Scared by rising insurance costs, some employers and insurance companies are predicting which employees will get sick.
Those predictions are based on answers to a survey about how they feel, or whether they're bored, upset or content. Indianapolis-based Haelan Group, a company working to improve the health and well being of people, claims its survey has a 92% accuracy rate.
The theory is many people who don't feel well aren't fighting the creeping crud but are grappling with stress or relationship issues or failing to use medication properly. The questions, as you might guess, concern privacy advocates, including Public Citizen, Ralph Nader's public interest watchdog group.
While disease management isn't new, playing the odds of who will have the Monday flu is. The goal, advocates say, is to head off adverse health events. It's unclear when the tests would be administered or what an employer would do after discovering its chief widget maker is bored and lonely.
They could certainly give Dionne Warwick and the Psychic Friends Network a run for their money, however.
Germ movers. Companies that transport infectious substances have a whole new set of guidelines to follow.
The Department of Transportation on Jan. 22 published rules for how genetically modified microorganisms, biological products, diagnostic specimens and medical waste must be transported.
The goal is to improve safety; recent accident reports show that regulations need to be strengthened.
The proposed rules will require that those microscopic bugs, among others, be subject to hazardous material transport regulations.
We probably don't even want to know how these things were packaged before.
Obstruction of justice. Buried in the 1,200 pages of Health Insurance Portability and Accountability Act privacy regulations is an odd provision banning the disclosure of medical information. The provision bars reports about a patient suspected of a crime without the suspect's authorization if police or other investigators say they need the information to determine if a law was broken, according to David Hellerstein, M.D., a healthcare regulatory services analyst with PricewaterhouseCoopers.
In other words, if someone gets hurt while committing a crime and winds up in the emergency room instead of the slammer, details of the injury can't be used as evidence unless the suspect says so. Which means that well-intentioned doctors could themselves wind up behind bars if they try to help out the cops.
Guess what . . . you're sick. If you think telling patients they potentially have a disease is instinctive to physicians, think again.
It took the New Jersey Supreme Court's Jan. 23 ruling to drive home the point that physicians have a responsibility to tell patients personally about any problems uncovered during an exam. The fact that an employer or other third party arranged for the exam doesn't excuse the physician from telling the patient about the problem.
The case began in May 1991 when a 27-year-old New Jersey man went to a physician for a pre-employment physical. During the exam, the physician noticed something suspicious on a chest X-ray, indicating possible lymphoma. But the doctor didn't tell the patient, instead telling the employer about the findings. The employer did not pass along the information to the patient either.
When the patient returned to the physician six months later complaining of weight loss and flu symptoms, the physician again failed to tell the patient about the findings. In December 1991 the patient was diagnosed with Hodgkin's disease. He died in October 1992.
During the trial, the physician argued he was responsible and told the employer about the abnormal X-ray. A jury ruled in favor of the doctor, and the appeals court upheld that verdict. But the state Supreme Court ruled that physicians have an obligation to patients.
"When a doctor who ascertains the abnormality communicates it directly to the patient, he or she has the best chance of obtaining prompt remedial care and the best hope of avoiding falling through the cracks of a multiparty system," Justice Virginia Long wrote in her opinion.