Thanks for writing this article. Sadly, my colleagues may have opened the door to the abrogation of our basic obligation to protect our patients' privacy. You should know that most of my colleagues felt that the idea was of major importance and wanted to see it addressed at our next meeting and I will, of course, do just that.
Here is what is at stake. When a patient signs a Health Insurance Portability and Accountability Act of 1996 form they are actually signing away their opportunity to protect themselves. The health plans that pay for the patients' prescription have the right through HIPPA to sell what is supposed to be de-identified data. RxHub and SureScripts, among others, sell this data. It is worth billions of course.
There are no privacy protections for our patients in any of the electronic-prescribing legislation. What is thought to be de-identified often gets "re-identified." We know, for instance, that patients can purchase life insurance without an exam. How can that happen? It happens because the insurer has the data as soon as they have the Social Security number and the patient's name.
My colleagues were correct that my additional resolution may not have been immediately germane to how e-prescribing will be financed, but it is absolutely germane to the Hippocratic oath.
I am hoping to work with legislators and the American Medical Association to make sure that there is the proper legislation to protect our patients.
I will not send an e-prescription except through private, encrypted e-mail. And I am working to bring simple and inexpensive encrypted e-mail to the physician's desktop. That could be the first step to not putting our patients' healthcare on a postcard on the Internet highway.
That said, thanks for bringing e-prescribing to the attention of your readers. It will surely be in the legislation coming out of Congress to get the Medicare sustainable growth-rate fixed.
I hope that Modern Healthcare will work with doctors to protect our patients' privacy in this new IT-driven marketplace.
Marcy Zwelling, M.D.Private Medical ServicesLos Alamitos, Calif.
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