Minnesota is typically in the vanguard when it comes to healthcare advances, says David Feinwachs, general counsel for the Minnesota Hospital Association, and the state recently took a couple of leaps forward in the area of electronic medical-records adoption. But at least one consumer advocate insists that the state also took a giant step backward in protecting patient privacy.
As politics and technology interests collide in Minnesota, it highlights the battle being fought between those who want unfettered access to patients medical information and those who seek to stop their most private information from becoming public knowledge. Now, however, some companies are learning how the same technology being used to pry into peoples personal data can also be utilized to block the view. As knowledge of these patient-consent applications become more known, there is more outcry that they be put to use.
Minnesotas $1.46 billion health and human services appropriation bill signed by Gov. Tim Pawlenty mandated that all hospitals and healthcare providers install interoperable EMR systems by Jan. 1, 2015, and the bill included $14 million to help small rural providers and clinics implement systems.
In addition, Minnesota Medical Association Chairman of the Board of Trustees Michael Ainslie says the state updated the Minnesota Health Records Act for the 21st century by clarifying EMR policies and laid the groundwork for the development of an electronic record-locater service, or RLS. An RLS is an index of patient-identifying information directing providers in a health information exchange, or HIE, to a patients health records. But, according to consumer healthcare advocate Twila Brase, the RLS did so at the expense of the states reputation of being a guardian of patient privacy.
Brase, who is a nurse and the president of the Citizens Council on Health Care, says provisions calling for patient consent for inclusion of their records in the RLS were removed and, in so doing, peoples personal medical information is being put at risk of being used by hackers, read by nosy healthcare workers and exploited by health plans.
When they can take our data and put it online without our consent, what this says is our data is not ours, she says. The whole idea is that data is gold and this is the 21st century version of the gold rush. Its about influencing medical decisions from outside the exam room and getting their hands on the data.
But Feinwachs says the RLS mentioned in the legislation is more concept than reality right now and he believesif the state moves ahead slowly but surelythere will be time to work out any problems.
A record locater service has the potential for abuse, but where we differ from Twila is that, clearly, we see electronic medical records are the wave of the future, he says. Its unrealistic to believe that electronic medical records wont become the norm in the future, and its unrealistic to believe that this form of rapid communication wont be used to make healthcare safer and more efficient.
While speeding up the process, Feinwachs says using the Web does have the side effect of making simple business transactions more complex. Nevertheless, Feinwachs says if participation in the RLS required an affirmative opt in by patients, there probably wouldnt be enough participation to make it worthwhile. He adds that other consent provisionssuch as making certain health information available to only certain providers at certain timesposes problems as well.
Its possible, but I dont think its practical, Feinwachs says, adding that consumers will have to make global decisions on the use of their information rather than having different choices for different situations.