CALIFORNIA FOCUS
FOR RELEASE: TUESDAY, JULY 26, 2022, OR THEREAFTER
BY THOMAS D. ELIAS
“DANGERS LURK IN FULLY ELECTRONIC HEALTH RECORDS”
If
you’re in Southern California and get laboratory workups at UCLA Health
Services, any Providence Health Center or the Cedars Sinai hospital network,
the results are quickly available to every doctor linked to any of those
systems.
The
same in the San Francisco Bay area if you’re a patient getting lab work at any
hospital in the Stanford University system and the University of California’s
San Francisco network of medical centers.
But if
you visit an independent specialist or a mental health professional, reports on
your visits may not make it onto either of these or any other large
computerized health care network.
For
there now are few official links between the major regional hospital systems
around the state.
This
reality, this little bit of privacy, figures to end on Jan. 1, 2024, whether
patients like it or not. Among others, that could affect women coming to
California for abortions from states where they are now illegal. It will also
create computer data when patients visit psychologists and psychiatrists, where
office visit reports mostly are not now computerized.
That’s because, as part of an
omnibus health care bill passed a year ago, state lawmakers almost as an
afterthought ordered creation of a unified statewide electronic records system
for virtually all types of patient information.
Also
in the bill was a well-publicized expansion of Medi-Cal’s patient population to
include many undocumented immigrants. So were expanded payments by Medi-Cal to
physicians, aiming to give them parity with doctors paid by the federal
Medicare system. And much more.
But
little attention went to Section 1862 of the bill (known as AB 133), which
required just one public hearing about the rules and operating principles for
the largest-ever state compendium of private medical records.
The
high-minded idea behind this was to make all medical data and treatment plans
for any patient seeing any California provider instantly available to all
eligible practitioners. Taking medical histories on first visits would become
very simple.
But it
will also end the concept of patients keeping any secrets from doctors,
psychologists or other medical folk.
All
this information will supposedly be available only to those who need
it, including hospitals, health plans, provider groups and doctors. But less
than two years ago, thieves used the nominally confidential records of the
Employment Development Department to steal upwards of $20 billion. Just last spring,
hackers pried open supposedly confidential state lists of applicants for
concealed weapon permits.
So no
matter what anyone says, there’s no guarantee of privacy for medical patients
under this system, even if doctors respect patient confidentiality.
If a
husband sees a psychiatrist and doesn’t want his wife or friends to know,
reports on the visits will appear on the system.
If a patient seeks a second
opinion but doesn’t want the original doctor to know she’s checking up on his
diagnosis or treatment plan, the original doctor can eventually see details of
the second opinion session. Visits to abortion clinics may not remain secret
from officials of other states, either.
Under
these conditions, how many people will forego treatments they now get? No one
can predict, especially when input on the new plan all has come from
“stakeholders,” the same people and companies who will legitimately access the
new system.
The
“guiding principles” of this plan do look benign: Assure that everyone gets
state-of-the-art treatment, regardless of race or finances. Make maximum data
available prior to vital medical decisions. Give patients access to all their
medical records. Reinforce data security. And make sure every provider enters
all information on every patient visit.
But
there has been too little public input into all this, no formal venue for
individuals to express misgivings or make suggestions. A lone (poorly-advertised)
public hearing is not enough input for something so far-reaching.
Proponents
of the new system gripe that too much medical information now resides in
isolated “silos” where it usually doesn’t help save lives or trauma.
But
when only so-called “stakeholders” – and not the patients whose records will be
compiled – are consulted about a change this big, trouble inevitably awaits,
and will probably arrive sooner rather than later.
-30-
Email Thomas Elias at tdelias@aol.com. His book,
"The Burzynski Breakthrough, The Most Promising Cancer Treatment and the
Government’s Campaign to Squelch It" is now available in a soft cover
fourth edition. For more Elias columns, visit www.californiafocus.net
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