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It's often the security issue that dogs Google, Microsoft and other purveyors of personal health records (PHR): How will so much personal medical data be kept safe? A tangential question for Google, however -- one that has dogged the search giant since its Google Health offering was first made available in May 2008 -- is whether Google's search-based advertising platform creates a conflict with storing personal health data. Speaking at the Mastermind Session at Everything Channel's Healthcare Summit in San Diego in November,Google Vice President of Research and Special Initiatives Alfred Spector told health care CIOs, solution providers and other attendees that Google intended Google Health as an extension of the Google brand, and it was and would continue to be entirely separate from Google's main advertising platform. Watchdog organizations have taken Google to task over that claim, however, with one, Consumer Watchdog, even accusing Google of trying to lobby Congress to allow it to sell medical records by loosening regulatory language in the stimulus bill. "The medical technology portion of the economic stimulus bill does not sufficiently protect patient privacy, and recent amendments have made this situation worse," wrote Jerry Flanagan of Consumer Watchdog in a Jan. 27 open letter to Congress. "Medical privacy must be strengthened before the measure's final passage, rather than allowing corporate interests to take advantage of the larger bill's urgency." Flanagan in the letter states that, "Google is said to be lobbying hard ... to weaken the ban currently in the draft measure on the sale of our private medical records." While Consumer Watchdog did not cite specific evidence of Google pushing for softer restrictions, Google responded to the group's claims on its Public Policy Blog last week. "The claim -- based on no evidence whatsoever -- is 100 percent false and unfounded," wrote Pablo Chavez, Google's Senior Policy Counsel. "Google does not sell health

Last week, President Barack Obama convened a health-care summit in Washington to identify programs that would improve quality and restrain burgeoning costs. He stated that all his policies would be based on rigorous scientific evidence of benefit. The flagship proposal presented by the president at this gathering was the national adoption of electronic medical records -- a computer-based system that would contain every patient's clinical history, laboratory results, and treatments. This, he said, would save some $80 billion a year, safeguard against medical errors, reduce malpractice lawsuits, and greatly facilitate both preventive care and ongoing therapy of the chronically ill. Following his announcement, we spoke with fellow physicians at the Harvard teaching hospitals, where electronic medical records have been in use for years. All of us were dumbfounded, wondering how such dramatic claims of cost-saving and quality improvement could be true. The basis for the president's proposal is a theoretical study published in 2005 by the RAND Corporation, funded by companies including Hewlett-Packard and Xerox that stand to financially benefit from such an electronic system. And, as the RAND policy analysts readily admit in their report, there was no compelling evidence at the time to support their theoretical claims. Moreover, in the four years since the report, considerable data have been obtained that undermine their claims. The RAND study and the Obama proposal it spawned appear to be an elegant exercise in wishful thinking. To be sure, there are real benefits from electronic medical records. Physicians and nurses can readily access all the information on their patients from a single site. Particularly helpful are alerts in the system that warn of potential dangers in the prescribing of a certain drug for a patient on other therapies that could result in toxicity. But do these benefits translate into $80 billion annually in cost-savings? The cost-savings from avoi

it is important to recognize that patient privacy was not at issue in Sorrell v. IMS Health because the data at question did not identify patients.

We all like to think our privacy is absolute. But if your job involves working across borders, you'll want to talk about privacy as a matter of degree rather than as an uncompromising right. Why? Not only do you want to be seen as someone who can get things done globally, but you also may personally want to be part of advancing social objectives that are arguably as important as privacy. Have you ever had to re-architect your global rollout of PeopleSoft or Lawson because of European Union privacy concerns? Or adjust how your company offers technical support to medical products sold in Europe? Have you ever been part of acquiring a failing European company where the privacy of employee data was a final sticking point? If you've seen projects with obvious social benefit get held up by seemingly minor data-related questions, then you might have been running up against this notion of "nothing trumps privacy." It's a popular idea. The half-billion people of Europe do view privacy as a human right. And they're not the only ones. As one of the first acts of the UN, Eleanor Roosevelt and the U.S. delegation in 1948 lobbied for the global adoption of the Universal Declaration of Human Rights(UNDHR), whose Article 12 states, "No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honour and reputation." With Europe and the UN using absolute-sounding language to describe a right to privacy, it's no wonder we have all of these delayed and downsized corporate projects. People are legitimately concerned about our sometimes reckless march into the Information Age, and they want to put some brakes on it. But does privacy trump all foes? I can think of at least six other equally important social objectives that regularly put limits on privacy: 1. Personal health. We all want to stay healthy - even when we lose the ability to communicate and give consent. Emergency-room personnel need access t

