Obama Plan to Digitize Health Records
Imagine all the things you do during a typical day to allow others access to your personal information. You go to the supermarket. Most likely you have a store card which gives you either rewards or a discount on some items. In return for these rewards the store has a computerized list of what you buy. Someone out there knows what toilet paper you use, if you have pets, and if you smoke or not. You go to another store to buy a toy for your child. If you have been there before, they already have your phone number, and the clerk calls you by name. You then go to the bookstore where they want to know your zip code before they even ring you up. And let's say you wish to buy something on-line. You are giving out all sorts of information including your credit card number which most companies like to store for your later convenience.
Do you write on-line, have a facebook page, belong to Myspace? Need I even tell you about the risks to your privacy? I am sure you have all heard the stories of how employers look on myspace pages to find evidence of drunken and lewd behavior of potential job candidates. Nowadays it is possible for others to find out about the intricate details of your personal life. I had a friend who I hadn't seen in over a decade ask me how often I played basketball. When I asked why, she said that she had entered my address into Google Earth and was able to see the details of my house, our car, and that we had a basketball hoop in our driveway.
Welcome to the digital age my friend.
Everyday people leave a trail of personal information everywhere they go. And there are risks at every twist and turn.
Does this mean we stop using our computers? More importantly does this mean we stop progress?
I am sure you may have heard by now of President elect Obama's ambitious plans to computerize our health records within five years. This isn't a novel idea. In fact, PC World magazine hailed the Bush administration back in 2005 as being visionary for their attempt to begin this process. The problem was that nothing really came of this vision. Obama simply plans to put this idea of digitalizing health records into action. What are the hold ups to implementation? This same article by Grant Gross states that one reason is resistance of health care providers themselves: "Some health-care providers have been slow to adopt electronic health records because they're paid per patient visit, and they aren't paying the bills, he said. It is against the financial interest of many providers to improve quality or to improve efficiency, because we pay by volume, and greater efficiency and quality, by definition, reduce volume." This is but one reason for the delay. Other problems include finding the tech people who can actually do the job, the great cost, and of course the outcry against possible risks to patient privacy.
It is not known which company will lead the way towards implementing this plan but Google Health seems to be one of the potential candidates. Many are sirening the warnings that such third party health information sources are not covered by HIPAA, the 1996 Health Insurance Portability and Accountability Act.. This means health information could potentially be more easily obtained by the government and even for marketing purposes.
Yet it is not like there will be zero safeguards to protect privacy. As pointed out in a quote found in a Time Magazine article entitled, "Medical Records Go Digital,"
"With paper, what's to stop the night janitor or front desk clerk from reading your record?" No system is without flaws.
The elements which are uncertain at this point are: Which contractors will be responsible for enacting this plan? How much security will we have against invasions of privacy? And what sorts of information will be kept using this method?
Just because we don't know all the answers yet to these questions, does this mean we throw out the baby with the bath water?
I for one, say no.
The benefits clearly outweigh the possible risks here.
We are talking about saving time, money, and most importantly lives. David Goldman of CNNMoney reports: "The savings of such a plan could be substantial. Brailer estimates that a fully computerized health record system could save the industry $200 billion to $300 billion a year."
And Lisa Girion of the Los Angeles Times reports that: "The Institute of Medicine, a nonprofit research organization affiliated with the National Academy of Sciences, has estimated that medical errors kill as many as 98,000 patients in U.S. hospitals each year." Would you be so against this system if you knew it would save your life or the life of a loved one?
Is it possible to have the benefits inherent to such a plan and also ensure our privacy? We shall find out in the years to come! I think Obama is on the right course. It seems backwards to me that everything else in our lives is digitalized but our health records. Will there be problems along the way? This is certain. But it would be like stopping the invention of the automobile because they might go too fast or need repair. Or perhaps we should go back to using typewriters because the internet may be a dangerous place. Progress has come. We need to run with it and try to make it work.
In the meantime I was curious as to how the on-line mental health community felt about this topic so I asked several of my fellow bloggers to offer their perspecitves which I shall share here.
Doctor Deb, psychologist, mental health advocate, and blogger extraordinaire has this to say about storing our health records on-line:
"Having the access of a digital file will certainly hasten testing and diagnoses, and ease the bulge of filing issues. But such access may invite a wide variety of breaches and misuses of personal information. The good, the bad and the ugly of it all will have to be considered a work in progress if this plan moves forward."
Susan, who is an advocate for people who suffer from mental illness, as well as the creator of a popular mental health blog entitled, "If you are going through hell keep going" explains her view on this controversial topic:
"This new plan really bothers me for some reason I cannot fathom. Maybe because I am opposed to Nanny States and Big Brother. If every medical file you have, from the moment you are born and the doctor slaps your backside- until they declare you dead and off the funeral parlor- is there- what if there are things you don't want people to know?
While it might be a good idea for some things- I don't care if people know my blood type is A neg, and I am not allergic to Penicillin- I don't even care if people know I want to be an organ donor. But that I have flat feet? Ugh, no.
But for everything else- it seems to be a sloping line from knowing I have had my tonsils removed twice- to my mental health hospitalizations. I am comfortable telling my doctor this, but not the whole world. Does the world really need to know I had a miscarriage and became anemic from it for the longest time? It just makes me uncomfortable when I think of things people want hidden in their files, like for example any history of sexually transmitted diseases, Aids, problems stemming from illegal drug use. Cancer. Suicide attempts- or if you were the victim of physical abuse.
I understand there is a good reason to do this, but it should be kept simple. Name, social security number, blood type, and organ donation. Which meds allergic to. Next of kin if under age. Anything more than that- to me. like I said is Big Brother, and that is something I don't want to see in my lifetime."
John D. who is a long time sufferer of depression and who writes about his efforts to recover and heal in his blog entitled, "Storied Time" also has worries about the risks to individual privacy:
"I'm impressed that the local health system I use has computerized records and can give me a written report after each visit. Doing this on a national scale, though, raises not only privacy issues related to hacking large system, but also issues about involuntary inclusion of private records for uses an individual couldn't control. Right now my permission is required to send records anywhere outside that local system - would that happen on a national scale? I also doubt the feasibility of connecting every doctor's office and local system around the country. Many of these attempts have failed, yet software marketers keep overselling the capabilities of their products to tie together incompatible networks. Lots of unresolved issues - so I would go slow and try to answer these first before jumping in."
So what are your thoughts? Do you fear that your private medical information could be found in the wrong hands due to the government's efforts to computerize health records? Or do you feel the advantages outweigh these risks? Please don't hesitate to share your opinion. We want to hear what you have to say.