact possible policy decisions may have on patients, physicians, hospitals and medical researchers.
Our blog title, by the way, stems from the Greek word prognostikos. It means “to have knowledge beforehand.” Not that we’re claiming to predict the future in this space, but we hope that a better understanding of what’s happening today in American healthcare will better enable us to participate in the debate that will shape, hopefully, an exciting tomorrow.
CATEGORIES: Access to Coverage for the Uninsured,
Confidentiality of Patient Information,
Evidence-Based Medicine,
Health Information Technology,
Health Literacy and Disparities,
Health Reform,
Healthcare Costs and Value,
Healthcare Workforce Shortage,
Liability Reform,
Medicare,
Other,
Patient Safety and Quality,
Protecting Innovation,
Wellness and Chronic Care Management |
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