So, this is how it has all played out: We now have the planks in place for a National Healthcare Registry, enwrapped within President Obama’s announced 23 Executive Actions yesterday. A National Health Registry system via *gun control legislation*…who’da thunk it?
Is that so far-fetched? It isn’t. In fact, I will argue, it has been the plan all along. Of course, his Obamacare plan was not to go into effect until his second term. He held his cards…waiting. He waited for the beginning of his second term as POTUS to implement part two of his socialist plan to ensnare Americans into a much larger, much more intrusive, completely freedomless scenario.
Obama knew there was no way he could never, ever, sell a National Healthcare Registry to the people at face value. He knew that there had to be a knee-jerk reaction to a highly emotionally charged scenario first. He knew that this needed to be carefully calculated into his pre-inaugural schedule. What better way to gloss what is going on.
My comments aside (which, by the way do not include any assumption to suggest that Sandy Hook was some sort of conspiracy), take a deep look at the abusive and invasive (non)wording of Obama’s 23 planks…then decide for yourself is this truly is not the implementation needed for a National Healthcare Registry System under the guise of *safety* or *the greater good*.
I kid you not, last month I went to the doctor for an annual wellness visit. This visit, by the Grace of God, was covered by my husband’s corporate insurance. Upon making the appointment, I was told that I was required to register my medical history online into Digichart. I refused. Upon showing up at my appointment, I was told the doctor would not see me unless I registered online via an in-office laptop. Digichart is a device in which to set up an EHR, or Electronic Health Record. Long and short, it is a medical information gathering system in digital format that is integrated across the medical spectrum to include a full and comprehensive record in one place…to be shared universally. An absolute invasion of privacy, regardless of HIPAA laws, and without accountability or consequence.
Unintended consequences
Per empirical research can lead to both intended and unintended consequences:
A 2008 Sentinel Event Alert from the U.S. Joint Commission, the organization that accredit American hospitals to provide healthcare services, states that “As health information technology (HIT) and ‘converging technologies’—the interrelationship between medical devices and HIT—are increasingly adopted by health care organizations, users must be mindful of the safety risks and preventable adverse events that these implementations can create or perpetuate. Technology-related adverse events can be associated with all components of a comprehensive technology system and may involve errors of either commission or omission. These unintended adverse events typically stem from human-machine interfaces or organization/system design.” The Joint Commission cites as an example the United States Pharmacopeia MEDMARX database where of 176,409 medication error records for 2006, approximately 25 percent (43,372) involved some aspect of computer technology as at least one cause of the error.
The National Health Service (NHS) in the UK reports specific examples of potential and actual EHR-caused unintended consequences in their 2009 document on the management of clinical risk relating to the deployment and use of health software.
In a Feb. 2010 U.S. Food and Drug Administration (FDA) memorandum, FDA notes EHR unintended consequences include EHR-related medical errors due to (1) errors of commission (EOC), (2) errors of omission or transmission (EOT), (3) errors in data analysis (EDA), and (4) incompatibility between multi-vendor software applications or systems (ISMA) and cites examples. In the memo FDA also notes the “absence of mandatory reporting enforcement of H-IT safety issues limits the numbers of medical device reports (MDRs) and impedes a more comprehensive understanding of the actual problems and implications.”
A 2010 Board Position Paper by the American Medical Informatics Association (AMIA) contains recommendations on EHR-related patient safety, transparency, ethics education for purchasers and users, adoption of best practices, and re-examination of regulation of electronic health applications. Beyond concrete issues such as conflicts of interest and privacy concerns, questions have been raised about the ways in which the physician-patient relationship would be affected by an electronic intermediary.
Privacy and confidentiality
In the United States in 2011 there were 380 major data breaches involving 500 or more patients’ records listed on the website kept by the United States Department of Health and Human Services (HHS) Office for Civil Rights. So far, from the first wall postings in September 2009 through the latest on December 8, 2012, there have been 18,059,831 “individuals affected,” and even that massive number is an undercount of the breach problem. The civil rights office has not released the records of tens of thousands of breaches it has received under a federal reporting mandate on breaches affecting fewer than 500 patients per incident.
Governance, privacy and legal issues
Privacy concerns
In the United States, Great Britain, and Germany, the concept of a national centralized server model of healthcare data has been poorly received. Issues of privacy and security in such a model have been of concern.
