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Health providers oppose records bill
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By TOM FAHEY
State House Bureau Chief
Tuesday, Mar. 11, 2008
A bill that would give patients specific privacy rights in electronic medical records is drawing opposition from hospitals and health providers.
The bill due for a vote tomorrow tries to balance privacy concerns against the move to electronic medical records, which the health industry says will increase health care quality and lower costs.
Sponsored by Rep. Cindy Rosenwald, D-Nashua, and privacy advocate Rep. Neal Kurk, R-Weare, HB 1587 would allow individuals to block access to their medical records, and to inspect them to see who's been snooping in their files. It would also allow a patient to block the transfer of a medical file to his or her doctor, and prevent its use in marketing or fundraising efforts.
The health outfits are concerned that the restrictions exceed federal privacy laws, and will discourage large and small practices from moving ahead with the kind of electronic medical record-keeping that was a priority for Gov. John Lynch's Citizens Health Initiative.
Lynch wrote in January in support of the bill, saying "HB 1587 recognizes that maintaining confidentiality is paramount in the move to electronic medical records." But the bill went through eight subcommittee sessions since then, and built in more privacy protections as it went along. It won an 11-8 endorsement in a committee vote.
Paul Spiess, chair of Lynch's Citizens Health Initiative, said he thinks the bill is a strong one that will protect patients. If privacy is not protected, he said, patients themselves will protest.
"It's critically important that the health care industry adopts electronic technology, electronic prescription, medical records and the ability to transfer that information," he said. "If we're going to move in that direction, we have to have privacy laws that reflect challenges today, not the challenges of a pre-electronic world ten years ago. This legislation intended to move down that path."
Besides hospitals and doctors, the Business and Industry Association, the insurance industry, nursing homes, even the state's dentists, oppose the bill. They argue it will slow the move to electronic records, and exceeds federal privacy laws.
Rosenwald defends it, saying, "It's a good bill and it strikes a good balance between individual privacy and institutional needs." She said federal privacy restrictions were passed as a minimum, not a maximum protection. She warns that Google and Microsoft are developing medical records software that will not be subject to federal privacy laws. That would give the pharmaceutical industry a free hand in reviewing records, she said. It would also make easier the new crime of medical identity theft, where someone steals information to get health coverage that can ruin the integrity of an individual's medical records.
Kathleen Bizarro, executive vice president of the New Hampshire Hospital Association, said mandates and restrictions in the bill, "essentially put a halt to the development of electronic medical records." Janet Monahan of the New Hampshire Medical Society said, "no small office is going to put out money for records system if they think the rules are going to change."
The BIA's Adrienne Rupp said that beside the records issue, "the bill will contribute to more confusion among providers, less information being shared among providers and contribute to the greater possibility of errors occurring." Rosenwald argues that the bill restores power to patients.
"Current law tips the balance of power to the provider, not the individual. In New Hampshire, we are unique in that the information in your medical records is deemed to be your personal property. We're lucky enough to actually own our records, but we don't have an effective mechanism to control access to it. This bill provides that," she said.
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YOUR COMMENTS
In response to Brian of N. Sutton's comment of : "It's quite simple to protect patients' medical records and doesn't cost a dime to do so", that is not entirely true. Many medical professionals spend thousands to protect patient records by purchasing software programs that back-up and store data, they also pay for office space just to house those medical records, they must comply with HIPAA standards for patient consent and information that is given, they must make sure that all documentation is protected from fire, theft, or other peril. All of this DOES cost money, but they are "hidden" costs that the typical physician office simply "absorbs". Sometimes, these costs may be passed down to the patient in terms of fees for services, but it is not the typical practice. I do agree that patient consent with regard to transfer or storage of any private, protected information should be the decision of the patient, not the health care provider, and at the same time, the physician is responsible for maintaining and ensuring the privacy of that data. When our government starts directing where our data will go to, it opens the door for all sorts of legal and privacy issues. The individual should be the one to direct their personal private health data.
- Jamie Z., Salt Lake City, UT
I am an EMT and LNA in New Hampshire. The right should always fall on the side of the individual to choose how their info should be stored and shared.
It should never be decided by the Government or a corporation. If someone wants to have their private medical information available on line Then let them opt-in to the system. We should not have to opt-out and we should not have to be fearful of our private records being accessed by the wrong people or used by companies to solicit sales. This is the most private of information that all individuals have and it should be safe guarded. I will be watching to see which legislators vote on the side of the people, and those who vote to appease corporations. I don't want the alternate in office.
- Jenn, Andover
No matter how many stakeholders line up against consumers in your state capitol, if New Hampshire patients do not trust that their privacy is being protected, you know that they will simply opt out one way or the other, and there is nothing that can be done to stop them. To proceed with plans that ignore patient privacy rights will only create expensive and dangerous computerized junk that nobody will trust - setting back progress for decades.
New Hampshire, there is no choice. You must give your citizens what they want. To do otherwise in a democracy is tyranny. Trust cannot be mandated. Darrell Pruitt
- Darrell Pruitt, Fort Worth, Texas
I agree with Brian. This is not about patient privacy but about some hospitals and other medical professionals that want to use the info in the records to make money. I suspect the major objection is the statement ...prevent its use in marketing or fundraising efforts."
- Doug Hogue, Merrimack
Blocking this bill is self-interested nonsense. EMR (electronic medical records) programs and a laptop can be obtained cheaply but most physicians are cheap to spend money on their practices so don't want to have any extra expense or have to do anything to protect patients unless the MD is paid to do so. Same goes for hospital administrators with a business or medical background.
The measures in this bill give individuals RIGHTS over their own private life and their bodies. Support this bill and if your local legislator, physician, and hospital does not, then you know they are more interested in their own finances (or power with the health care establishment in the case of the legislator) than they are in you.
- Nurse in NH, Manchester NH
I don't buy the arguments by the opponents of the privacy protections.
My doctor operates a small office. It's only he and his wife. He uses electronic medical records. There are no privacy worries as he doesn't share his patients' records with anyone without written authorization of the patient. The computer containing the medical records is not connected to the internet.
When I'm in his office, he has a computer screen facing me so I can see everything he's doing with my records. I review my records with him. It's quite simple to protect patients' medical records and doesn't cost a dime to do so. The opponents of HB 1587 want to make money on your private medical information and don't want you to know that.
- Brian, N. Sutton
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