Health Freedom Watch
Electronic Medical Records (EMRs):
Trick or a Treat?
As the federal government moves full steam ahead to create
a national interoperable (linkable) system of electronic medical
records (EMRs), it is giving the American people a false
assurance that the new system will safeguard and even improve
their health privacy. In this effort, a new federal Commission
on Systemic Interoperability was established (as part of the
Medicare Modernization Act of 2003) to push for the creation
and implementation of linkable electronic medical records and
thus national sharing of health information.
The Commission vision statement says that it will "develop
a comprehensive strategy.for the adoption and implementation
of privacy-protected systems of electronic personal
health information" (emphasis added). In its October 25 report
titled "Ending the Document Game: Connecting and Transforming
Your Healthcare through Information Technology," the Commission
stresses that one of the benefits of a connected system of health-care
information is that "By more effectively limiting unauthorized
access and tracking who views personal healthcare information,
interoperability provides patients with more security
and confidentiality" (emphasis added).
Yet, unless the Commission amends or repeals the federal
medical privacy rule, nothing could be further from the truth.
As the Institute for Health Freedom has stressed many times
over the past three years, under existing federal law individuals'
records can be accessed by many third parties (such as insurers)
without their consent, and they are not even entitled to know
who has been viewing their records in most circumstances.
How can officials of the U.S. Department of Health and Human
Services (HHS) and their various committees and commissions
continue to claim that we will have greater health privacy with
EMRs? The reason: because the federal government
has turned the term 'health privacy' on its head. Citizens and
policymakers should consider the following important fact: 'Health
privacy' is not even defined in the federal medical privacy
Thus when HHS uses the term, it does not necessarily mean
a confidential relationship between doctor and patient. Rather,
it means a system in which the government decides who can access
people's health information.
Given HHS's misguided use of the term, a first step in the
forthcoming national debate over EMRs should be for all parties
to state unambiguously what they mean by 'health privacy' and
whether they support the freedom to maintain truly confidential
relationships with health-care providers. Only then will Americans
know the full implications of adopting a national system of
linkable electronic medical records. And only then will they
be able to decide for themselves whether the forthcoming national
EMR system is a trick or a treat.
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Strong Supporter of EMRs Considers
One of the strongest and loudest proponents of electronic
medical records (EMRs) is former House Speaker Newt Gingrich.
He recently told an online health magazine that "paper kills"
and "Paper [medical] records are an utterly irrational national
security risk." Gingrich is fond of stressing how EMRs could
save money and lives. But what about the freedom to maintain
confidential relationships with health-care providers? Is this
freedom not worth restoring and saving, too?
Gingrich announced on October 13 that unless another candidate
for president promotes his ideas, he might run for the Republican
nomination in 2008. It's likely that EMRs and health-privacy
issues will become a hot topic in the next presidential election.
Thus, here are some important questions that Americans should
consider regarding the upcoming national debate:
- Should Americans have the right to maintain private contracts
with the health-care providers of their choice, and therefore
the freedom to pay privately for care and avoid sharing health
data with government, insurers, and other third parties?
- Should individuals be free to weigh for themselves the costs
and benefits of saving money and having more efficient health
care versus protecting their privacy?
- Should the federal government serve as the largest payer
for health care in the United States-indeed, the world-thereby
making it one of the largest storehouses of health data?
Given the serious concerns that so many citizens have about
health privacy, this issue is certain to remain an important
topic. A national debate on privacy could provide a great opportunity
to expose the truth about the federal medical privacy rule:
how it actually eliminates consent and thus the control that
individuals have over the flow of their personal health information.
- United Press International, "Group Pushes Electronic Medical
Records" (October 19, 2005).
- CBS News, "Newt Gingrich Considers Run For President" (October
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Is Big Brother Planning to Tag and
Track Prescription Drugs Electronically?
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The U.S. Department of Health and Human Services (HHS) announced
on October 5 that it is funding pilot programs for establishing
electronic prescription-drug systems. HHS states "As part of
the support to establish high-quality efficient e-prescribing
systems, $6 million is being awarded by CMS [Centers for Medicare
& Medicaid Services] to fund e-prescribing pilot programs using...[standards],
as required by the Medicare Modernization Act of 2003." Additionally,
Healthcare Informatics Online points out that electronic
prescribing is a focal point of the Medicare Modernization Act
(MMA) of 2003, stressing that under Medicare Part D (which takes
effect in 2006), prescriptions can be renewed with just a mouse
Since the federal government now is the largest payer for
health care in the United States, it has the ability to coerce
physicians into implementing anti-privacy practices they might
not set up in a truly free-market system. Citizens should watch
to make sure the federal government does not use its Medicare
muscle to apply financial penalties to physicians who do not
write electronic prescriptions. All told, a national mandatory
(or coerced) electronic prescribing system would make it much
easier for Big Brother to tag and track citizens' use of prescription
What's more, the Food and Drug Administration (FDA) is promoting
the use of radiofrequency identification (RFID) technology to
"enhance the safety and security of the [prescription] drug
supply" in the United States by 2007. According to the FDA's
Center for Drug Evaluation and Research, RFID is a state-of-the-art
technology that "uses electronic tags on product packaging to
allow manufacturers and distributors more precisely to track
drug products as they move through the chain of custody, from
the point of manufacture to the point of dispensing. It is similar
to the technology used for tollbooth and fuel purchasing passes."
One has to wonder how such electronic tagging would be used
by FDA, Medicare and other government entities. Will it be used
simply for inventory purposes or to monitor citizens' use of
prescription drugs, too?
As the nation moves forward with modernizing its health-care
system, it should not overlook the most important, principled
reform of all: being free to choose one's health-care providers
and treatments, and to maintain confidential relationships.
- HHS Press Release, "HHS Accelerates Use of e-Prescribing
and Electronic Health Records" (October 5, 2005).
- Healthcare Informatics Online, "Getting Started on
- Statement by Robert J. Meyer, M.D., Director, Office of
Drug Evaluation II, Center for Drug Evaluation and Research,
FDA before the Subcommittee on Regulatory Affairs, Committee
on Government Reform, U.S. House of Representatives (September
Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2005 Institute for Health Freedom.