NEED
Now that hospitals and offices are getting on the EHR bandwagon and they are discovering the pearls, perils, and pitfalls of it, it is coming to light that physicians aren’t the only people who need to be educated about electronic health records and using them. According to a new study by PwC (PricewaterhouseCoopers LLP) and some general “noticing” of things, it is being discovered that patients aren’t quite on the e-records band wagon yet either. PwC surveyed 1000 consumers and found that only 14% of them had gotten their records electronically from their physician (I didn’t see a note that indicated any connection between desiring to get their records electronically, and being able to get them because of the office not being able to issue it.) Setting aside that potential problem- 14% get e-record, 30% said they don’t know why they would ever need them, and 50% requested paper records. When consumers were asked how they would like to interact with their doctors electronically the top three answers were to: follow-up from their doctors, make appointments, learn about treatment information.
In other articles I read statistics like half the people think EHRs are good and helpful and would be willing to jump in there with their medical data, while the other half has their brakes on and are worried about privacy concerns. Moreover the people who spend the most time with physician who should use or would most benefit from e-record use and access are the baby-boomer/Medicare group, most of whom are not “e” people. They do not tend to use computers much if at all and are not “connected”. They don’t use the internet. They don’t use the newer phones. For most of them, “e” is a letter in retirement.
PcW article: http://www.healthcareitnews.com/news/pwc-hospitals-need-get-patients-emr-bandwagon-meet-mu
CARE
Also in the news this week, were headlines about the Feds actually giving a civil fine to someone in a HIPAA case. Now there are boatloads of gunk attached to this case (it’s in Maryland, involving Cignet Health) and the fine did not seem to be entirely dependent upon a HIPAA infraction, but there is a take-away here. The case seemed to have started because 41 patients requested their medical records information and didn’t get it. Now, you should bear this in mind for future reference, by 2015, when penalties are going to be attached to not using an EHR meaningfully in your office, you may be on the wrong end of an audit or problem if a patient requests their e-records and you cannot fulfill that request.
The other take-away here is that Cignet did eventually turn over the medical records to the Justice department, but they didn’t just turn over the records of the 41 patients in question, they turned over all 4500 patient records they had. That means they i
nappropriately disclosed the records of 4459 patients that were not part of the probe- Can you say HIPAA violation? When you share data, hard copy or electronic it has to be pertinent, appropriate, to the correct party, and only as requested.
FierceHealthcare article with their links: http://www.fiercehealthcare.com/story/feds-impose-first-civil-fine-ever-hipaa-case/2011-02-23
EXPLOITATION
Collected, organized, data in computer databases, mmmm yep, EHR. So there are all of the things the insurance companies and the government want the data for, and then there are the scientists and researchers. Yes, a lot of fantastic information could be gleaned from those same sets of data, but they don’t like impersonal data, they claim without the “genome” and full data attached, that they can’t get the full, in-depth information that they want, could, or should be able to get. Well, this is the argument, as recently as this week, at the physician IT symposium Sunday at the Health Information and Management Systems Society convention in Orlando, FL as discussed by Dr. John Mattison, chief medical information officer and assistant medical director of the Southern California Permanente Medical Group and Dr. Christopher Chute, a professor of medical informatics in the division of Biomedical Statistics and Informatics in the Department of Health Sciences Research at the Mayo Clinic.
Per the ModernHealthcare.com blog article “Privacy and genes” by Joseph Conn he quoted Dr. Chute as follows: http://www.modernhealthcare.com/article/20110221/blogs02/302219938
“I actually believe that the value of the electronic health record has started to shift,” Chute said. “The value to society is greater than it is for the patient.”
Now it wasn’t bad enough that they had originally wanted to give each individual person an identifying number (beyond their social security number) and that they wanted this information attached to the data. This goes beyond that in that they want and will be able to identify each of us on a genetic level so that they can compare their study data and pursuits against the human genome, which can only be done by looking at each of our data in connection with our very DNA. Sure does give you a chill doesn’t it? Let’s mix everyone’s individual genetic information, with their personal information and habits, with government subsidized EHR implementation, with socialized government medicine, and you get shades of George Orwell’s “1984”, mixed in with the latest string of sci-fi scary realities where we are all labeled and used against ourselves by our very DNA – who you will be a donor for, who you will marry, what job you will have, what control your insurance company will have over your care, etc.
I don’t think the marginalized “individuals” do or will feel the same way as Dr. Chute. (And they wonder why 50% plus of people do not want to give out and share their personal data.)
CHANGE
Before you start to think “yeah, that won’t happen to us, we have HIPAA, and privacy barriers”, think again. Where opportunity exists, there also will lay exploitation and change.
News from Britain this week: “Patient Confidentiality Could Be Under Threat From Health Reforms, Warns British Medical Association” http://www.medicalnewstoday.com/articles/217451.php
MedicalNewsToday.com reported in the above article that the British government is taking the next steps with their socialized medicine and data. They too have decided that the ease of accessing and sharing information should take precedent over the needs of an individual’s privacy. They are ahead of us, doing similar things to what President Obama thinks is good for the United States, and even they are coming back to this same problem. It isn’t getting resolved anywhere, it is generally being bypassed for ease of data access and ease of data flow.
On this cusp of the e-healthcare revolution, much confusion, contention, and concern still exists. As we continue to bull our way though it (like a bull in a china shop), all I can say is give yourself plenty of padding, protect yourselves as best as possible, and try not to drown as the waves of change come crashing down around you. Protect yourselves and your patients, you will both be grateful.
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