The Federal Trade Commission today approved a final consent order settling claims that CVS Caremark violated customers' privacy and the Health Information Portability and Accountability Act (HIPAA) when it failed to dispose of records properly last year. Earlier this year, CVS Caremark agreed to settle FTC charges that it failed to take reasonable and appropriate security measures to protect the sensitive financial and medical information of its customers and employees, in violation of federal law. In a separate but related agreement, the company's pharmacy chain also has agreed to pay $2.25 million to resolve Department of Health and Human Services allegations that it violated HIPAA regulations. "This is a case that will restore appropriate privacy protections to tens of millions of people across the country," said FTC chairman William Kovacic following the settlement. "It also sends a strong message to other organizations that possess consumers' protected personal information. They are required to secure consumers' private information." Under the final consent order, CVS Caremark is required to rebuild its security and confidentiality program, which will be audited every two years for the next 20 years. The HHS settlement requires the company to develop a new training program to instruct employees on how to handle patient data.

"UC San Francisco said late Tuesday it has alerted 600 patients and others that an external hacker may have obtained "temporary access to emails containing their personal information" as a result of a late September phishing scam. The breach occurred about three months ago, and was investigated in mid-October, but wasn't disclosed to the public until Dec. 15. Corinna Kaarlela, UCSF's news director, told the San Francisco Business Times late Tuesday that individuals whose data may have been compromised were notified between Oct. 21, when an in-depth investigation began, and Dec. 11, when it was completed. UCSF said Tuesday that an unnamed faculty physician in the School of Medicine was victimized in late September by the alleged scam. The physician provided a user name and password in response to an email message fabricated by a hacker, that appeared as if it came from those responsible for upgrading security on UCSF internal computer servers. UCSF's Enterprise Information Security unit subsequently identified the breach and disabled the compromised password. UCSF says it conducted an investigation and in mid-October determined that emails in the physician's account ─ including some containing demographic and clinical information and, in a few cases, Social Security numbers ─ may have been exposed."

The statement did not indicate whether the information was paper-based or downloaded electronic information, and hospital officials were not immediately available for comment. The information likely was paper-based because "it appears the patients impacted by the incident were limited to individuals born between 1988 and 1992," according to the statement.

"It has been a bad past couple of months for healthcare information security. In October and November, multiple healthcare organizations announced patient data losses that made headlines in their communities, and national news in a few of the most egregious instances in which breaches involved hundreds of thousands of records."

"Nearly every practicing doctor in the United States is being warned that their identities might have been stolen when the laptop of an employee of an insurance trade group was snagged from a car in Chicago. The laptop contained business and personal information such as Social Security numbers, addresses and certain identification numbers on the laptop of an employee from the Chicago-based Blue Cross and Blue Shield Association, a trade group for the nation's Blue Cross health insurance plans. The association confirmed that an employee "broke protocol and transferred to a personal laptop" information that was stolen in late August. No patient information was on the database, and so far, no doctor has reported a security breach. However, nearly 20 percent of the doctors listed in the database have their Social Security numbers as their medical-care provider identification, putting these health professionals at risk for identity theft, according to an article in the Chicago Tribune."

