Extortion Argument for HIT De-Identification

A Really Scary Tale

By D. Kellus Pruitt; DDSpruitt

Upon arriving at the office early one morning recently, Dr. Smith logged on to the Internet to check her email. Among the usual pieces of junk email, one from Nigeria caught her eye. She recognized the name of one of her patients, written in bold letters. She thought, “That’s odd.” Smith opened the email to read more.

The Threat 

“I am revealing the name of your patient, who lives on Oak Street, as proof that your computer has been hacked. I have social security numbers, birthdates, insurance information … You name it, and I’ve got it. It will go on the market in 24 hours if you do not do exactly what I say …” (This is the start of price negotiations – for the first time).

The Decision 

What will Dr. Smith do? At the very best, she can hope that it’s a bluff. Nevertheless she must contact not only the FBI, but every one of her patients who are at risk of identity theft. That alone will bankrupt her practice because a large portion of her patients will never return. They will look for dentists with paper records. The very worse thing she could do is pay the ransom. In the end, how much did the bad guy risk to destroy a wonderful career, even if it was a bluff, or a devastatingly mean trick? You can relax now; this story is fiction. Here is the non-fiction.

NEWS FLASH!

“Script said the new letters were received by Express Script clients in recent days and is similar to the letter it first received. That letter included personal information on 75 people covered by Express Scripts, including birth dates, social security numbers and prescription information. The sender demanded money from the company, under the threat of exposing records of millions of patients.” – BusinessWeek [11.11.08]

More: http://www.businessweek.com/ap/financialnews/D94CVLJO0.htm

Lose the Threat 

Dentists must lose this danger or lose their computers. Let’s temporarily put aside our dreams about how wonderful technology might become and open our minds to ways to go around insurmountable obstacles instead of pretending everything is wonderful in stakeholder land. For once, let’s seriously look into de-identifying our patients’ electronic dental records already. Forget about HIPAA and inspections. Forget about AHIC Successor Inc. Forget about CCHIT, CMS and even the HHS. Forget about Newt Gingrich and the past, present and future Presidents of the American Dental Association who prefer to be irrelevant than to discuss anything bad about electronic dental records. And especially forget, with prejudice, executives of dental insurance companies who demand interoperability on their NPI-driven terms. Let’s sidestep the biggest mistake in healthcare history. It does not have to be ours.

More Info:  Dictionary of Health Information Technology and Security 

www.HealthDictionarySeries.com

Not a Fete’ Accompli 

Some leaders who have poor understanding of the modern marketplace would lead ADA members to believe that there is nothing that can be done to stop eHRs in the United States of America, no matter how expensive, dangerous and lousy stakeholder interests make them. Why; “cause I said so?”

Example:

Let me give you an example: “If we don’t participate, then who knows what will happen regarding the dental part of the eHR? eHR is on the way.” – Dr. John S. Findley, President of the ADA in “President-Elect’s Interview: Part 2,” ADA News Online (ADA members only).

More: http://adabei.com/members/resources/pubs/adanews/081006_findley.asp

If we don’t participate, Dr. Findley, dentistry will proceed with safe paper records like it has for a century or so.  I have clearly shown that far worse things could happen.  Shouldn’t we “first do no-harm” to our dental patients?  What happened to the ethics of the American Dental Association?

Stakeholder Optimism 

Even though optimistic stakeholders, hobbyists and hangers-on disagree with me, electronic dental records are not inevitable. At least they are not inevitable in the next decade or so.  They can easily become so lousy and so mistrusted by doctors and patients alike that they will set back miracles from Open Source Evidence-Based Dentistry forever. They are almost there already because of ambitious stakeholders, hobbyists and slow-moving hangers-on; like Dr. John S. Findley.

Assessment

Remember, decades ago the US was supposed to be on the metric system.  Sometimes inevitability takes so long that you might as well just forget about it.  And, the metric system even makes sense.

Conclusion

Unlike medical records which must remain secure even if de-identified, nobody, I repeat, nobody cares about breached dental histories. Physicians may have no choice. Dentists do! As always, your thoughts and comments on this Executive-Post are appreciated.

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

Subscribe Now: Did you like this Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

 

The National Health Care-Scare

The Markets and Health Economics

By Dr. David Edward Marcinko; MBA, CMP™

marcinko

As a centrist fiscal conservative – social liberal – I tend to side with libertarian issues and not political parties. Nevertheless, I was dismayed with the recent presidential election and wondered what impact it would have on the stock markets. Mr. Market replied with haste.

