Protecting patient medical records from unwarranted prying is a goal that has almost universal appeal.
But as two pieces of federal legislation prove, it's far more complicated than it appears at first glance.
The first lawmakers to wade into the issue were Rep. Gary Condit (D-Calif.) and Sen. Patrick Leahy (D-Vt.), who introduced bills during the 1994 healthcare reform debate.
Those bills attracted little attention, however, and the issue resurfaced last October when Sen. Robert Bennett (R-Utah) introduced his own plan that drew support from other Republican lawmakers.
But several drafts and more than half a year later, Bennett is still trying to find a compromise between provider groups, which are concerned that the rules will be so intrusive that they will stifle the move to integrated delivery systems, and consumer advocates, who say the law will be useless if it isn't airtight.
On the House side, Rep. Jim McDermott (D-Wash.), a psychiatrist, has introduced his own version of the plan that has several elements in common with the Bennett plan (See chart). One key difference is the McDermott bill would extend privacy rules to genetic information, opening a new controversial arena.
According to a Bennett aide, the newest version of the Senate privacy bill is expected to be released next month. Senate Labor and Human Resources Committee Chairwoman Nancy Kassebaum (R-Kan.) has indicated her committee will vote on the plan at the earliest possible date, probably in mid-June.
But that is only if Bennett can find a bill that overcomes the concerns of some providers. They are concerned the rules will make it difficult for integrated delivery systems to share patient information.
James Scott, president of the Premier Institute in Washington, said hospital groups want to make sure the "requirements make sense in terms of integrated delivery systems."
In a letter to lawmakers, the Healthcare Leadership Council, which represents hospital, pharmaceutical, insurance and business groups, said the Bennett plan would "interfere with the ability of network-based health plans to operate effectively by complicating the referral process between providers and by undermining appropriate information-sharing by clinicians."
But Kathleen Frawley, director of the Washington office of the American Health Information Management Association, which represents health information workers, said the bills would not make it harder to pass information within an integrated network but would "only limit it to information that is really needed."
Physician groups also have criticized the Bennett plan. Alan Nelson, M.D., executive vice president of the American Society of Internal Medicine, said provisions that allow patients to review information and pursue changes "could impose serious paperwork burdens on overextended practitioners.