When Private Isn't (Quite) So Private

OK.  So the world knows we buy Charmin bath tissue and M&Ms and like to shop at Lord & Taylor. But how would you like it if you went to the ER for an appendicitis attack and it showed up on your chart you'd had an STD in college?

According to Melinda Beck of The Wall Street Journal, with all this digitizing of our medical info, "The sharing of Americans' health information is set to explode in coming years, with millions of patients' medical records converted to electronic form and analyzed by health-care providers, insurers, regulators and researchers."

Many experts agree it may be next to impossible to safeguard all that patient data, or keep it from getting into the wrong hands.  New rules may change some of this, but it's still a major threat.

"The reality is, our ability to exchange electronic information is already well beyond our ability to control it," John Leipold tol Beck.  He's CEO of Valley Hope Technology in Norton, Kan., which makes electronic record systems for behavioral-health providers.

Beck notes that one key new provision of the new "requires doctors and hospitals not to disclose medical information to a patient's insurer if the patient requests it and pays for the services out-of-pocket. The information can be noted in the patient's medical file, but stopping it being revealed to insurers inadvertently may be difficult, some health-care providers say."

She gives as an example a patient who pays "cash to have a sexually transmitted disease (STD) treated at a hospital and asks that his insurer not be informed. But many payment contracts between hospitals and insurers currently give the insurers considerable access to patient files for quality review and other oversight."

If the same patient returned with a different ailment, an insurance case manager reviewing his care "could readily see the STD treatment in his file," Beck quotes John Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston, and co-chair of a federal advisory committee on data standards.

Data segmentation -- sorting out data so some can see it and others can't -- is not yet ready for primetime, Beck reports.

She adds that "the question of how much control patients will have over their records is increasingly urgent." Though the government is paying doctors and hospitals up to $30 billion in incentives to turn their paper files into electronic records that can not only streamline a patient's care but also link to cancer registries, public-health agencies and other data-sharing projects (and punishing them if they don't), that electronic information is now pretty much available to all.

But gathering this data's all for a very good reason.  "Researchers, insurers, federal officials and doctors are counting on the trove of data in digital records to revolutionize care, helping identify the most effective treatments so they can cut costs without harming quality," Beck writes.

So what does this mean for you?  There's not much you can do right now, but just be aware that your medical records that you once might have thought were private really aren't so much these days.



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