Obama Weighs into Electronic Health Records (EHRs)

Privacy Issue Complicates Push to Link Medical Data

New York Times

By ROBERT PEAR

Published: January 17, 2009

WASHINGTON — President-elect Barack Obama’s plan to link up doctors and hospitals with new information technology, as part of an ambitious job-creation program, is imperiled by a bitter, seemingly intractable dispute over how to protect the privacy of electronic medical records.

Representative Edward J. Markey said strong privacy protections were needed to prevent “a nightmare for consumers.”

Rahm Emanuel, the White House chief of staff-designate, said it was “essential” to protect personal health information.

Lawmakers, caught in a crossfire of lobbying by the health care industry and consumer groups, have been unable to agree on privacy safeguards that would allow patients to control the use of their medical records.

Congressional leaders plan to provide $20 billion for such technology in an economic stimulus bill whose cost could top $825 billion.

In a speech outlining his economic recovery plan, Mr. Obama said, “We will make the immediate investments necessary to ensure that within five years all of America’s medical records are computerized.” Digital medical records could prevent medical errors, save lives and create hundreds of thousands of jobs, Mr. Obama has said.

So far, the only jobs created have been for a small army of lobbyists trying to secure money for health information technology. They say doctors, hospitals, drugstores and insurance companies would be much more efficient if they could exchange data instantaneously through electronic health information networks. Consumer groups and some members of Congress insist that the new spending must be accompanied by stronger privacy protections in an era when digital data can be sent around the world or posted on the Web with the click of a mouse..

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“Health information technology will succeed only if privacy is protected,” said Frank C. Torres, director of consumer affairs at Microsoft. “For the president-elect to achieve his vision, he has to protect privacy.”

Senator Sheldon Whitehouse, Democrat of Rhode Island, and Peter R. Orszag, director-designate of the White House Office of Management and Budget, said electronic medical records could be more secure than paper records.

“If the files are electronic,” Mr. Whitehouse said, “computers can record every time someone has access to your medical information.” But, he said, the challenge is political as well as technical.

“Until people are more confident about the security of electronic medical records,” Mr. Whitehouse said, “it’s vitally important that we err on the side of privacy.”

The data in medical records has great potential commercial value. Several companies, for example, buy and sell huge amounts of data on the prescribing habits of doctors, and the information has proved invaluable to pharmaceutical sales representatives.

“Health I.T. without privacy is an excellent way for companies to establish a gold mine of information that can be used to increase profits, promote expensive drugs, cherry-pick patients who are cheaper to insure and market directly to consumers,” said Dr. Deborah C. Peel, coordinator of the Coalition for Patient Privacy, which includes the American Civil Liberties Union among its members.