Innovations in Healthcare it Raise Privacy Concerns

Each day, thousands of people visit doctors and hospitals across the nation. Each of those patients is associated with a plethora of information, from an extensive medical history to a long line of medications. The medical community uses this information to carry out your medical care and maintain an ongoing relationship. Access to and use of this information carries with it a great responsibility that could literally be the difference between life and death.

In 2007, actor Dennis Quaid and his wife gave birth to twins. But soon, the twins developed staph infections, and the parents took their newborns to Cedar-Cinai Medical Center for treatment. The infants were to receive 10 units of Heparin, but human error intervened, generating a catastrophe. First, a pharmacist mixed the 10-unit bottles with the larger dose bottles. Then, a nurse grabbed the larger bottles by mistake. The infants received 1,000 times more medication than necessary, and the babies nearly lost their lives.

The disastrous dosing triggered Cedar-Cinai to transform their patient care technology. The hospital employed RFID technology, or Radio Frequency Identification. This barcode system eliminates error dramatically and saves lives. Such an innovative scanning system enables healthcare workers to verify medications, track and monitor mobile equipment, identify and track patients and employees, and maintain inventory.

Another advancement in healthcare technology is the utilization of e-prescriptions. This relatively new concept describes the electronic form of traditional pen-and-paper prescriptions. The advocacy of this new system began on December 8, 2003, when the Medicare Modernization Act included e-prescriptions in its revisions. Then, in July of 2006, the Institute of Medicine published a report on e-prescriptions, further supporting the technology. This method enables the medical community to quickly learn of plan benefits, find out past and present medications, and confirm whether or not a patient has filled his or her medication. Such efficiency promotes medication compliance and optimal accuracy.

According to John D. Halamka, MD, healthcare information technology employs the use of several commonly used terms. An "electronic medical record" is a health record used "within one healthcare organization." By comparison, an "electronic health record" is a health record used "within more than one health organization." Halamka also states that a "personal health record" is a health record from "multiple sources" that individuals can "manage, share, or control." Lastly, he states that "practice management" is when a doctor maintains his or her practice via "scheduling, registration and billing." These terms may be ambiguous to some, but they designate simple ideas that can facilitate better patient care.

With so much information passing between people, privacy is most certainly a concern. Perhaps Oscar May, Chairman and Chief Development Officer of Quality Surgical Centers, said it best:

"It is my impression that most patients believe that their health information is protected by the HIPAA legislation (and to a large degree it may be), but that isn't the stated purpose of the law. Consequently, the move to establish electronic medical record as the norm must specifically address individual privacy concerns."

Beginning on October 27, 2008, the U.S. Office of Management and Budget, the General Services Administration, the Federal Chief Information Officers Council, and the National Academy of Public Information worked together to host a National Dialogue, or a public discussion via the internet, to address the question, "How should we expand the use of information technology and protect personal privacy to improve health care?" The six-day discussion attracted many users, and together, they concluded that privacy includes three main areas: individual person, environment, and synthesis.

The individual person, or the recipient of health care, is associated with personal medical records. Healthcare workers may need to legitimately share those records for the sake of insurance or research. Additionally, as discussed, "A person should know what individual health information is being collected, for what purpose, and for what use." Furthermore, as stated in the National Dialogue report, "Except where required by law, the individual should have ultimate control over who their personal health information is shared with and for what purpose."

The second privacy group is the environment, which should be one of transparency. The discussion panel also stated that people should have access to their own medical records on a records system. Additionally, officials should not need individual consent when submitting reports to health authorities. Regarding personally identifiable information, however, panelists did want mandatory consent. Participants also concluded that de-identifying (non-identifying) information should not require consent if it is genuinely de-identifying.

Synthesis, the third and final aspect of privacy, implies that one's consent can apply to all future information transactions by all health care providers. With that said, panelists felt that people should be allowed to privatize particularly personal health information, even if it inhibits health care. Further still, patients want the option to share information with selected individuals. During situations when patients are too ill to give consent, panelists stated that professionals should maintain privacy according to the patient's previously expressed consent. Additionally, they stated that organizations should release only the absolutely necessary information to insurance companies to initiate payment. Finally, participants in the discussion emphasized that organizations should protect personally identifiable information with the strongest security measures available.

As technology advances, health care becomes more streamlined. This efficiency brings with it a sense of responsibility and trust. Patients trust their physicians to provide accurate care while maintaining privacy and security. From computerized care to a public panel discussing privacy, America is well on its way to a healthy, secure future.

Deanna Brownlee, Assistant Editor for TechnologyProfessional.Org

Sources

"A National Dialogue on Health IT and Privacy: Final Panel Report." scribd.com. National Academy of Public Administration. 16 Apr 2009 .

"Dennis Quaid's Medical Nightmare." Oprah.com. 16 Apr 2009 .

"E-Prescribing." HHS.gov. 031 Mar 2009. Department of Health and Human Services. 16 Apr 2009 .

"HIPAA Privacy Rule and Research with De-identified Information (Section 164.514) ." partners.org. partners.org. 16 Apr 2009 .

"Medicare Modernization Update." HHS.gov. 27 Mar 2009. HHS.gov. 16 Apr 2009 .

"RFIDHealthcare.com." RFIDHealthcare.com. BlueBean Company. 16 Apr 2009 .

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Halamka, John D. "Life as a Health Care CIO." http://geekdoctor.blogspot.com. 16 Apr 2009. 16 Apr 2009 .