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HIT and Privacy Issues

10 Responses

1. Judith, on January 22, 2009 at 2:01 AM said:

   POMRs,

   Did you know that according to blogger Tim Elwell, Dr. Larry Weed introduced the first eMR in 1966?

   Back then, it was on paper, and was called the “Problem Oriented Medical Record” or POMR. This innovation, out of the University of Vermont, held great promise.

   Now, over 40 years later, eMR adoption is between 12-15%, or even less in the small provider office setting. Of course, the paper POMR is more secure, private, inexpensive and not easily hacked.

   -Judy

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2. Dr. Pruitt, on January 26, 2009 at 6:45 PM said:

   Careful with that, Mr. Tullman of Allscripts,

   On my good days, when things I predict seem to fall into place just like I described, I like to proudly announce to my Medical Executive-Post readers that I will continue to do my best to describe the event horizon of history for them in an interesting manner – in the hope that they too will grab a voice and get involved.

   I don’t want to lose you now, because I think it is going to get really interesting for Allscripts soon, and I want the opportunity to tell you “I told you so” … or not. I predict that within a week, CEO Tullman will feel the start of a prolonged media backlash because of his close relationship with CCHIT (I mean really, who could not see that disaster coming)?

   I also think the price for Allscripts’ (MDRX) stock is in for a tumble when physicians really begin to understand what Dr. Hayward Zwerling already knows about CCHIT – I will say that by June, MDRX will lose everything it gains in the next two months, while the Fortune 500 will show slow, unexciting gains. I could be wrong. Remember, I’m a dentist, this is a hobby, and I’m just guessing for crying out loud. No wagering, please.

   My comment from yesterday, “Dr. Hayward Zwerling, meet Mr. Glen Tullman,” scooped Fortune Magazine reporter Mina Kimes’ article about Tullman by a day … and Kimes probably had a head start on me. Her article is titled “One potential winner from stimulus bucks.”

   http://money.cnn.com/2009/01/26/technology/allscripts.fortune/?postversion=2009012611

   Like my own article, Kimes’ article describes how Allscripts CEO Glen Tullman is the luckiest business dude in America. He’s in the right place at the right time. He’s got game. And he’s got Obama’s ear.

   Kimes confirmed my suspicion that Tullman and Obama had more than a passing interest in each others’ interests. Kimes writes that Tullman advised Obama about the EHR issue before the election. It didn’t hurt that they are both from Chicago.

   After reading my article, one only needs to read a few of Kimes’ words to understand why what is good for Allscripts is not necessarily good for the nation’s healthcare:

   “Tullman hopes that Obama will swiftly use the money to implement incentives and penalties. ‘The government has to make sure that they incentivize not only the acquisition, but the utilization of these systems,’ [Tullman] says.”

   Kimes adds, “In order to receive grants, doctors would need to embrace information technology — and, inevitably, embrace Allscripts’ products.”Kimes also confirmed that Tullman has problems keeping his pride in check. He says things he will surely regret. Doesn’t he have PR people?

   “Imagine — the most influential person in the world says everyone has to have your product in five years. You can’t paint a better picture.” – Allscripts CEO Glen Tullman, January 26, 2009.

   I’d be careful where you point that, Glen. You could put a hole in a nice shoe or two.

   Darrel K. Pruitt; DDS

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3. Phillip, on January 28, 2009 at 11:03 AM said:

   Bravo VA – Not!

   RE: HIT Privacy Issues

   And, some politicians, patients, doctors and pundits want national healthcare?

   Didn’t the Veterans Affairs Department just agree to pay $20 million, in a class action lawsuit alleging invasion of privacy, to veterans for exposing them to possible identity theft in 2006 by losing their sensitive personal information?

   The lawsuit came after a VA data analyst admitted he had lost a laptop computer and external drive containing the names, birth dates and Social Security numbers of up to 26.5 million veterans and active-duty troops.

   Of course, the money will come from the US Treasury exactly at this time of financial meltdown. Jus consider; how many kids could be immunized; or uninsured patient treated with this money.

   Now, we all understand human error; but it could only occur on such a large scale with eHRs.

   -Philip

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4. Sue Reber, on February 6, 2009 at 7:58 PM said:

   Dear Dr. Pruitt,

   It’s clear that you are frustrated with our inability to give you the definitive answers you seek. Neither Dennis nor I, or other CCHIT staff, are in a position to answer your question. The Commission has not taken up the question of electronic dental health records – the relevant standards and criteria for functionality, inter-operabilty and security required to build an inspection process – and the value of a certification program to their adoption.

