The medical record has become a tool for oversight and research, without requiring consent, overriding patients’ rights to privacy, writes Susan Israel, M.D., in the winter issue of the Journal of American Physicians and Surgeons.
Data compiled from electronic medical records and insurance claims will be used to create treatment “guidelines” that will define value-based care. Physicians will be pressured to follow them in order to be “paid for performance,” Israel explains.
Patient and physician behavior will be tracked and scrutinized, eliminating privacy from medical practice. Physician initiative will decline, and patients will have no recourse but to accept the treatments mandated for them by the monolithic, government/insurer-controlled healthcare delivery system, Israel states.
Despite audit trails and passwords, confidentiality depends on hundreds of people in clinics, hospitals, corporations, and government agencies nationwide not leaking or misusing patient information that could harm individuals’ opportunities or be used to exert political pressure on a government official or legislator, Israel notes. Additionally, hackers are busy accessing the medical data of millions of people for profit and electronic espionage.
“A national Health Information Exchange (HIE) is planned for electronic health records, giving its access to medical practitioners across the country and to government oversight agencies, often without patient consent,” Israel writes. “When the public becomes aware of the broad access to their private records, many will not disclose needed medical history until their illnesses are so advanced it costs the system even more for treatment. For psychiatric patients refusing to seek treatment, one would expect increases in suicide and homicide.”
Some states have established an All-Payer Claims Database (APCD) with identified health plan claims data. While some data is “de-identified when released,” Israel points out that re-identification is often possible.
APCDs, she writes, “will create a lifetime (for a newborn) medical dossier on all of us which we can only hope is not hacked, misused, or re-identified when distributed. Whether or not the states can force the self-insured health plans to turn over patient health insurance claims data to their All Payer Claims Databases is now being heard before the Supreme Court in Gobeille v Liberty Mutual Insurance Company.”
Israel concludes: “We need to foster a public debate over citizens’ right to medical privacy vs. government seizure of private information without consent, because any loss of privacy rights undermines our society, and threatens our freedoms and our way of life.”
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
Read full article: http://www.jpands.org/vol20no4/israel.pdf