Privacy and e-Prescribing

On April 14, 2008, a broad coalition of organizations sent a letter to Senator John Kerry and Representative Allyson Schwartz expressing strong support of their proposed electronic prescribing legislation - the Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007.

One suggestion bears particular note. Mindful of the broad public concern over privacy and confidentiality (and the appeals of a small group of privacy advocates that arguably excessively dominate Congressional hearings), the group argues for a systematic evaluation by GAO of prescription data use practices as a necessary part of any legislation.

Rather than focus on a particular technology, the organizations lending support seem to be pointing to a more extensive set of data sale and use practices already in place and often not included in the public debate.

This emphasis places needed attention not only on the future implications of a more comprehensive digital medication management framework but also on the current array of data use practices. Before one argues for more policy and legislation, this writer believes it would indeed be valuable for GAO to conduct this study - even if the E-MEDS bill does not advance.

Quoting from the letter to Senator Kerry and Representative Schwartz:

We believe that efforts to realize the safety and savings benefits of comprehensive health information technology (HIT) must move forward within a framework of privacy and security protections. For example, many consumers have concerns about the data mining of prescription drug information, and the success of efforts to promote widespread adoption of HIT ultimately will depend on the willingness of consumers to accept the technology.

In the absence of a national privacy and security framework for the exchange of health data, we feel strongly that obtaining more definitive information about how prescription data are currently being used is a key step to addressing privacy concerns. Thus, we strongly support including in any e-prescribing legislation a requirement that the General Accounting Office (GAO) investigate the prescription data mining industry and publish a report to Congress. The report should define clearly from whom data miners are getting data, whether it is fully de-identified, how easy it is to re-identify, what the policies/procedures are for ensuring that it is de-identified (or not re-identified), and to whom they are selling data.

[Selective use of bold font added for emphasis in this posting ]

The coalition includes:

• AARP
• AFL-CIO
• American Federation of State, County, and Municipal Employees
• Center for Medical Consumers
• Childbirth Connection
• Consumers Union
• Health Care For All
• National Consumers League
• National Family Caregivers Association
• National Partnership for Women & Families
• SEIU

Read other related letters:

• The Coalition for Patient Privacy Rights - arguing for access for those with disabilities
• The Coalition for Patient Privacy - comprehensive letter