Re: Health Privacy Project

["admin" <admin@worldccr.org>]

This is very interesting. Thanks, Peter for posting this:

Peter Marshall provided the following verbage about [or from Health Privacy Project] which appears to address the issue of patient privacy:
> - - - [snip]
>  Best Practices: The Project is identifying "best >practices" models for 
>  health privacy and security.

Work in this area is important and significant, in my opinion. 

>  State Law Compendium: The Project is preparing a >practical, 
>  comprehensive guide to state health privacy laws.

Excellent idea, and hopefully, available to the masses. 
>
>         STAFF 
>
>  Janlori Goldman - Director (Bio)           >goldmajl@gunet.georgetown.edu 
>  Zoe Hudson - Policy Analyst (Bio)           >hudsonz@gunet.georgetown.edu 
>  Scott Sanders - Field Director (Bio)       >sanderss@gunet.georgetown.edu 
>
>------ 
>
>
>         What You Can Do Now To Protect Your Privacy 
>
>  Request a copy of your medical record. 
>  Currently, 28 states give individuals a legal right to >inspect and copy 
>  their medical records. Even if your state does not >provide such a legal 
>  right, you may be able to inspect and copy your record >upon request.

Now, this is interesting.  The individual should have a copy of their medical records, because - - - ?  I'm not sure what purpose this serves.  Keeping in mind, that privacy issues are more about the flow of information than about who has physical possession of a document, this suggestion seems to be more of an exercise to keep people busy and to offer a false sense of security.  Beyond that, I am hard-pressed to understand the utility of such a step. 

>  Request a copy of your file from the Medical Information >Bureau. 
>  The Medical Information Bureau (MIB) is a membership >organization of 
>  more than 600 insurance companies.

If ever there was a statement that would antagonize, anger, and speak to the heart of what the issues are regarding individual privacy, this is the ultimate.  Why on earth would anyone want a copy of a private medical record that is available to 600 insurance companies?


> When applying for
>insurance, you may 
>  be authorizing the insurance company to check your >records with MIB to 
>  verify that the information you have provided is >accurate.

Actually, I think this is backwards.  My private medical record, the accurate one, is sitting with my physician.  The MIB is holding "garbage", and if that's what they want, then so be it.  If, on the other hand, they want accurate information, they should contact the individual, and make arrangements, eh?

> MIB does not 
>  have a file on everyone.

Where did the MIB get the files it does control?  When did they get the information?  Was it before the patient got the information?  Probably.

> MIB reports are compiled on those with serious 
>  medical conditions or other factors that might affect >longevity, such 
>  as affinity for a dangerous sport. If MIB has a file on >an individual, 
>  that person has a right to see and correct the file.

This is absolutely ludicrous.  The MIB wants individuals to see and correct their files obtained without permission from the individual, in order to what?  Does the MIB need the patient to update and verify the information is correct, so they can make more money by claiming that each record is accurate, as noted by the patient?
 
>
>  Talk about confidentiality concerns with your doctor. 
>  Your health care provider should be able to help you >understand the 
>  uses of your health information, and may be able to >offer certain 
>  assurances of confidentiality. For example, some >providers keep 
>  treatment notes separate from the general medical chart >to help ensure 
>  that the most sensitive information remains >confidential. Your provider 
>  may also be able to help you understand the current >limits of 
>  confidentiality, such as what kinds of information he or >she is 
>  required to provide for insurance purposes.

I applaud this advice, and would simply add that actually, what information is considered confidential might better be expressed as an understanding that all medical information in a patient record is considered confidential.  Discussion about how to control the flow of that confidential information is probably more relevant and quite a bit more important.
 
>
>  Read authorization forms before you sign; edit them to >limit the 
>  sharing of information. 
>  Before you sign any forms find out to whom you are >authorizing the 
>  release of your medical records and for what purpose. >You may be able 
>  to limit distribution and restrict secondary disclosures >of the 
>  information by revising the authorization form. Be sure >to initial and 
>  date your revisions 
>
>  Register your objection to disclosures that you consider >inappropriate. 
>
>  Registering objections may not result in immediate >change, but sharing 
>  your concerns will help to educate your providers, >plans, and others 
>  seeking health information. These entities should be >aware that lack of 
>  privacy impacts how you seek and receive your health >care. 
>
>  Be cautious when providing personal medical information >for "surveys," 
>  health screenings and on medical information Web sites. 
>  Ask how the information will be used and who will have >access to it. 
>
>  Educate yourself about medical privacy issues. 
>  The resources page provides a list of informative >publications and Web 
>  sites. 
>
>Institute for Health Care Research and Policy, Georgetown 
>University,1999.