I had a long conversation with Todd Cozzens Thursday about his future—and ours. Cozzens is still in Boston, but is finishing his first full week there as a venture partner—essentially the East Coast eyes and ears—for Silicon Valley-based Sequoia Capital, a premier private-equity and venture-capital firm with a long track record in technology investing.
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Previously, I blogged about the Colorado Regional Health Information Organization's blueprint on how patients' behavioral-health records might be linked to other medical records in health information exchanges.
The word "barrier" in the CORHIO report in referencing patient consent laws sounded familiar. A scan of our archives reminded my why.
In 2002, HHS rewrote the Health Insurance Portability and Accountability Act privacy rule, eliminating patient consent as a requirement for most healthcare records disclosures.
In 2005, HHS awarded a $17 million contract to RTI International and the National Governors Association with the aim, in part, to provide ammunition for then-Rep. Nancy Johnson (R-Conn.), whose health information technology bill called for federal pre-emption of state privacy laws in favor of one uniform federal law.
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Earlier this month, the Colorado Regional Health Information Organization released what its authors must hope will become a blueprint for sharing behavioral-health records via health information exchanges.
I hope not.
The 34-page report, "Supporting Integration of Behavioral Healthcare through Health Information Exchange" (PDF), is part of CORHIO's Behavioral Health Information Exchange Project.
The project erroneously supposed that patient consent laws are "barriers" to exchange. In fact, these laws are the opposite. They're vital foundations to sharing accurate patient records.
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The recent breach of patient-identifiable healthcare records in Utah is unusual, but not unique, in that it reportedly involved the work of hackers and the extent of the exposure was not immediately known.
According to the publicly available segment of the 410 major breach reports collected by HHS' Office for Civil Rights, 24 (not quite 6%) were the result of hacking, primarily of computer servers. Those 24 breaches exposed 550,083 patients' records, or just 3% of the nearly 19.2 million records involved in all 410 reported incidents involving more than 500 patient records.
So far, the Utah breach, at the latest report could involve as many as 780,000 beneficiaries of the state's Medicaid and Children's Health Insurance Program participants. That would make it the single-largest breach involving hacking since the civil rights office began collecting breach reports in September 2009 under a congressional mandate.
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It's a little-known fact, but the health information technology regional extension program was really my idea.
I'm from Indiana, where we do corn and beans right. One reason is Purdue University, which runs our cooperative extension service. Purdue has helped farmers introduce new technology, best practices and workflow improvements for more than a century. Now, it's doing the same for healthcare providers, running Indiana's health IT extension service.
I also worked as a Peace Corps ag extension agent in Africa.
But the health IT extension idea didn't come to me until about 2003 or so, not until I'd visited with Dr. Lewis Coulson, a health IT evangelist and a contributor to the Veterans Affairs Department's VistA electronic health record, at the VA's West Side (now Jesse Brown) Hospital in Chicago. Coulson was so gung-ho, I think he would have run next door to Cook County Hospital and installed VistA there himself—if only the VA would have let him. That's when it occurred to me: We ought to create a health IT extension service to empower folks like Coulson.
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