E-health records – help or harm?
July 15, 2011 by nancy_barto
Like everything else, your medical records are going viral.
To hasten the move from paper to electronic systems, the Federal Stimulus bill earmarked $23 billion in incentive payments to health care providers.
Payments are flowing to qualified health care providers - hoping paperless systems will bring cost efficiencies to the health care system and help doctors improve patient outcomes.
But will it? The e-system did not help baby Genesis Burkett of Chicago. It led to her untimely death.
The medical error that killed baby Genesis began with the kind of mistake people often make when filling out electronic forms: a pharmacy technician unwittingly entering the wrong information into a field on a screen.
Now accidents happen, and few advocate rejecting e-health records altogether because of them, but moving full steam ahead without heeding legitimate warnings is just as foolish…and dangerous. Internet Security, for example -
As Chandler caller, Mark Healy - founding partner of TTW Systems, commented on KFYI’s Terry Gilberg program in June while interviewing me on this issue: “There is no such thing as internet security. There are temporary precautions that have not yet been overcome; but encryption, passwords, security through obscurity and legal protections (hippa, ferpa) all fail eventually.”
Besides the common misconception that information in an electronic format is somehow more accurate than paper, patient advocate Dr. Deborah Peel, President and Founder of Patient Privacy Rights, has been working for strong and appropriate laws protecting consumers’ privacy and security as government pushes health care providers headlong into an electronic world they are ill-prepared for.
Dr. Deborah Peel and other health care advocates were instrumental in helping the Arizona Legislature set important ground rules in regards to use of patient information in Health Information Exchange (HIE) systems this session (HB 2620). As a result – the law requires that before a physician or health care provider can share your information in an HIE system, they must obtain your consent, plus - as technology allows, patients will be given more opportunity to control which information is shared with whom.
This is just the beginning.
Other issues remain unresolved – which is why the Health Privacy Summit in D.C. this year was so important. It brought together the best minds from all persuasions on these issues to help educate and move government and industry to solve the inherent problems involved with electronic systems and the new way health care is utilizing them.
Sen. Nancy Barto was one of the panelists at the Summit. View the panel discussion here and Press Release. Check out what happened at the rest of the 1st Health Privacy Summit at Georgetown Law Center in D.C. in June. Some of the issues addressed:
- Data Breaches. 10 million patients have had their medical records breached in 272 events from April 17 through May 17.*
- Patient Privacy. Few patients realize that all those HIPPA forms we’re so used to wading through when we see a doctor don’t protect the privacy of your information. Congress eliminated Consent for HIPPA in 2002.**
- Data Selling. Web-based Electronic Health Records companiy, Practice Fusion****, can make $100M selling software and $250M selling patient data, according to Anderson, who also wrote, “Selling data can be more profitable than selling software.”
- View fascinating video clip: hospitals buying ‘hacking’ insurance.
Know your rights as a patient and your options to keep your information safer. Ask your doctors if they use a HIE (Health Information Exchange). If so, you must be able to consent to your information being added to it.
*According to a HIP/SA analysis of OCR’s (HHS’s Office of Civil Rights) breach statistics.
**“The consent provisions…are replaced with a new provision…that provides regulatory permission for covered entities to use and disclose protected health information for treatment, payment, healthcare operations.” 67 Fed.Reg. 53,183
***Treatment, Payment and Operations. What does that mean? Click to read “Don’t bet on knowing your records’ whereabouts.”
****See Practice Fusion.com. Chris Anderson’s 2009 book “Free, the Future of a Radical Price,” confirms that Practice Fusion’s business model is selling patient data, not ads or software.
As a board member of a small nonprofit hospital in Southern Arizona, and a member of its IT Committee, I concur there are huge challenges in making medical records electronic that go beyond patient privacy. But itt seems that the questions isn’t whether it’s going to happen, but when and how.
The costs are anything but trivial. While there is some federal money available for the transition, once it’s gone, it’s gone. Our 14-bed hospital has taken on three additional high-paid IT people and probably will need one or two more before it’s done. After the feds pay the up-front cost, we’ll be paying the salaries (I estimate $250,000-$400,000 a year) forever. And we’re one of the little guys.
Electronic medical records also slow down the doctors. There is some evidence they will give more comprehensive exams to each patient because of the prompts they will receive, but they simply won’t be able to see as many patients. In a true free market, we could hire more doctors and charge more per visit, but there are two major problems: There just aren’t enough docs to go around (especially in rural Arizona) and payers (especially Medicare and AHCCCS) want to pay far less per visit, not more.
That’s just a couple of issues that rural hospitals will be facing due to the forced adoption of EMR. I’m sure the metro hospitals have problems of their own that parallel or exceed ours. I have no doubt many more will shake out as the process proceeds.