In a study that is unlikely to find favor among privacy advocates, researchers from two academic institutions warned that increased efforts to protect the privacy of health data will hamper the adoption of electronic medical records systems. The study, conducted by researchers at MIT and the University of Virginia, said EMR adoption is often slowest in states with strong regulations for safeguarding the privacy of medical records. On average, the number of hospitals deploying EMR systems was up to 30% lower in states where health care providers are forced to comply with strong privacy laws than it was in states with less stringent privacy requirements. That's because privacy rules often made it harder and more expensive for hospitals to exchange and transfer patient information, thereby reducing the value of an EMR system, the study found.

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Two companies that collect, analyze and sell prescription information are mounting a Supreme Court challenge to New Hampshire's first-in-the-nation law making doctors' prescription writing habits confidential. In an appeal filed March 27, IMS Health Inc. of Norwalk, Conn., and Verispan LLC of Yardley, Pa., tell the high court that the law violates their First Amendment right to free speech in pursuit of their business. The law, aimed at thwarting hard-sell tactics by drug companies to doctors, makes it a crime for pharmacies and others to transfer information disclosing a doctor's prescribing history if the information could be used for marketing of prescription drugs in New Hampshire. Patients' names are not included in the data. The companies say that the ruling by the 1st U.S. Circuit Court of Appeals in Boston that upheld the law's constitutionality could be broadly applied to newspaper publication of stock market information and many other services that gather large amounts of information. The money made by selling the information to drug makers, the companies say, allows them to provide the same material to researchers and humanitarian organizations at little or no cost. The law first took effect in 2006. The following year, U.S. District Judge Paul Barbadoro in Concord ruled in the companies' favor and said the law violated the First Amendment. Another federal judge subsequently ruled against a similar law in Maine, relying heavily on the New Hampshire decision. But the 1st Circuit overruled Barbadoro, calling the law a valid step to promote the delivery of cost-effective health care. "Even if the Prescription Information Law amounts to a regulation of protected speech - a proposition with which we disagree - it passes constitutional muster," the court said. "In combating this novel threat to cost-effective delivery of health care, New Hampshire has acted with as much forethought and precision as the circumstances permit and the

Healthcare organizations are losing more than just names, addresses and Social Security numbers. When their data gets stolen, patients lose the privacy of their medical conditions, treatments and medications while at the same time falling prey to identity theft, medical billing fraud and other criminal schemes. Theft of electronic medical records is on the rise, and the implications are getting more serious. In a 2008 survey of identity theft victims, the Identity Theft Resource Center found that 67% had been charged for medical services they never received and 11% were denied health or life insurance due to unexplained reasons.

"As many as 68,000 members of CalOptima, the Medicaid plan for Orange County, California, may be at risk of identity theft and fraud after several CDs containing their personal information disappeared while in transit, the agency reported. "CalOptima's claims scanning vendor sent the electronic media devices to CalOptima through the U.S. Postal service by certified mail," the agency said. "On Tuesday, October 13, 2009, CalOptima discovered the apparent loss of the devices when the external packaging materials were delivered by the U.S. Postal Service without the box containing the devices." The missing discs include patient information such as names, addresses, Social Security numbers, diagnoses, and billing codes. CalOptima said it notified state and federal agencies of the breach on October 14, and posted an alert on its Web site on October 15."

U.S. lawmakers need to make sure privacy safeguards are in place before pushing electronic health records (EHR) on the public, senators and witnesses said at a Senate Judiciary Committee hearing today. Health IT improvements are needed to improve the quality and efficiency of health care in the U.S., but patients might be wary of electronic health records without strong privacy safeguards built in, Sen. Patrick Leahy (D-Vt.) said. "If you don't have adequate safeguards to protect privacy, many Americans aren't going to seek medical treatment," Leahy said. "Health care providers who think there's a privacy risk ... are going to see that as inconsistent with their professional obligations, and they won't want to participate." An $825 billion economic stimulus package, called the American Recovery and Reinvestment Act, includes $20 billion targeted toward health IT efforts. The bill, which could come before the full House for a vote this week, establishes an Office of the National Coordinator for Health Information Technology, which will be responsible for driving health IT standards.