The Question 

In the short term, the stock market collapsed back in September when most pundits opined that President-elect Barack Obama would become our new leader. In fact, the DOW has not seen its current lows since 1998, or so.

More specifically, according to one analyst from Wall Street – Paul Shread – “the Dowshould have strong support between here and 7000, which would cover the 1998 and 2002-2003 lows (7200-7400), the 50% decline mark (7100) and the October 1997 low (6971). This would be a very important place for the market to make a stand.” But other chartists see the markets falling even further, with the S&P dropping as low as 400. Why is this?

The Answer is Uncertainty, Doubt and Fear

While the mounting credit default swap and mortgage crisis has had a major role in sinking stocks, some speculators worry that Obama will follow through on promises to raise income taxes on dividends and capital gains; eliminate the estate tax exemption, rescue the auto-industry and  the: airlines, home builders, furniture, footgear and apparels, textiles, glassware, tobacco, beer brewers and perhaps a few others, and generally make it difficult for private employers to resist unionizing drives. In other words – there is a rising level of fear, doubt and uncertainty over the seeming potential of Keynesianism and governmental guarantees and protectionism – rather than the opportunities of capitalism. All disguised in the “cloak of change”.

Enter the Politicians

Some economists – tax and policy experts – fear that if Obama, Speaker Nancy Pelosi and Senate Majority Leader Harry Reid bailout these manufacturing segments instead of filing for Chapter 11, the country may face a very long recession. Just look to Japan some two decades ago, when the country bailed out its failing banks and corporations instead of letting them fall so that innovative competitors could take their place.

According to Niall Ferguson, a scholar who has studied the relationship between political, banking and financial fortunes –”you can stick money into every orifice of the big banks — their mouth, their nose, their ears, wherever — but if they can’t make loans because they have to reserve against future losses, and if they won’t make loans because there’s a recession, it won’t do any good,” Ferguson says. “If they can’t lend, there’s no money multiplier — they’re stuck, they’re zombies. It’s Japan all over again.” And, some ghoulish traders are indeed hoping for a deep recession. Today, Japan is still in worse shape than we are.

Phoenix Rising

Following such a debacle, the failed companies might then re-organize with some of their current workers under revamped union contracts. Reorganization, new labor contracts and new employee and retiree health benefit plans would make them competitive and profitable after emerging from bankruptcy; much like the proverbial Phoenix.

National Health Insurance, et al

Our physician clients and investors also are also worried that if national health insurance becomes a reality, defense spending is reduced and/or onerous regulations imposed on the surviving banks and Wall Street, the economy will be in for ride rougher than the one we have experienced to-date. No wonder a recent poll suggested that more than half of all doctors did not encourage their offspring to follow their career footsteps.

Other pressing issues for the medical profession, according to the HealthCare Group – Co-Chaired by Angela Braly of Wellpoint Inc., Dr. Denis Cortese of the Mayo Clinic, Jeffrey Kindler from Pfizer Inc., and Dr. Daniel Vasella from Novartis AG – include tort reform,defining and measuring medical value, payment reform, and building the health care workforce of the future with an emphasis on primary care, nursing and other allied health professionals. Moreover, true healthcare reform must involve integrating issues like Single Payer Systems, Consumer Directed Health Plans, Pharmaceutical Price Competition, Advanced Electronic Medical Records, and Quality & Outcomes Disclosure, etc.

The Obama Cabinet

President-elect Obama’s staff and cabinet appointments will also offer important clues for the markets, going forward. In addition to Rahm Emanuel, as the President-elect’s Chief of Staff, hearsay suggests Laura Tyson or Bill Richardson for Secretary of Commerce, Hillary Clinton as Secretary of State and Timothy Geithner as Treasury Secretary. Other considerations include Renee Glover for Secretary of Housing and Urban Development [HUD], Max Cleland as Secretary for Veteran’s Affairs, Janet Napolitano for Homeland Security, Jim Jones as National Security Advisor; and Richard Danzig and/or Chuck Hagel for other Cabinet Posts. Yet, Tom Daschle as Secretary of HHS is not exactly an “agent of change”, as the term is commonly understood.

Assessment

As the world’s markets sink, the pressure on our new administration will be to clarify these issues. Only then, will a stock market bottom be reached, and the dismal economy begins to reverse itself. Hopefully, the health care-scare will then be mitigated.

Conclusion

Your thoughts and comments on this Medical Executive-Post are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Product DetailsProduct DetailsProduct Details

Product Details  Product Details

Product Details