July 1, 2014: The "P" in HIPAA is Not for Privacy

At 6:30 AM on November 9, 2011, I awoke to a WTOP news flash:  "In the works is a federal monitoring system for electronic medical records."

Even back then, this wasn't good morning news.  This was before Edward Snowden and Lois Lerner and all the things we have learned about the erosion of privacy in our lives.  Doctors are trained in the ethics of patient privacy, and we know breaches have serious ramifications.  We were pretty well in control of patient privacy when officials came along and told us we needed to produce long winded legal forms covering every aspect of what happens to patient charts, personal data and financial information.  As if we didn't know.  This was in anticipation of electronic medical records (EMR), the development of which has been inevitable.

With the advent of EMR all of our medical information and the gist of our private discussions with our doctors will be out there in an open sea of data just like our e-mails.  "Oh, don't worry.  We only fish in the sea for the good of patients everywhere.  We can investigate, analyze and compare patient charts all across the country!  We will direct financial resources into those drugs and procedures that help everyone, and we will then decide for you the best treatment of your disease - - in spite of your doctor."

This mass accumulation of patient records ostensibly for the treatment of medical disease is highly overrated.  Any attempt to draw conclusions on patient care from this behemoth of data represents pseudo-science.  It will never take the place of a well designed prospective double blind study or even the researching of protected patient data in a retrospective study.

Our medical records, paper or electronic, should be as they always were:  protected in a doctor's office and easily available to us with a written requisition.  The records are for those who we choose to treat us individually.  If you can't imagine that anyone in the government would dip into your records, just ask Senator Grassley.  If you agree that our privacy is threatened by recent allegations of overreach by the IRS, you can always hope that the hard drive serendipitously crashes.