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Electronic healthcare standards: big brother has arrived ... (Updated)

UPDATE: 07-21-10 WHAT GOOD ARE INCOMPLETE OR UNSECCURE HEALTH RECORDS?

CNSNews is reporting ...

"Dr. David Blumenthal, the Obama administration's National Coordinator for Health Information Technology, said on Tuesday that patients can choose to omit procedures such as abortions and positive HIV tests from the electronic health records (EHR) that every American is supposed to have by 2014 under the terms of the economic stimulus law that President Barack Obama signed last year."

HIV/Aids is a major condition which will affect every part of the human body and would be a significant factor in the delivery of healthcare. Is the next exclusion for politicians and prominent celebrities who have reportable STDs (Sexually Transmitted Diseases)?

Or is the government telling us that our medical records are not secure and protected?

Original blog entry ...

What Congress did not see fit to enact …

Health and Human Services has put forth new regulations that define the content, format and transmission standards for electronic healthcare records. All enabled by the Congressional democrats who gave us Obamacare but refused to create, consider and pass a companion security law that provides for a mandatory five year prison term for those who inappropriately access  and/or disclose the medical records of another person for personal, political or profit reasons. A clear unambiguous law which will cover individuals, government workers, the media and especially members of Congress who normally exempt themselves from this type of restrictive legislation.

While HIPAA (Health Insurance Portability and Accountability Act)  purports to provide a measure of privacy and security relating to medical records, it provisions are violated on a daily basis and people are rarely prosecuted under its provisions.

The imperfect “national identity card” …

The key to your medical records is currently your Social Security Number and you should consider the implications of using this as a medical record identifier. For those that suggest another biometrically-based identification system based on fingerprints, retinal scans or, heaven forbid, DNA, the civil libertarians would go crazy to prevent such an absolute identifier from being used. Especially DNA with its law-enforcement potential and the ability for corrupt police, prosecutors and others to falsely swear out an affidavit, complaint or warrant – based on nothing more than the alleged word of a so-called “confidential informant.”

Civil rights and privacy activists are greatly concerned about the creation and use of a national identity card. And even the use of interoperability standards for drivers’ licenses which can be used as single national identity card. How will they feel when the grossly imperfect Social Security number becomes the “key” to a citizen’s medical records – in essence a national identity number. And I say imperfect because the Social Security Number was designed before the use of error-correcting check-digits and before the system was compromised by illegal aliens who used stolen, forged and bogus numbers to obtain employment and healthcare.  No matter what Obama made had said while in campaign-mode (the media’s euphemism for lying to the public), illegal aliens will received healthcare and be using the very same record system now in use. Pray that they do not confuse accounts and deny or delay your care – or accidently kill you based on wrong medical information. Think it can’t happen, consider the number of wrong organs, limbs and blood transfusions that have been made under normal conditions.

A word about “encryption” …

Even though your medical records may be “encrypted,” let us consider a few factors:

One, it is more likely that an insider with the keys to the kingdom and behind the protective firewalls that will be the snoop and the person that will reveal this information to third-parties.

Two, the government and their contractors are most likely to have the keys to any encryption scheme and are already empowered to snoop on any and all data communications (CALEA – Communications Assistance for Law Enforcement) including those which contain privileged information (attorney-client, doctor-patient, priest-penitent)

Three, we have seen government employees, agents and contractors loose laptops and other electronic devices and storage media containing medical records with little or no sanctions.

And four, the data tagging structures used for the medical data are well-defined and highly-repetitive, giving aid and comfort to code breakers.

Coercion, not at gunpoint, but under severe economic threat …

Every American citizen, illegal alien or other individual that comes in contact with the medical establishment is mandated to have an electronic health record by 2014. So says Obamacare. So while citizens cannot be directly threatened by the government to create such a record, the government has no problem threatening individual doctors, medical groups, medical facilities, medical equipment suppliers and insurance companies with the loss of funds and/or reimbursement if they do not comply.