Privacy concerns in healthcare apply to both paper and electronic records. According to the Los Angeles Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient’s records during a hospitalization, and 600,000 payers, providers and other entities that handle providers’ billing data have some access also. Recent revelations of “secure” data breaches at centralized data repositories, in banking and other financial institutions, in the retail industry, and from government databases, have caused concern about storing electronic medical records in a central location. Records that are exchanged over the Internet are subject to the same security concerns as any other type of data transaction over the Internet.
The Health Insurance Portability and Accountability Act (HIPAA) was passed in the US in 1996 to establish rules for access, authentications, storage and auditing, and transmittal of electronic medical records. This standard made restrictions for electronic records more stringent than those for paper records. However, there are concerns as to the adequacy of these standards.
Threats to health care information can be categorized under three headings:
-Human threats, such as employees or hackers
-Natural and environmental threats, such as earthquakes, hurricanes and fires.
-Technology failures, such as a system crashing
Wait! What? What about governmental intrusion? Most States already do background checks…so what in the world would be so far-reaching as to open familial documents to search for hereditary traits? This is so encouraging…let’s continue:
Within the private sector, many companies are moving forward in the development, establishment and implementation of medical record banks and health information exchange. By law, companies are required to follow all HIPAA standards and adopt the same information-handling practices that have been in effect for the federal government for years. This includes two ideas, standardized formatting of data electronically exchanged and federalization of security and privacy practices among the private sector.
Did you catch that? right at the end there. . .FEDERALIZATION. Yep, sure took a long time to get there. Of course, the whole point is to bury that part by exhaustively dry mumbo-jumbo.
Private companies have promised to have “stringent privacy policies and procedures.” If protection and security are not part of the systems developed, people will not trust the technology nor will they participate in it. So, the private sector know the importance of privacy and the security of the systems and continue to advance well ahead of the federal government with electronic health records.
Pinky-swear? Really? Our privacy is contingent upon the spit-handshake between a private corporation and the federal government…who could, incidentally that could be bought out at any time…including by the government.
Now, if you are still unsure yourself on this, with the above information in mind, read through Obama’s 23 Executive “Actions”, and decide for yourself:
The following is a list, provided by the White House, of executive actions President Obama plans to take to address gun violence.
1. Issue a Presidential Memorandum to require federal agencies to make relevant data available to the federal background check system.
2. Address unnecessary legal barriers, particularly relating to the Health Insurance Portability and Accountability Act, that may prevent states from making information available to the background check system.
3. Improve incentives for states to share information with the background check system.
4. Direct the Attorney General to review categories of individuals prohibited from having a gun to make sure dangerous people are not slipping through the cracks.
5. Propose rulemaking to give law enforcement the ability to run a full background check on an individual before returning a seized gun.
6. Publish a letter from ATF to federally licensed gun dealers providing guidance on how to run background checks for private sellers.
7. Launch a national safe and responsible gun ownership campaign.
8. Review safety standards for gun locks and gun safes (Consumer Product Safety Commission).
9. Issue a Presidential Memorandum to require federal law enforcement to trace guns recovered in criminal investigations.
10. Release a DOJ report analyzing information on lost and stolen guns and make it widely available to law enforcement.
11. Nominate an ATF director.
12. Provide law enforcement, first responders, and school officials with proper training for active shooter situations.
13. Maximize enforcement efforts to prevent gun violence and prosecute gun crime.
14. Issue a Presidential Memorandum directing the Centers for Disease Control to research the causes and prevention of gun violence.
15. Direct the Attorney General to issue a report on the availability and most effective use of new gun safety technologies and challenge the private sector to develop innovative technologies.
16. Clarify that the Affordable Care Act does not prohibit doctors asking their patients about guns in their homes.
17. Release a letter to health care providers clarifying that no federal law prohibits them from reporting threats of violence to law enforcement authorities.
18. Provide incentives for schools to hire school resource officers.
19. Develop model emergency response plans for schools, houses of worship and institutions of higher education.
20. Release a letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover.
21. Finalize regulations clarifying essential health benefits and parity requirements within ACA exchanges.
22. Commit to finalizing mental health parity regulations.
23. Launch a national dialogue led by Secretaries Sebelius and Duncan on mental health.
It’s okay. It’s a lot to chew on…take your time…
For the record, I refused to submit my private information in digital form. I informed the secretary that I was concerned that there was no guarantee that the company collecting the information would not be sold out, therefore, selling my personal, private health information. SHe looked at me as though I had three heads, then responded with “The Doctor will see you now”.
