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News of the Day ... In Perspective

10/07/2006

CIA, Blue Cross benefit from interoperable electronic health records

In-Q-Tel, a venture capital firm backed by the Central Intelligence Agency, is investing in a company that sells software used for managing electronic health records (EHRs), according to an Aug 14 report in Government Health IT. The tool called a “master patient index” could be used as a substitute for the unique citizen health identifier, to which Americans are adamantly opposed.

Blue Cross Blue Shield (BCBS) announced the creation of Blue Health Intelligence (BHI), comprised of claims and health information from 79 million enrollees. It plans to disclose this data to employers, drug companies, device manufacturers, and other corporations. BCBS executives say that the data provide “a treasure trove of information that employers working with health plans can use to extract greater value for their health care dollars.”

BCBS Medical Director David Plocher, M.D., said he was “very enthralled about the ability to help multi-state employers fix their healthcare costs.”

BCBS is debating internally whether or how much to charge for the data. Other corporations derive considerable revenues from selling health data. IMS Health sold prescription drug data for $1.75 billion in 2005, and the AMA sold phsycian databases for $44.5 million in 2005.

Dr. Deborah Peel of Patient Privacy Rights states that BCBS is acting in violation of state and common laws requiring patient consent before medical records are disclosed. “There is great risk that de-identifed records can be re-identified, and no laws prohibit the re-identification of health data” (Health Freedom Watch, September 2006).

Many employers, including one-third of Fortune 500 companies, demand access to medical records when hiring or making promotion or benefits decisions. Bad information can put careers and insurance, as well as life and health, at risk.

Clearing medical records of bad information is more difficult than fixing erroneous credit reports. Identity theft infects medical records, and if one’s medical information gets intertwined with someone else’s, HIPAA makes it even more difficult to investigate. Hospitals may argue that the file can’t be turned over to the patient without the consent of the other patient whose information might be included.

In one case, a patient who had had shoulder surgery got a bill for the amputation of her right foot. Patient Lind Weaver determined that someone else had fraudulently obtained care under her name and sent the bill to Weaver’s insurer (Joseph Mann, LA Times 9/25/06).

AMA President William G. Plested, III, M.D., urges physicians to use electronic medical records (EMRs). While stating that claims of cost reductions are overblown, he sees the EMR as a great boon for peer review. “I am committed to any technology that makes it easy to document daily practice patterns and outcomes in a fair and unbiased manner” (AM News 10/2/06).

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