March 4, 2009
Two Forms of ID and Your Colonoscopy Report, PleaseBy Carol Peracchio
For the past two years I have been employed in nursing as a medical record reviewer. I've reviewed hundreds of records, the old fashioned handwritten kind, and also the electronic medical record (EMR).
I am not ideologically opposed to EMRs. When done well, they are much more efficient and easier to read and use. However, it can take months to train an office in EMRs. And if the computers are down, everything stops. But overall, EMRs are a net plus. No, what I'm opposed to is Obama's plan to set up a Ministry of Health Information. In Obama's stimulus bill recently signed into law are provisions that will allow Washington unfettered access to every American's health history through the magic known as the EMR.
When I hear Obama and his spokesmen giving us the hard sell about EMRs I am reminded of the Sham-Wow® pitchman. EMRs will cure everything wrong with our health care! Watch as EMRs tackle that long wait to see your doctor! Now you're whisked into the exam room in ten seconds or less! High deductibles your problem? Not with EMRs! Our computerized records will cut overhead by 50%! Are you getting this, Camera Guy?
The problem with their sales pitch is it isn't convincing. After all, no one in the Obama administration has any experience with EMRs or in taking care of sick people. Like many non-medical people, Obama apparently envisions American health care like the television program Gray's Anatomy: chock full of gorgeous physicians who push the gurneys themselves and come up with exotic diagnoses based on high tech data. Every patient is teetering on the edge of calamity. Thank God the EMR has Mr. Patient's every burp recorded and at Dr. McDreamy's fingertips. Otherwise he'll never be able to make the life-saving diagnosis of Mrs. Jane Doe by commercial!
In reality, the vast majority of patients have dull ailments like bursitis and pneumonia. They see the doctor for their diabetes and the surgeon to get their gall bladder out. Most of us see the same doctor for years. If we move, Dr. New's office gets our records from Dr. Old's office. Most people would be stunned to find out how quickly an experienced physician can get "up to speed" on a new patient. We like to think we're complicated, fascinating cases. Most of the time, we're pretty boring.
"But what if the patient is unconscious or otherwise unable to communicate? Won't having everyone's health records in a central location help in that instance?" the Obama team will ask.
This situation does occur. People who take daily medications should carry a list with them. Those who have chronic illnesses or allergies should have medic-alert bracelets. There are solutions to this rare occurrence besides placing 300 million people's medical records in the hands of ACORN Health Information Management.
I recently heard an expert on television claim that gathering everyone's EMRs on one big government server will solve that sterotypical problem -- the doctor with indecipherable handwriting. I have to agree that some of these doctors must be writing with their feet. However, I employed a much simpler remedy than taking steps toward socialized medicine. I called the doctor and asked him what he wrote. True, there are practitioners out there who should not be allowed anywhere near a pen. But if my records are going to be sent to Barack Obama, I'd prefer they remain illegible!
How about the sharing of medical information between institutions? The new administration insists this is another reason they need all your private health records in Washington. Dr A at General Hospital needs a consult from Dr B at Memorial Hospital. In days of yore they would phone, fax or email. If I remember my geometry correctly, the shortest distance between two hospitals would not include a trip through Nancy Pelosi's office. Ask the mortgage industry how much "help" it is to have Washington in the middle.
In 2003, the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule took effect. Across America millions of health care workers attended numerous inservices to learn how the law "establishes regulations for the use and disclosure of Protected Health Information (PHI)." There would be no more indiscriminate sharing of a patient's status with anyone who called the hospital unit. Nurses were told that all PHI was on a "need to know" basis: if a health care worker didn't have an excellent reason to be in a patient's chart or EMR, that worker could be fired. Patients are now asked to list exactly who can be given information, including their spouse; in other words, the patient should control the dissemination of his PHI. I've heard the complaints that at times we've gone overboard with confidentiality. However, I really don't think we want to go back to the days when Mrs. Jones checked in to the hospital and the news hit the beauty parlor on Main Street before she was in her room.
So why are we now so anxious to hand Obama and the Democrats our most personal health details? Don't tell me my information is safe; I'm sure Jack Ryan felt the same way about his sealed divorce records. Once your records are cyberwinging their way to Harry Reid, et. al., it's out of your and your doctor's hands. That little STD you had? The results of an HIV test? The fact that your sister carries the breast cancer gene? Who wants to know? That's the 780 billion dollar question.
What has happened to the American liberal? Where are the protestors who felt the Declaration of Independence should be edited to include the right to privacy along with life, liberty and the pursuit of happiness? Suddenly, because a Democrat president and Congress are asking, the Left is lining up at Kinko's to copy and mail their health records to Washington, DC. Wake up! Remember, it is entirely possible that in two years the Republicans may be back in power. Have you thought out that a Republican Congress would then have access to your EMR? And if you think that you'll ever get the EMR genie back in the bottle, well, you probably also order products from late-night TV.
So since the liberals (and the mainstream media) have swallowed the EMR sales pitch hook line and sinker, I've been wondering if there's anything the rest of us can do to protect our private health information. And here is where I'd appreciate some expertise from the lawyers who frequent this site:
Do we as individuals have any right to keep private our own Protected Health Information?
If my doctor has to get my permission before leaving lab results on an answering machine, shouldn't he have to get my permission before sending my PHI to Washington DC? We need another Schechter Poultry, someone who will stand between Obama's New Deal and our medical records and cry "Halt!" Or has the right to privacy gone the way of the house call?
Carol Peracchio is a registered nurse.