The backers of a new plan to give doctors free software to induce them to write electronic prescriptions are selling the plan as a way to convince the public and doctors that using e-prescriptions is good medicine; unfortunately, they neglect to mention the harm and risks of current e-prescription systems (Initiative to offer free e-prescribing. Daily Dose, Jan. 16).
We can applaud the idea of electronic prescribing, but the plan by the National ePrescribing Patient Safety Institutewhich includes big IT vendors and major insurerscontains no new privacy guarantees. More than a decade ago, payers hired data aggregators and data handlers to construct the e-prescription system. The businesses they hired, such as pharmacy benefit managers, switching companies and others, realized that identifiable prescription data would be extremely valuable to the pharmaceutical industry, insurers and large employers. These major corporations clamored for access to e-prescription data to use for marketing, medical underwriting and to discriminate against applicants for jobs and promotions.
The e-prescription system was built without any regard for the large existing body of state and national laws and ethical standards of medical privacy that require informed consent before medical records can be used or disclosed. Most patients have no knowledge that their prescriptions are being used for secondary purposes.
Using sensitive prescription records without patient consent violates the Hippocratic oath and the American Medical Association Code of Medical Ethics. It is illegal to disclose medical records without informed consent for a specific purpose in every state of the U.S. Who would argue that prescription records are not medical records?
In 2002, I filed affidavits in the federal lawsuit Citizens for Health vs. Leavitt showing how pharmacies continually disclosed my familys prescription records without my consent, and that despite my repeated requests that they cease this activity, it continued. The plaintiffs asked the federal court in the Eastern District of Pennsylvania to restore the right of consent that HHS eliminated in the 2002 amendments to the Health Insurance Portability and Accountability Act of 1996. The judge agreed that I had lost my right to control access to my prescription records. We lost at the trial and appellate court levels, and the U.S. Supreme Court refused to hear the case.
If the highest court in the land will not defend citizens long-standing legal and ethical rights to medical privacy, then Congress must more clearly define our rights and protections in statute.
It is time to use technology wisely to improve health. It is also in the best interests of the nation to use technology to preserve and strengthen our right to privacy.
Patient Privacy Rights Foundation