If efficient electronic technology threatened the privacy and security of medical records, most consumers of health care services would opt for privacy and security.
That's at the heart of a simmering dispute between at least one North Dakota clinic and a partnership between a major health insurer and teams of medical providers. The focus of the concern is whether the records-sharing initiative violates a federal law that protects patient privacy. But even the suggestion that private medical records might be accessed (or sold?) without patient approval or even knowledge should worry everyone who goes to the doctor.
The clinic, Mid Dakota of Bismarck, has opted out of the initiative. Its chief executive officer said failure to contact patients whose records would be part of the sharing initiative violates the Health Information Portability and Accountability Act, often called HIPAA. Participants in the MediQHome partnership require personal health data to be shared with an Atlanta-based health quality consultant, MDdatacor. The idea is to better manage patients, especially those with chronic diseases, to improve outcomes and reduce costs.
Sounds great. But at what cost? At what risk to patient record privacy? Are "efficiencies" and "cost savings" worth the risk to privacy? And what about violation of HIPAA? The primary objection to the initiative is that it shares records with a third party without patient approval, which critics say is a HIPAA violation.
Participants in the initiative, including Blue Cross Blue Shield of North Dakota and some 75 percent of the state's primary care clinicians, seem to think the system is useful and secure. They say it complies with federal medical records privacy requirements. They say patients must sign off before records are shared via the initiative.
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But if a major clinic's legal analysis has concluded the initiative violates HIPAA, questions remain. And since BCBSND is an advocate of the initiative, pressure for providers to participate - however subtle - can be assumed.
The point is that privacy - especially medical records privacy - should not be threatened by record-keeping and records-sharing technology simply because the technology is perceived to be more efficient and can reduce costs to insurers and health care providers.
The Bismarck clinic's caution is justified. Administrators there seem to be putting patient privacy ahead of some notion of cost-saving efficiency. It would be a surprise if other providers did not have similar concerns but have been reluctant to speak out for fear of irritating the state's biggest health insurer, which just happens to be among the most enthusiastic participants in the records-sharing initiative.
Forum editorials represent the opinion of Forum management and the newspaper's Editorial Board.
