The Health and Human Services Department has received mixed reviews for its decision to insist that the next iteration of the Nationwide Health Information Network (NHIN) allow patients to control who sees their electronic health records on the network.
Dr. Robert Kolodner, interim national coordinator of health information technology, said March 1 that trial networks funded by his office should give “people the capability to decide how they view, store and control access to their own information. A person could say how that information flows to specific entities or completely block the flow of information.”
“If they do what they say, it’s a tremendous thing for privacy,” said Dr. Deborah Peel, founder of the Patient Privacy Rights Foundation. “It’s exactly what we’ve been talking about for a long time.”
Peel said she talked with Kolodner and learned that he wants to give patients the ability to control what happens to their health information, “down to the data field level.” “I think his intentions are fantastic,” she said.
Asked whether such a network would be technically feasible, Peel said the existing technology would support that degree of granularity in controlling the flow of EHR data.
But Mark Rothstein, director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine, said he doubts the HHS move will make a difference. “I don’t really have a lot of confidence that it would really have any effect whatsoever,” said Rothstein, a member of the official National Committee on Vital and Health Statistics.
The reason Rothstein was less than enthusiastic about the HHS move: Privacy problems are primarily policy and legal issues in his view, not technology-based. Rothstein recently testified before a Senate subcommittee, criticizing HHS for failing to tackle privacy and other policy issues associated with development of the NHIN. Kolodner's announcement doesn't address many of the policy questions, he said.
Kolodner’s office “has indicated no prior interest in this concept,” Rothstein said, suggesting that there is no way to know how committed HHS is to its plans. Others have pointed out it is one of the first HHS health IT initiatives that deviates from plans outlined by Kolodner’s predecessor, Dr. David Brailer.
At an HHS-sponsored meeting on privacy and security issues at the state level this week, consultant David Kirby of Durham, N.C., spoke in favor of the Kolodner announcement, saying he found it encouraging.
Buttressed by a Government Accountability Office report, Democrats and privacy advocates recently have criticized HHS for neglecting to deal with the privacy questions associated with health IT.
From the battlefield to the home front: Managing medical data
Government Health IT presents Col. Claude Hines Jr., program manager for the Defense Health Information Management System, in this recent InSight eSeminar. Col. Hines discusses the health information technology and tactical challenges faced by the military medical community in Iraq, Afghanistan and other areas of conflict. In doing so, he describes the current information technology solutions for transferring clinical data between battlefield care givers to health care personnel at military treatment facilities worldwide.
