You can examine the text of this proposed legislation and vote at http://www.patientprivacyrights.org/site/PageServer.
Promoting health insurance technology in the spirit of saving money, this legislation is a reminder that patient privacy is quickly becoming a thing of the past.
While we all think we know about doctor/patient privilege, we've already complied with health insurers who disclose on every form that we consent to the use of our information in the course of processing claims. We're being pushed to keep our own personal health records. And this legislation wants to centralize even more information.
There are three key problems with all of this legislation including alternatives proposed by organizations such as Patient Privacy Rights:
FIRST: Who is getting the dollar savings? These proposals do not benefit consumers. The dollar savings being spoken about in S.1693 will not be for consumers, but for medical services providers who will have centralized access to individual health data. This "streamlining" is a trade-off of patient privacy for the benefit of others. The same is true for the Personal Health Record encouragements, asking consumers to disclose all of their health information to a centralized place, usually the insurance company. But these provisions do not create a presumption that duplicate or repeat testing won't be done (which would save consumer dollars). So, for instance if you are Connie Conscientious and record your personal health record with your insurer, then you see a doctor and want to rely on your thorough history to influence what he needs to do or not, this won't occur as personal health records are not required to be used as "facts" by physicians so while it might be a fun project, its benefits to patients are minimized.
Second: Who benefits from centralized information? The old time Medic alert bracelets were supposed to be used in case someone was in a situation where their allergy to penicillin, peanuts, or condition such as diabetes would have to be communicated to medical services personnel when they couldn't speak for themselves. The new personal health disclosures are being marketed the same way and in the event you are killed through the administration of drugs to which you are allergic would conceivably be a basis for lawsuits. However, the extensive history being requested from patients including episodic events such as a venereal disease are only being used to determine the RISK you present to insurance companies that you might actually need medical services.
Third: What remains of the doctor-patient privilege?
Very little. That privilege is being waived by us, we are giving it away in order to get health insurance, apply for benefits, get reimbursement. There are few if any requirements to maintain patient privacy with CONCRETE consequences for breaches. This is important because federal dollars spent on the HIPPA are wasted with the pseudo privacy provisions that are really only being used by medical services personnel to deny access for non-medical family members to their loved ones information. If you doubt this, the next time you get a call from a "wellness" program, ask where they got your information from, it will be their employer insurance company.
So where does patient privacy stand? Nowhere. What's the benefit of having this knowledge? In this environment we should support physician responsibility for keeping accurate records in a high technology environment. Access to these records by all other medical service personnel (and of course insurers) is fine, we've given them access to all that anyway and this means that physicians will have to commit to what they write in your patient file. It also means that we should advocate legislation that provides for serious financial and business licensure consequences for those who misuse our information and that this liability should be prima facie, meaning if there is a breach then the person who violated privacy has the burden of proving why they should NOT be liable instead of having the patient have to prove why they SHOULD be liable. The burden of proof should not be on the consumer. Finally, it means that just like when credit report agencies get your credit score wrong because of misinformation, there must be an appeal process similar to that available to us as credit card users: If you put something in "your record" in dispute, it CANNOT be used against you until RESOLUTION by an impartial arbitrator (so that you and I are not denied insurance coverage during the course of appeal) AND that such services are supplied to consumers for FREE, no costs, even if the decision is not in their favor.
