Share Your Comments on the Forthcoming
National Electronic Medical-Records Network
Submit Public Comments by January 18, 2005
January 2, 2005
Do you approve of having your personal health information (including mental-health records and genetic data) linked to a national electronic medical-records network and widely used without your knowledge or permission?
On November 15, 2004, the U.S. Department of Health and Human Services (HHS) called for public comments on its plans for a National Health Information Network (NHIN) within ten years (Federal Register, vol. 69, no. 219). This would include establishing "interoperable" (easily exchanged) electronic health records (EHRs) for all citizens.
HHS has outlined four main purposes for the national networkto:
- inform clinical practice (with data from EHRs);
- interconnect clinicians so that they can exchange health information using advanced and secure electronic communication;
- personalize care with consumer-based health records and better information for consumers; and
- improve public health through advanced bio-surveillance methods and streamlined data collection for quality measurement and research.
National Network Could Be Centrally Linked
HHS states in its public notice: "The NHIN could be developed and operated in many ways....It could be highly decentralized or somewhat centrally brokered [emphasis added]. It could be a nationwide service, a collection of regional services or a set of tools that share common components.
"It could be overseen by public organizations, by private organizations, or by public-private consortia. Regardless of how it is developed, overseen or operated, there is a compelling public interest for a NHIN to exist. Therefore, the National Coordinator for Health Information Technology is seeking comments on and ideas for how a NHIN can be deployed for widespread use" [emphasis added].
It's clear that the federal government is most interested in the views of various industries. HHS says, "There are many perspectives that can be brought to bear on this important topic. Health information technology organizations, healthcare providers, industry associations and other stakeholders all have important insights that will inform future deliberation." But HHS goes on to note that "Comments from the public at large are also invited."
The following questions may be of particular interest to Health Freedom Watch readers:
- What effect will the creation of electronic health records and the NHIN have on citizens' privacy? This is especially important to consider, given that individuals' freedom to give or withhold their consent before their health information is released to others has been eliminated.
- Will citizens be required to have a "unique health identifier" or other unique tracking device to make sure records are not duplicated in the NHIN?
- Is participation in the NHIN voluntary or mandatory for individuals?
- Is participation voluntary or mandatory for doctors and other health-care providers? (This would essentially make participation mandatory for their patients too.)
- Will citizens have a right to know who has accessed their health information compiled in or linked to the national network? (Under the federal medical privacy rule, citizens do not have a right to an accounting of when and to whom their health information was disclosed for purposes related to treatment, payment or "health-care operations.")
- Is President Bush fully informed about the federal medical privacy rule, and does he know that it actually eliminates the individual's and family's ability to decide who has access to personal data, including mental health records and genetic information?
Deadline Is January 18, 2005
Citizens must submit their comments about the proposed NHIN by 5 p.m. (eastern standard time) on January 18, 2005. They can send comments by regular mail or e-mail. Mail comments to HHS (it's always a good idea to send important documents via certified mail):
National Coordinator for Health Information Technology
Department of Health and Human Services
Attn: NHIN RFI Responses
Hubert H. Humphrey Building, Room 517D
200 Independence Avenue, SW
Washington, DC 20201
Send electronic responses to: NHINRFI@hhs.gov. The subject line must be titled "NHIN RFI Responses." For additional information, contact Lee Jones or Lori Evans, Office of the National Coordinator for Health Information Technology, toll-free at (877) 474-3918.
For additional information about plans for a National Health Information Network (NHIN) and medical privacy issues, see:
National Health Information Network (NHIN)
Federal Workgroup Meets to Discuss National Health Information Infrastructure (NHII): The federal Workgroup on the National Health Information Infrastructure (NHII) is working to develop a national health-information system and electronic personal medical records for U.S. citizens.
Background of the NHII and Workgroup: What is a "National Health Information Infrastructure" (NHII)?
President Bush Proposes Screening the U.S. Population for Mental Illness
The Final Federal Medical Privacy Rule: The Definitive Guide