As the federal government moves full steam ahead to create a national interoperable (linkable) system of electronic medical records (EMRs), it is giving the American people a false assurance that the new system will safeguard and even improve their health privacy. In this effort, a new federal Commission on Systemic Interoperability was established (as part of the Medicare Modernization Act of 2003) to push for the creation and implementation of linkable electronic medical records and thus
national sharing of health information.
The Commission vision statement says that it will "develop a comprehensive strategy…for the adoption and implementation of privacy-protected systems of electronic personal health information" (emphasis added). In its October 25 report titled "Ending the Document Game: Connecting and Transforming Your Healthcare through Information Technology," the Commission stresses that one of the benefits of a connected system of health-care information is that "By more effectively limiting unauthorized
access and tracking who views personal healthcare information, interoperability provides patients with more security and confidentiality" (emphasis added).
Yet, unless the Commission amends or repeals the federal medical privacy rule, nothing could be further from the truth. As the Institute for Health Freedom has stressed many times over the past three years, under existing federal law individuals’ records can be accessed by many third parties (such as insurers) without their consent, and they are not even entitled to know who has been viewing their records in most circumstances.
How can officials of the U.S. Department of Health and Human Services (HHS) and their various committees and commissions continue to claim that we will have greater health privacy with EMRs? The reason: because the federal government has turned the term ‘health privacy’ on its head. Citizens and policymakers should consider the following important fact: ‘Health privacy’ is not even defined in the federal medical privacy rule.
Thus when HHS uses the term, it does not necessarily mean a confidential relationship between doctor and patient. Rather, it means a system in which the government decides who can access people’s health information.
Given HHS’s misguided use of the term, a first step in the forthcoming national debate over EMRs should be for all parties to state unambiguously what they mean by ‘health privacy’ and whether they support the freedom to maintain truly confidential relationships with health-care providers. Only then will Americans know the full implications of adopting a national system of linkable electronic medical records. And only then will they be able to decide for themselves whether the forthcoming national EMR system
is a trick or a treat.
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