   I have communicated with Dr. Powell as to the appropriate process for you and your colleagues to participate with the Commission’s work, and I have offered to speak with her by telephone if she needs more information. We would be happy to sponsor a teleconference on the topic of the Commission’s current programs and process if you or she can put us in contact with a representative organization with which we can work.

   As I’ve noted in earlier emails, the most effective way for the dentistry community to provide a case for expansion or inclusion in current CCHIT criteria is to participate in the frequent open public comment periods for the current programs – for example, the Child Health Ambulatory eHR certification program – or to submit a case for expansion to a special care setting. The next and final open comment period for 2009 ambulatory eHR programs will be March 30 – April 28.

   I think I should clear up what may be a misunderstanding. CCHIT does not “decide about EHRs for the nation.” We are not a government agency. We are a private, nonprofit organization offering a voluntary certification program for electronic health records used in physician offices and hospitals, and for health information exchanges. We are a federally recognized certification body. The federal government, and some private health plans and quality improvement organizations, have chosen to require certification for participation in specifically designed EHR incentive programs for office-based physicians. You may wish to contact HHS, CMS or the Office of the National Coordinator for Health Information Technology if you have questions about the applicability of their programs or future plans to your practice.

   Regards
   C Sue Reber
   Communication Director, CCHIT
   Certification Commission for Healthcare Information Technology
   503.703.0813 cell | 503.249.9589 fax
   sreber@cchit.org

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5. Dr. Pruitt, on February 6, 2009 at 8:01 PM said:

   From: Sue Reber [mailto:sreber@cchit.org]
   Sent: Thursday, February 05, 2009 4:21 PM
   To: darrelldk@tx.rr.com
   Cc: Powell@rmu.edu; dwilson@cchit.org
   Subject: CCHIT

   You wrote – “Dear Sue and Dennis”,

   Sue, you did indeed thoroughly answer my question last week, and I apologize for not sending a thank you note. You were very accommodating. Thank you.

   I’m sorry that you were inadvertently bothered again, but today’s was a different question to a different person … or so I thought. It may have been wrong for me to take this liberty, but Dennis’ email arrived out of the blue this morning in response to my hit-and-miss efforts at communication a while back. Since it is admittedly difficult to reliably get a response from the CCHIT website, I thought – why not? Dennis was available and offering to answer a question. What difference would it make to him if I slip in a different one, a week later? Who’d know?

   Though I may be a pain, please understand that whatever CCHIT decides about eHRs for the nation, it will have a serious impact on my dental practice – possibly adding tremendous expense and danger to the care I give my patients. This is not a hobby. This is serious. I want to know what is happening.

   Ever since you informed me the first time that interoperability in dentistry has not yet been considered by CCHIT, and then added that I am virtually the first person to even mention it, I have been understandably concerned. As if the revelation of a huge information vacuum for my profession at CCHIT were not enough, I now question the interoperability of the CCHIT staff with each other. I knew beforehand that Dr. Valerie Powell, PhD., had established contact with CCHIT in June of 2008 concerning the importance of dentistry in eHR plans. What happened to that information? Please let us know if her concerns need to be repeated for CCHIT. We are in touch.

   My still unanswered question that I posed to Dennis – How will eHRs benefit dental patients? – is an attempt to find out how much CCHIT actually knows about dentistry. That gives me an idea about the baseline level of knowledge I have to start with in a long education process that I assume has been left up to Valerie Powell and me to complete.

   CCHIT is way behind where it should be if dentists are to be interoperable by 2014. Trust me. We know more about this than you do.

   Darrell K. Pruitt; DDS

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6. Robinson, on February 17, 2009 at 11:40 PM said:

   Darrell, Philip, Judy and Everyone,

   Recently, Dallas Parkland Memorial Hospital lost a lap top computer believed to be carrying the names, birth dates and Social Security numbers of 9,300 employees. In fact, many pundits wonder why the data wasn’t encrypted in the first place.

   What do you think? Two issues always seem to surface in these cases: 1] security and, 2] human error.

