Barton works to improve medical records

From the WDL
Barton works to improve medical records

By JONATHAN BLUNDELL Daily Light staff writer

In an effort to increase efficiency and save medical costs, U.S. Rep. Joe Barton (R-Waxahachie) is helping lead legislation through the Energy and Commerce Committee that would enable health care records to be stored and transferred electronically.
The Wired for Health Care Quality Act, or S 1418, was unanimously passed in the Senate in November and awaits approval from the House.
The bill was introduced in the House by Rep. Darrell Issa (R-Calif.) in January and is being looked at by the Subcommittee on Health.
A similar bill, HR 4157, was also introduced in the House by Rep. Nancy Johnson (R-Conn.) in October and was referred to the House Ways and Means Committee.
Proponents of the plan say it will enhance the adoption of a nationwide health information technology system and enable health records to be passed quickly from doctor to doctor and health care providers to improve efficiency and reduce costs.
“The general issue is that medical records are in the dark ages,” said Barton, who was admitted briefly to George Washington University Hospital after a heart attack on Dec. 15. “When I was in the hospital last time I had to answer the same questions four or five times. People are still using manual files and manually writing things down. And if they do update the records on the computer, they’re keeping it on their own workstation and not sharing it with other computers.”
Barton said it’s not clear if his committee or the house will move on any one specific bill yet, but the Energy and Commerce Committee expects to hold hearings on the general issue within the next month.
“We may choose one of the bills already introduced as a base bill but we’re still discussing the general issue now,” Barton said. “We have the secretary of health testifying before my committee on the bill this week. He’s been supportive of the concept.”
Barton said he’s also met with the new House Majority Leader, U.S. Rep. John Boehner (R-Ohio), who is also supportive of the idea.
“I think this is something we can move into play this year,” Barton said. “I believe it will save tens of thousands of dollars with the improvements and you’ll get a lot more efficiency when you transfer records electronically with proper confidentiality agreements.”
But patients’ privacy and confidentiality has Dr. Deborah Peel, founder of Patient Privacy Rights, concerned.
“The only reason people trust the health care system now is that people expect their doctors to protect their information,” Peel said. “But many people don’t realize they had their rights eliminated in 2003.”
In 1996, Congress enacted the Health Insurance Portability and Accountability Act, which protects workers’ health isurance coverage when they change or lose their jobs.
But amendments to the bill in 2003 allow certain entities the right to view patients’ records.
“Several hundred thousand entities have the right to look at records without the patient ever knowing,” said Diane Quest, a PPR consultant. “Self-insured employers, insurance companies, pharmacies, doctors and any businesses associated with health care can all view a patient’s records. We’re concerned that the new bills in Congress don’t have any teeth in them in regards to protecting privacy.”
Not only do the entities have the right to look at new records, but older records that patients may have requested to remain private as well.
“The April 2003 amendments are retroactive,” Peel said. “This amendment applies to all records prior to 2003 Ð regardless of whether you signed forms thinking that information was private.”
Quest and Peel both said they’re not against the bills, but are concerned that all aspects are covered.
“When you make records electronic there are good things that happen,” Quest said. “But we’re concerned about the privacy issues. The records will become more accessible to everyone and the bills that they’re considering rely on HIPAA for protecting rights, but HIPAA doesn’t do enough to protect patients.”
One of Peel’s greatest concerns is that patients will never know who has access or who looks at their records.
“None of the bills presented so far give patients the right to see and control who sees their information,” Peel said. “They may never know who’s looking at their private medical records. That might not seem like a big deal, but there are medical conditions a patient may have that you don’t want your pharmacy or employer or just any hospital employee to know about.
“Health practitioners, hospitals, insurance plans and self insured employers all have federal permission to disclose your health care information,” Peel said. “All of them can use and disclose your record even if you object Ð and they don’t have to keep audit trails. We’re in danger where even if patients don’t choose to allow sharing their records people can still see them without permission. The right to consent has been replaced by federal regulatory permission for 600,000 entities to view your information.”
Peel said she is hopeful that Barton will be as stringent with protecting patients’ records as he has been with financial and data information.
“We’re very hopeful that Barton will be a medical privacy hero as he’s been for data breaches and privacy of other kinds of records,” Peel said. “He’s been a powerful advocate for privacy in other areas and we hope he does the right thing in this area, too.”
Barton and the Energy and Commerce Committee recently held hearings on keeping personal phone records private.
“Our e-mail is clogged with spam. Our computers are covertly monitored with spyware. Our personal information is bought and sold by information brokers. And now we learn that a phone number and one hundred dollars can buy you a month’s worth of call information for just about anyone,” Barton said in a press conference following the hearings. “These are very personal and private records of who we call, when we call and how long we spend on the telephone call. This is an invasion into our personal privacy and, if I have anything to do with it, will not be allowed to continue for very much longer.”
“We’re hoping, that as the chairman of the Energy and Commerce Committee, Barton will set the bar high for medical records and consumer control as he has for financial and consumer records,” Peel said. “Every survey says people are concerned about their medical privacy. You want people treating you to have the information they need, but you need to have control over who sees that information.”
Peel said a similar issue has arisen within the Veterans Affairs Health Care System.
“We had a VA doctor write his personal position to us,” Peel said. “The VA is a prime example of what this new system could look like. It’s designed for use by doctors and the government essentially for their own uses, without input or consent from the veterans.”
While the system is designed to allow VA doctors the ability to easily share information across the country, Peel said anyone in a VA hospital can see your records.
“If they don’t want info shared they have to be rich enough to go outside the system,” Peel said. “If you have a record in San Diego they can pull it up in Washington, D.C., but anyone with access to the system can read everything. There are many things available on your records that you might never imagine anyone would know about, other than your personal doctor, but they’re available to anyone who picks up your chart.”
Peel said just like credit or financial records, patients need more control over their records.
“Patients should decide who gets to view information,” Peel said. “Every patient doesn’t want each and every one of their doctors to see everything. You may not want your psychologist, and certainly not your employer, to know of certain medical conditions that don’t concern them, such as an STD.”
Another area of concern is between security and privacy of records.
“It’s confusing when you talk about security and privacy protection,” Peel said. “Where as security protection is a firewall and encryption to keep outside users of the data away, privacy matters concern those within the system gaining access to records without a patient’s consent. Obviously there have to be high security areas put in and of course the public is completely petrified of security breaches, but we also need to be as concerned about the privacy of records.”
Barton said while other bills presented lack patient privacy initiatives, he is a supporter of patient privacy and his committee is actively working to protect patients’ rights.
“On the issue of patient privacy, we can work on that,” Barton said. “There’s nothing specific in the Senate bill, but that’s something we’ll improve in the house.”
Barton said fellow committee member Rep. Cliff Stearns (R-Florida) was directly working on patient’s privacy for the bill.
The Energy and Commerce committee is expected to continue hearings before a bill is brought before the house.
“The first thing we’ll do is have a legislative or general policy hearing,” Barton said. “Then we’ll hold a mark up on a specific bill before amendments will be added and a vote taken.”
Barton said there was no specific time line on when that vote might come.

On the Internet:
On the web visit: http://www.patientprivacyrights.org and http://joebarton.house.gov