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Re: Policy versus implementation

  I seem to have been drawn into a dispute about ideology vs reality.
  I am not debating the issues of whether there is a cost to not doing
  anything versus the cost to do something.   The costs of each option should
  be estimated in terms that make some comparable sense. For example, would Mr
  Lewis opt for maximum security and confidentiality in his health clinic if
  it meant that health care would cost 15% more and therefore some number of
  people could no longer afford it?  This is truly a zero sum game where money
  or resources spent on one part of health care means less for another.  What
  part of health care would Mr Lewis suggest be cut in favor of more security?
  Mr. Lewis asks how we should measure the costs that are not financial in
  nature.  We can look at the options proposed to avert those problems and see
  if the price is worth it.  Should we enact the most Draconian security
  confidentiality measures that cripple any long term heath services research
  and diable any efficiencies in health care produced by automation or should
  we search for a middle ground where violators of confidentiality are
  punsihed severely but health care providers are allowed to practice
  efficiencies and divert resources from handling files and passing paper to
  treating patients. 
  Mr Lewis suggets that we eliminate some of the places that gather and store
  data.  Let me gently explain to Mr Lewis that  there are thousands of these
  places doing this now - we call them hospitals and clinics and extended care
  facilities and by many other names.  Their business is providing care - and
  a primary concern already is patient confidentiality.
  Mr. Lewis also believes that "the people" alone should decide whether
  ligislation is correct.  The issue of the patient's right to confidentiality
  versus the public health good is not a simple question which can be answered
  by an absolute vote in either direction.  As repositories of responsibility
  and expert knowledge, we should be able to craft a middle ground position
  where maximum good accrues to all sides.
  I suggest we look for solutions rather than more rhetoric.  I suggest that
  Mr. Lewis become the Director of Information Services at a hospital and
  solve the issues directly.
  Lewis Lorton, Executive Director
  Healthcare Open Systems and Trials
  444 North Captol, NW
  Suite 414
  Washington, DC 20001
  tel   202/434-4771   fax  202/434-4766  
  Home page
  Program Home Pages
  Healthcare Information Infrastructure Technology Program -- http://hiit.scra.org
  Healthcare Information Technology Enabling Community Care --
  10096 Hatbrim Terrace
  Columbia,  21046
   direct 410-715-1181     direct fax 410-992-7060