- ATLANTA - With patients leading
healthcare onto the internet - and doctors and hospitals following close
behind - many wonder: Just how secure is all the information being put
into electronic form?
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- The uncomfortable answer: Not very. Health records are
already less private than most people think. And despite new federal regulations
that were finalized in mid-April, it's unclear whether converting them
to electronic form will make them more safe or less. ``In many ways, health
records are not confidential because of decisions we have made as a society
about the kind of healthcare we want,'' said Robert Gellman, a privacy
expert in Washington. ``We have decided we want public health, so we allow
people to be tracked down and treated. We have decided we want research,
and researchers need access to records. We have decided we want third-party
payment; someone else pays your bill, and that someone is frequently (an)
employer.''
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- On average, the paper record of a single medical encounter
- a check-up, for example, or a visit to a specialist - makes 17 stops
in the health-care system, from the physician, lab staff and pharmacy personnel,
to health and life insurance managers, researchers, state vital statistics
bureaus and more, according to an analysis presented at a recent meeting
on health privacy in Washington. At each stop, someone reviews the information
in the record - for instance, to prepare a prescription, authorize a payment
or double-check a hospital's record-keeping.
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- ``If people really understood the extent to which their
medical records are used and disclosed, they would be more likely to engage
in privacy-protecting behavior than they do now,'' said Joanne Husted,
senior counsel for the nonprofit Health Privacy Project at Georgetown University.
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- Health information can leak out of the system even when
the privacy of a medical record remains intact. Expectant mothers, for
example, are routinely bombarded by offers for parenting magazines, samples
of baby formula and freebie bottles, nipples and onesies, even when they
haven't asked for such goodies and don't remember signing up for them.
The culprits, privacy experts say, are often the ``free magazine issue''
cards found in obstetricians' offices and the registration lists for baby
expos, which are compiled and sold by marketing firms.
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- ``As early as my first trimester, I started to get things
I hadn't asked for,'' said 35-year-old Nija Meyer of Duluth, Ga., whose
son was born two months ago. ``I work in marketing, so I can't say I didn't
expect it -- and I'm never annoyed by a free sample! But someone who wasn't
prepared for it might have a very different reaction.''
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- Medical privacy is of vital concern to Americans. A national
survey done for the California HealthCare Foundation found that one in
every five people believes that an insurer, employer or health plan already
has improperly gained access to their personal medical information. One
in six said they had done something to protect themselves against a potential
breach of privacy, from using several doctors so that none would have a
complete record on them, to paying cash for care instead of submitting
an insurance claim, to simply not getting care at all.
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- The survey respondents were expressing concern about
paper medical records. Toss the internet into the equation and the fears
become magnified. A second study done for the same foundation found that
two out of five people didn't want their doctors to have internet access
to their medical records, one out of four would refuse to buy drugs or
refill a prescription online and one in six would not visit web health
sites at all -- for fear that information about their concerns would be
collected and circulated.
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- The speed at which data can be sent over the net may
make it easier for both mistakes and hacking to happen, but it doesn't
take electronic transmission for privacy to be breached.
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- Concerns about breaches of privacy have become so intense
they are affecting medical research. ``It is a real, palpable fear,'' said
Barbara Fuller of the National Human Genome Research Institute. ``One-third
of people recruited for breast cancer research by the National Institutes
of Health have refused to enroll for fear they might suffer genetic discrimination
in jobs or insurance coverage afterward."
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- The discomfort over privacy issues is so great, in part,
because there is little recourse when privacy is breached. There is no
national law that protects or even defines medical privacy.
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- The federal regulations recently finalized will provide
the first national protection, but they do not go into effect for two to
three years. The regulations give consumers the right to inspect and copy
their medical records, limit disclosure of some of their medical information
and be given notice when their information is disclosed.
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- Source: Cox News
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