   Robinson

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7. Darrell, on April 16, 2009 at 6:49 PM said:

   Privacy is not negotiable, Dr. Deborah Peel

   What happens if stakeholders push lawmakers to spend 20 billion dollars on a national interoperable eHR system that the principles don’t trust from day one? How will the government force physicians to tell the truth about their patients’ frailties? And how will they force me to be honest with my doctor?

   Privacy is an obstacle that simply cannot be willed away for convenience regardless of mandated rules. Don’t say you heard it from me, but I suspect that many doctors in the nation, especially psychiatrists, are already keeping two sets of records – a public, insurance/government set, and a private, accurate set. Blame that on the Hippocratic Oath.

   I read a story in iHealthbeat yesterday titled: “Study: EHR Adoption Lower in States With Stricter Privacy Rules” (no byline)

   http://www.ihealthbeat.org/Articles/2009/4/15/Study-EHR-Adoption-Lower-in-States-With-Stricter-Privacy-Rules.aspx

   The article describes a study performed by researchers at Massachusetts Institute of Technology and the University of Virginia that discovered that electronic health record adoption is slowest in states with stricter privacy regulations.

   “According to the study, privacy rules often make it more difficult and expensive for hospitals to exchange and transfer patient data, which reduces the value of an EHR system.”

   One of the report’s authors, Catherine Tucker of the Sloan School of Management (MIT), is quoted: “What we found was that privacy laws are getting in the way of hospitals” trying to exchange data with one another, adding, “Policymakers are going to have to choose how much [EHR] adoption they want and at what cost to patient privacy.”

   Deborah Peel, founder and chair of Patient Privacy Rights called the study “preposterous,” and responded: “There are many reasons why there is low adoption, but privacy is not one of them.”

   Deborah Peel is wrong.

   For several years, I’ve followed and supported her efforts to promote patient privacy, and this minor gaffe will not change a thing. Dr. Peel is a courageous and devoted humanitarian who has almost single-handedly drawn the attention of the nation to the importance of privacy in healthcare – often fighting a lonely battle against the largest public and private entities in the nation. She has testified on OUR behalf numerous times before lawmakers and has literally won for US citizens freedom from oppression.

   That is why it surprised me to read her argue over the price of privacy. I thought she would know better. Peel appears to have cast aside common sense, and has been lured into playing a stakeholders’ game.

   Counter to Peel’s claim, it is just too obvious that privacy rules cannot possibly make the implementation of an interoperable eHR system any cheaper or easier for transferring data. Nevertheless, even without the trust of physicians and patients, I’m sure there is enough Wall Street momentum in the healthcare IT industry to adequately waste $20 billion on something digital. After all, Allscripts CEO Glen Tullman is a trustee of CCHIT – the government-approved eMR credentialing enterprise – and a good friend of someone else from Chicago, Barack Obama.

   Other than causing a waste of taxpayer money in a healthcare IT bubble, does lack of trust cause irreversible harm? Within the last week or so I read somewhere that soldiers returning from Iraq who suffer from post-traumatic stress syndrome are committing suicide at an increasing rate because they allegedly don’t want to be labeled as emotionally unstable on their military electronic health records, which are now promised to follow them to the grave.

   Let’s be compassionate. Without trust, health care is oxymoron.

   D. Kellus Pruitt; DDS

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8. Jim, on January 9, 2010 at 4:13 PM said:

   Remember, that you medical practice is a business and how its’ data and information is used is also vital to your organization. Information technology (IT) and its infrastructure must therefore be protected through careful security policies. These policies are guided in part by the risk inherent in your health organization’s IT infrastructure, its competitive strategy, and its asset and risk management policies.

   It is important, however, not to over focus on security implementation so that you overlook the clinical operation management and patient-centered care in your healthcare facility.

   Jim

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9. Mandell, on July 16, 2012 at 11:51 PM said:

   Guess Who’s Back?

   http://www.webpronews.com/guess-whos-back-sopa-and-acta-are-sneaking-into-law-behind-your-back-2012-07

   SOPA And ACTA Are Sneaking Into Law Behind Your Back

   Mandell

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10. Morgan Reed, on January 8, 2015 at 1:32 AM said:

    PRIVACY

    “It is incredibly important that Congress, the Department of Health and Human Services (HHS), and the Food and Drug Administration (FDA) work with the mobile industry to adopt a more sensible implementation of the laws that govern health privacy.”

    Morgan Reed
    Executive Director
    [ACT The App Association]
    via Ann Miller RN MHA

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