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eWeek.com, in its Health Care News section, reports in an article entitled "Stitching Up Health Records: Privacy Compliance Lags" that more than 80 percent of companies involved in health care have technology and processes in place to provide the level of patient privacy protection required by the Health Insurance Portability and Accountability Act (HIPAA). The act required compliance by April 2003, which means that almost 20 percent of health care companies are "unable or unwilling to implement federal privacy requirements" according to a twice-yearly survey of health care payers and providers conducted by Phoenix Health Systems and Healthcare Information and Management Systems Society (HIMSS).
According to William "Buddy" Gillespie, vice president and CIO at WellSpan Health, which includes two hospitals, a home health care provider, a pharmacy, and about 40 physicians offices, managed care plans, and other outpatient treatment facilities in Pennsylvania and Maryland, it isn't that health care companies find privacy and security technology hard to manage; the problem is that HIPAA rules are often vague and technology is developing so quickly that it's often hard to decide whether flash drives, hot-site disaster recovery, and other specific storage and file management technology are covered or satisfy the rules.
Read the entire article at http://www.eweek.com/article2/0,1895,1949646,00.asp
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eWeek.com reports in its Health Care news section in an article entitled "Survey: Hospital CIOs Want Electronic Medical Records" that a survey of more than 200 health care executives, mostly CIOs at hospitals in the U.S., reports almost one-quarter of the organizations represented in the survey have a fully operational electronic medical records system and that forty percent of the hospitals have signed a contract for an EMR system or actually initiated installation. Only about ten percent have no plans at all to implement electronic records.
While a majority either already have or are on the way to having electronic medical records, it seems they aren't really interested in sharing the information in those records. About three-quarters say that they don't have any plans to participate in an RHIO (regional health information organization). Only about 14 percent actually participate in a RHIO; and only about 20 percent reported that they have an RHIO in their area.
What's on the hospital IT wish list? Single-sign-on identity management (almost four-fifths report expecting to have it in place in a few years, only about one-fifth already have it), and expanding the functionality of their web sites (three-quarters want to be able to offer patients the ability to schedule appointments online). About two-thirds are interested in offering a physician portal.
78 percent of those surveyed are "satisfied" or "very satisfied" with the performance of their vendors -- the suppliers, application vendors, and consulting firms that help make their technology work -- and almost four-fifths outsource some part of their IT.
http://www.eweek.com/article2/0,1895,1927818,00.asp
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This article, posted by Tillinghast Licht Perkins Smith & Cohen, LLP, on Findlaw.com, looks at the application of information technology to the health care industry from a decided legal standpoint. Outlining the broad goal of health care reform as the basis for the dynamic growth of integrated delivery systems, the article discusses the risks and security threats involved in electronic medical records systems. From a professional liability perspective, the article points out that while computerized medical records might pose less risk than multiple medical histories in different locations, with different or even contradictory information in them, the flip side of that coin is that the risk of breaching patient confidentiality may be higher as more personnel may have easier access to a larger amount of patient information in a centralized electronic medical information model.
If a system lacks reasonable security in design, operation, or maintenance, the article goes on to postulate, a court could determine that records stored on that system are not sufficiently reliable to be admissible in a legal proceeding, leaving the health care provider or practice unable to defend itself properly in a malpractice case. Several scenarios and at least one suggested approach to security and limited access are discussed in the article as well.
http://library.findlaw.com/2004/Sep/19/133570.html
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The American College of Physicians (ACP) is calling for Medicare to reimburse primary care physicians for using electronic health records and communicating with patients via e-mail and telephone, according to this article on "Government Health IT."
Medicare does not routinely reimburse phone and e-mail communications, but studies have found that they can increase the quality of care and improve physician productivity, the ACP report states.
Because mostly small medical offices have resisted using EHRs and the cost of the systems is more burdensome for them, Congress and the Centers for Medicare and Medicaid Services could also limit the extra payment to physicians in small practice settings, the report states.
http://www.govhealthit.com/article92155-01-31-06-Web
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"Government Health IT" published an article on January 25, 2006, reporting that the Center for Health Transformation, an advocate group in Washington DC, told the Medicaid Commission that "technologies are available that can deliver markedly better care at a fraction of the cost," referring to electronic health records (EHRs), e-prescribing, and telemedicine.
http://www.govhealthit.com/article92100-01-25-06-Web
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This survey, published in April 2005 by the American Health Information Management Association (AHIMA), was released in conjunction with the second annual National Health Information Privacy and Security Week, April 10-16, 2005, to raise awareness among healthcare professionals, their employers, the media, and the public regarding the importance of protecting the privacy, confidentiality, and security of personal health information (PHI).
http://www.ahima.org/marketing/email_images/2005PrivacySecurity.pdf
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Executive Summary
This report examines current state and federal law protecting the confidentiality of health information. It focuses on four specific areas: public health information held by government, privately held health care information, HIV and AIDS-related information, and immunization information.
The ways in which our modern medical and public health systems collect, store, and use personally identifiable information have increased both the potential benefits from access to such information and the possible harms from improper uses and disclosures. The report examines the importance of both the collection of health information and the protection of its privacy. The collection and use of health information involves two important goals, yet sometimes competing goals: 1) gathering and disseminating accurate and timely information on the incidence and prevalence of disease, health information necessary for health care of individuals, assessment of health care and public health needs and evaluation of programs, services, institutions and providers; and 2) protecting that information from uses or disclosures that cause harm to individuals to whom the information pertains. The report reviews the current privacy safeguards under both state and federal law in order to determine whether they are adequate to protect the privacy of individuals and are consistent with effective health policy.
http://www.epic.org/privacy/medical/cdc_survey.html
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" The Emergence of National Electronic Health Record Architectures in the United States and Australia: Models, Costs, and Questions," by Tracy D. Gunter, M.D. and Nicolas P. Terry, LLM, is a referenced, peer-reviewed viewpoint article appearing on the Journal of Medical Internet Research. Emerging
electronic health record models present numerous challenges to health
care systems, physicians, and regulators. This article provides
explanation of some of the reasons driving the development of the
electronic health record, describes two national electronic health
record models (currently developing in the United States and Australia)
and one distributed, personal model. The US and Australian models are
contrasted in their different architectures (“pull” versus “push”) and
their different approaches to patient autonomy, privacy, and
confidentiality. The article also discusses some of the professional,
practical, and legal challenges that health care providers potentially
face both during and after electronic health record implementation.
(J Med Internet Res 2005;7(1):e3)
doi:10.2196/jmir.7.1.e3 http://www.jmir.org/2005/1/e3/
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"By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care."
President George W. Bush
State of the Union Address, Jan. 20, 2004
This article, from Whitehouse.gov, outlines the President's view of challenges to the U.S. health care system, and offers a summary of the solutions that his Health Information Technology Plan proposes over the next 10 years. Transforming Health Care: The President's Health Information Technology Plan points to high cost, preventable errors, uneven health care quality, and poor communication among doctors, hospitals, and other providers as the major challenges to the system. Electronic health records will be designed to share information privately and securely between health care providers when authorized by the patient. President Bush believes that innovations in secure exchange of medical information will help transform health care. Practices that are already storing patient records electronically with a system such as the NextGen EMR and other information systems are already taking steps towards that goal. The Department of Health and Human Services is working with the private sector and other Federal agencies to identify and endorse voluntary standards. http://www.whitehouse.gov/infocus/technology/economic_policy200404/chap3.html
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