This would be implemented by simply refusing reimbursement for Medicare, Medicaid and insurance claims if the claim was not submitted with a link to the patient’s electronic health record. So much for the stick.

Now we find the carrot; potential reimbursement for the costs of approved electronic recordkeeping systems and perhaps enhanced reimbursements for those who are early adopters of the technology.

The major fallacies of electronic medical records …

Administration officials who are promoting Obamacare for purely political reasons often suggest that medical records will improve emergency healthcare and eliminate many of the common medication errors.

“U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced final rules to help improve Americans' health, increase safety and reduce health care costs through expanded use of electronic health records.”

Face it, human beings are complex organisms which continually change over time and in response to their environment. With the exception of chronic disease – and even with chronic disease, emergency room physicians always take an oral history and order the tests which they deem appropriate. There is little or no time to research a patient’s medical history and make determinations on what may or may not have happened in the past.

Additionally, the system is not immediately useable unless some of the patient’s past medical records are entered into the system. A time-consuming and costly process fraught with error; both from sloppy hand-written notes and possibly misfiled documents relating to another patient. Sort of like Obamacare itself, the taxes start immediately and the medical coverage is six years down the road.

To believe that a recordkeeping system will keep a physician from prescribing the wrong medication assumes that there is some form of artificial intelligence in these systems which are little more than electronic versions of a doctor’s notes, test results and billing information. A fatigued physician can just as easily make a mistake with a pull-down menu of acceptable drugs as one who simply writes the prescription on the pad.

Notice that the system is light on actual patient benefits, but is designed more for government’s use as a cost containment vehicle. Surprise. Surprise.

“Special records” …

Some laws make a distinction with recordkeeping relative to psychiatric care, drug addiction and usage and, of course, communicable diseases of a social nature like HIV/Aids. Will these records be similarly protected in the government’s database with the same safeguards as those afforded to politicians, say a William Jefferson Clinton?

Healthcare or social policy …

In case you haven’t noticed Obamacare demands that each patient’s record include a list of medical conditions, treatment notes, current medications … and not to be intrusive or anything, smoking status and an obesity indicator (BMI – Body Mass Indicator). What, lifestyle choices chronicled for use by the government, possibly to deny or limit future care. You bet. That is, unless you are a democrat (or member of the current ruling party) or a union member. Your record will also contain other vital information such as healthcare insurance status, possibly links to financial accounts and payment sources (ostensibly for reimbursement) as well as demographic information which will allow your data (anonymized, of course) to be used to analyze the healthcare delivery system.

Bottom line …

It’s not that I am adverse to medical technology or recordkeeping that will save lives and enhance one’s quality of life, it is that I am against a government that has shown a propensity to arm-twist, blackmail and otherwise influence individuals to get its own way. I do not believe there are sufficient safeguards in place unless my unequivocal medical record security act is enacted into law.

I am under no misapprehension that this recordkeeping experiment will lead to “healthcare exchanges” and a one-payor system with the government totally responsible for your healthcare and your political loyalty to the single party which proposed this Obamination known as Obamacare.

If physicians and medical facilities can see some utility in electronic healthcare records systems, by all means use these standards to develop uniform and communicable data. But restrict the government’s access to just the medical condition and treatment that occasions the payment and not the entire record to be stored in a government database.

President Barack Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi have assured us that this is the most transparent and accountable Administration in the history of the United States. So why should we believe them when they claim Obamacare is the answer to a better life?

Liars and traitors all.

-- steve

Capture

Reference Links …

Secretary Sebelius Announces Final Rules To Support 'Meaningful Use' of Electronic Health Records

Mayo Clinic backs Microsoft health records storage site, so what?|OneCitizenSpeaking

OBAMA STIMULUS: COMPROMISING YOUR HEALTH RECORDS FOR POLITICS AND PROFITS|OneCitizenSpeaking

Danger: The SINGLE most important key to protecting your health records! | One Citizen Speaking

Microsoft HealthVault: Can you trust Microsoft or any other commercial vendor with your health information? One Citizen Speaking


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