Security and identity
During Q&A, a doctor from a large practice in New York City strode to the microphone to warn about the litigious atmosphere that HIE may enable. Attorneys able to openly access electronic medical records will have a field day with that longitudinal patient data, he warned, accelerating the pace of malpractice suits in the U.S.
Mostashari ranged from smiling to brow-furrowing in answering this issue. "The patient owns the data!" he exhorted at one point, stepping away from the microphone to plead his case. More soberly, he characterized the legal worries as "problems we didn't imagine happening before."
Meanwhile, away from the microphones, ONC's health IT policy committee labored in January to assure that patient consent travels with that data from provider to provider. Toward that end, ONC has tested new eConsent processes, starting in western New York state, with results to be published later this year.
Fruits of this effort can't arrive soon enough. Without clear consent, some patients will freak out when they see their healthcare data following them around. What providers see as their ticket to ACO nirvana may appear to some patients as a kind of Big Brother, if they haven't been fully educated about all the consent forms they normally sign without reading.
Then there's what I consider the elephant in the room: what the technologists, including Mostashari, describe as a lack of digital key distribution that continues to prevent easy verification of patient identity as patients travel from provider to provider.
The federal government is prohibited by law from being the provider of digital keys that would establish a national patient identification system in the U.S.
This puts us at odds with practically every other industrialized nation on the planet, and hampers our efforts to implement not only ACOs but all manner of population health and public health innovations, not to mention to greatly reduce fraud and waste.