This website provides readers an historical perspective on the evolution of various healthcare laws and regulations affecting healthcare freedom and privacy.
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Newsletter

Health Freedom Watch
January 2008

Contents:


Microsoft Seeks Patent for System to Remotely Monitor Office Workers

Microsoft is seeking a U.S. patent for software that would enable employers to monitor workers’ “productivity, physical well-being and competence,” the Times of London reports.  The patent application, the Times says, reveals that:

  • The “‘unique monitoring system’ … could link workers to their computers” via wireless sensors that measure “heart rate, galvanic skin response, EMG, brain signals, respiration rate, body temperature, movement facial movements, facial expressions and blood pressure.”
  • Managers could use the system “to monitor employees’ performance” according to those criteria.
  • The software could also “automatically detect frustration or stress in the user [and] offer and provide assistance accordingly.”
  • “Physical changes to an employee would be matched to an individual psychological profile based on a worker’s weight, age and health. If the system picked up an increase in heart rate or facial expressions suggestive of stress or frustration, it would tell management that he needed help.”

The Times writes, “Technology allowing constant monitoring of workers was previously limited to pilots, firefighters and NASA astronauts. This is believed to be the first time a company has proposed developing such software for mainstream workplaces.”

Implications for Freedom and Privacy

The issue of remote monitoring of physiological indicators raises some important ethical issues, including:

  • Who would own and control the release of employees’ data collected by employers?
  • What right to privacy do individuals/employees have regarding their physiological and other personal health data?

With the development of new employee-surveillance technologies, it’s important for Americans to consider the need for strengthening privacy and civil rights in the information age.

Source:  “Microsoft Seeks Patent for Office 'Spy' Software,” TimesOnline, January 16, 2008: http://technology.timesonline.co.uk/tol/news/tech_and_web/article3193480.ece

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Collective Care: Medical Groups, National Accrediting Agency, and Large Employers Promote “Medical Home” Concept

The National Committee for Quality Assurance (NCQA), a private not-for-profit health-care accrediting agency, along with some large employers and medical groups, are promoting the “medical home [concept,] … a model of care where each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care” (emphasis added). In a January 8 news release NCQA says, “The physician-led care team is responsible for providing all the patient’s health care needs and, when needed, coordinating care across the health care system…. Many large health plans, as well as Medicare and Medicaid, are planning demonstration projects to learn more about how [medical] practices can become medical homes and the quality and cost advantages of doing so” (emphasis added).

This concept was defined by the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics, the American College of Physician (ACP), and the American Osteopathic Association (AOA).  Ten elements are associated with physician practices comprising “medical homes” (quoting the release):

  • Use of paper or electronic charting tools to organize clinical information
  • Use of data to identify important diagnoses and conditions in practice
  • Adoption and implementation of evidence-based guidelines for three chronic conditions
  • Systematic tracking of test results and identification of abnormal results
  • Referral tracking, using a paper or electronic system
  • Clinical and/or service performance measurement, by physician or across the practice
  • Performance reporting, by physician or across the practice
  • Active patient self-management support
  • Written standards for patient access and patient communication
  • Use of data to show standards for patient access and communication are met

In the Annals of Family Medicine, AAFP president Dr. Jim King explained that “physicians themselves cannot be recognized as medical homes; only a physician practice can earn the designation of ‘patient-centered medical home.’ That means a patient-centered medical home is a team effort, involving everyone in the practice” (emphasis added). The journal reported that the Council of State Governments adopted a resolution urging its members to establish and fund medical-home pilot projects.  “The resolution will be sent to governors and state legislative leaders, creating an opportunity for AAFP chapters to open a dialog with these officials about the importance of the patient-centered medical home model in reforming health care at the state level,” the journal stated.

NCQA stressed that “Large employers have also embraced the patient-centered medical home concept.”  Paul Grundy, chairman of the Patient-Centered Primary Care Collaborative and director of Healthcare, Technology and Strategic Initiatives for IBM Global Wellbeing Services and Health Benefits, told NCQA, “The question isn’t whether we should implement the medical home, but how. These standards clearly assess and identify effective medical homes.”

Founded in 1990, NCQA’s mission is to improve the quality of health care and elevate this issue to the top of the national agenda.

Sources:

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“Wired for Health Care Quality Act” Threatens Privacy and Control over Personal Information

Given the federal government’s ambitious plans for establishing a national electronic medical-records system, everyone should keep a close watch on the Wired for Health Care Quality Act.  Senate bill 1693 would foster a nationwide interoperable health information-technology (IT) system while purportedly aiming to improve the quality and lower the costs of health care. The political strategy of combining a popular idea (improvement in medical care) and an unpopular idea (the anti-privacy national database) in a single bill appears to be at work here.

Many members of Congress and staffers who don’t understand the anti-privacy features of the current federal “privacy” regulations won’t fully see through the misleading promises of S. 1693.  The first page of the Senate report states, “The bill enhances the use of health information technology to improve health care quality, while protecting the privacy and security of health information” (emphasis added).  The bill also includes a section (Sec. 3013) titled “Ensuring Privacy and Security,” which says an operator of an electronic health database would be deemed a “covered entity” under the privacy regulations.  This means such an operator would be permitted to share patient information with over 600,000 other covered entities (such as insurers) without consent, as permitted under the privacy regulations.

Thus the bill actually would destroy patient privacy by facilitating the electronic exchange under the misleading promise that privacy will be protected.  The Institute for Health Freedom has been stressing since 1999 that the privacy regulations do NOT ensure true patient privacy because they permit the release of personal health information—without patients’ consent—for purposes related to treatment, payment, and health-care management.      

What can you do to protect your health privacy and inform Congress about proposed health IT legislation and how it could destroy health privacy?  Inform your representatives and staff about the federal medical-privacy rule and its true impact on patient privacy.  Educate them by doing the following:

  • Ask if they have actually read the full text of the privacy regulations as published in the Code of Federal Regulations.
  • If they have not, ask them to do so to become fully informed about the anti-privacy features.
  • Make an appointment with your members of Congress and their staff (either in Washington, D.C., or at their local office near your home) to inform them about how the privacy regulations destroy patient privacy (by eliminating patient consent and therefore control over the flow of electronic records).
  • Share and circulate information from pro-health privacy groups that advocate health-privacy rights, including the Institute for Health Freedom (www.ForHealthFreedom.org), Citizens’ Council on Health Care (www.cchconline.org), and Patient Privacy Rights (www.patientprivacyrights.org).

Note: Senators Hillary Clinton and Barack Obama are both co-sponsors of the Wired for Health Care Quality Act (S. 1693).  Perhaps they are especially in need of education regarding the privacy regulations.

Sources:

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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2008 Institute for Health Freedom.