I had a chance to speak with Dr. David Mendelson during the Radiological Society of North America show in Chicago this week. A project he mentioned provided another data point in what I've been seeing as a trend—restoring some measure of control to patients over the sharing of their healthcare information.
Working toward patient control of information
Mendelson is chief of clinical informatics at Mt. Sinai Medical Center in New York and co-chairman of Integrating the Healthcare Enterprise International. Mendelson was an RSNA presenter on health information technology to a standing-room-only crowd.
His talk included an update on a pilot project that his hospital and four other provider organizations are working on under a $4.7 million contract from the National Institutes of Health' National Institute of Biomedical Imaging and Bioengineering. The idea is for radiologists to use standards-based messages to send encrypted radiological images and reports to a data clearinghouse, where they will be routed to patients' personal health records.
Mt. Sinai went live with the system in August, Mendelson said, followed by medical centers affiliated with University of California-San Francisco, the University of Maryland and the Mayo Clinic, with a recent addition to the group, the University of Chicago, working to get launched.
"The primary emphasis is consumer control through PHRs," Mendelson said. "You can send your images to everywhere you want."
PHRs have Web-based viewers so an image can be pulled up, with the patient's permission, in the provider's office, Mendelson said. Or, if a patient wishes, he or she can e-mail the encrypted image from his or her PHR to a provider before a visit. Using a clearinghouse in the middle eliminates the need for each provider to develop interfaces with multiple PHR vendors, he said.
So far, only about 100 to 120 patients have enrolled. Most are patient with the inevitable start-up glitches and newness.
"They want it to work," Mendelson said. So far, "Nobody has said to me, 'I'm done with you.' "
Mendelson said he hopes to "open this up" to other radiologists next year.
Also this week, the Federal Trade Commission settled with Facebook over its heretofore wobbly privacy policies. To get the feds off its back, Facebook must install a comprehensive privacy program and now must obtain a member's consent before it changes its system in a way that would affect that user's privacy preferences.
In revising the HIPAA privacy rule in 2002, HHS staffers enfeebled patient consent, replacing it with "regulatory permission" for covered entities to disclose patient records for most common uses without consent.
By this year's end, HHS rule-writers are supposed to come up with a revised set of privacy rules to reconcile HIPAA with more stringent privacy provisions in the American Recovery and Reinvestment Act of 2009.
I hope they don't continue in the direction of 2002—toward further erosion of patient control—but rather go with the flow of current events toward stronger patient consent.
Follow Joseph Conn on Twitter: @MHJConn.
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