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Every day for one hour, Olympic-level athletes all over the world have an appointment they cannot break. The swimmer Dara Torres, a 12-time Olympic medalist, squeezes her hour into training, running errands and caring for her 3-year-old daughter. The curler Nicole Joraanstad schedules her hour at dawn, but says it often interrupts her sleep. The Olympic decathlon champion Bryan Clay makes himself available at night, when he is most likely to be home with family. Since Jan. 1, Olympic-level athletes have had to schedule their daily availability - hour and place - three months in advance so drug testers can find them, according to new World Anti-Doping Agency rules. And violating those rules can have serious repercussions. Three missed drug tests within an 18-month period during an athlete's appointed hour count as a positive drug test and can result in a one- to two-year ban from competition. Because the element of surprise is crucial to effective testing, athletes are also subject to random out-of-competition tests at any time. And they are tested at competitions. Jacques Rogge, the president of the International Olympic Committee said, "Sports today has a price to pay for suspicion." But some athletes say the rules have gone too far. "It's absolutely too much," Torres said in a telephone interview. "Why make this more cumbersome when we do so much already? We're at the point where we have to find a middle ground." Never before has there been so much protest regarding out-of-competition testing. Athletes in nearly every sport as well as organizations like FIFA, soccer's international governing body, have publicly criticized the doping agency's regulations. At least one lawsuit challenging the rules is in court. Sixty-five Belgian athletes, including the world-class Quick Step cycling team and its star Tom Boonen, filed a class-action lawsuit claiming that the new rules violate European privacy laws.

"Reporting from Washington - When your doctor writes you a prescription, that's just between you, your doctor and maybe your health insurance company -- right? Wrong. As things stand now, the pharmaceutical companies that make those prescription drugs are looking over the doctor's shoulder to keep track of how many prescriptions for each drug the physician is writing. By obtaining data from pharmacies and health insurers, the drug companies learn the prescribing habits of thousands of doctors. That information has become not just a powerful sales and marketing tool for the pharmaceutical industry but also a source of growing concern among some elected officials, healthcare advocates and legal authorities. "

Customers of CVS' pharmacy will be able to import their prescription records into a Google Health account as a result of an expanded deal between the two companies. The deal was announced Monday. An earlier deal already allowed workers whose company uses CVS Caremark to handle drug benefits to use Google Health to store their drug records. The new deal expands this to customers of CVS' network of retail pharmacies. "We now offer all of our consumers the ability to download their prescription and medication history into their Google Health Personal Health Record, whether they are CVS/pharmacy customers, CVS Caremark plan participants or visitors to our MinuteClinic locations," said CVS Caremark Executive Vice President Helena Foulkes in a statement. "By enabling patients to download their prescription information directly into their personal health record, we are helping to close the gap in today's fragmented health care system and provide a full view of a patient's health." To use the tool, the companies said, consumers need to sign up for the prescription management feature on CVS.com as well as be authenticated. With the latest deal, Google said it now believes more than 100 million Americans will have the option of viewing their drug history within Google Health. Microsoft, which is also trying to sign consumers up for its HealthVault service, announced a deal with New York-Presbyterian Hospital on Sunday which will allow patients of that hospital system to export their records to a HealthVault account.

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

Do you know what your data did last night? Almost none of more than 27 million people who took the RealAge quiz realized that their personal health data was sold to drug companies, who in turned used that information for targeted e-mail marketing campaigns. There's a basic consumer protection principle at work here, and it's the concept of "unfair and deceptive" trade practices. Basically, a company shouldn't be able to say one thing and do another: sell used goods as new, lie on ingredients lists, advertise prices that aren't generally available, claim features that don't exist, and so on. RealAge's privacy policy doesn't mention anything about selling data to drug companies, but buried in its 2,400 words, it does say that "we will share your personal data with third parties to fulfill the services that you have asked us to provide to you." They maintain that when you join the website, you consent to receiving pharmaceutical company spam. But since that isn't spelled out, it's not really informed consent. That's deceptive. Cloud computing is another technology where users entrust their data to service providers. Salesforce.com, Gmail, and Google Docs are examples; your data isn't on your computer -- it's out in the "cloud" somewhere -- and you access it from your web browser. Cloud computing has significant benefits for customers and huge profit potential for providers. It's one of the fastest growing IT market segments -- 69% of Americans now use some sort of cloud computing services -- but the business is rife with shady, if not outright deceptive, advertising.

Indianapolis - New developments suggest another drug store giant may face punishment for trashing your privacy. Now, Walgreens wants to settle its case - whether the state wants to or not. 13 Investigates discovered personal information in drugstore dumpsters in Indiana and across the country. WTHR exposed the problem at CVS and Walgreens pharmacies three years ago, and the Indiana attorney general's office has been investigating ever since. Walgreens says it finally has a settlement with the state - or does it? "We reached an agreement on the material terms of a settlement agreement," Walgreens attorney Stacy Cook told the Indiana Pharmacy Board Monday morning. The attorney general's office disagreed. "There was never an agreement that was reached," said Deputy Attorney General Morgan Wills. The attorneys met with the pharmacy board at Walgreen's request because the nation's second-largest drug store retailer says it had a deal the attorney general's office backed out on. "It's simply that they've changed their mind," Cook said. The attorney general's office admits it had started to negotiate terms of a settlement with Walgreens in January, but the state later decided to halt its settlement negotiations when the federal government announced a $2.25 million settlement with Walgreens' rival CVS.

The Senate and House appear headed for a clash over competing visions of how to protect the privacy of patients' electronic medical records, with the House favoring strict protections advocated by consumer groups while the Senate is poised to endorse more limited safeguards urged by business interests. President Obama has called creation of a nationwide system of electronic medical records fundamental to health-care reform, and both chambers of Congress have included about $20 billion to jump-start the initiative as part of their stimulus bills. But as with much in the stimulus package, it is not just the money but the accompanying provisions that groups are trying to influence. The effort to speed adoption of health information technology has become the focus of an intense lobbying battle fueled by health-care and drug-industry interests that have spent hundreds of millions of dollars on lobbying and tens of millions more on campaign contributions over the past two years, much of it shifting to the Democrats since they took control of Congress. At the heart of the debate is how to strike a balance between protecting patient privacy and expanding the health industry's access to vast and growing databases of information on the health status and medical care of every American. Insurers and providers say the House's proposed protections would hobble efforts to improve the quality and efficiency of health care, but privacy advocates fear that the industry would use the personal data to discriminate against patients in employment and health care as well as to market the information, often through third parties, to generate profits.

The FBI and Virginia State Police are searching for hackers who demanded that the state pay them a $10 million ransom by Thursday for the return of millions of personal pharmaceutical records they say they stole from the state's prescription drug database. The hackers claim to have accessed 8 million patient records and 35 million prescriptions collected by the Prescription Monitoring Program. "This was an intentional criminal act against the commonwealth by somebody who was trying to harm others," Gov. Timothy M. Kaine (D) said. "There are breaches that happen by accident or glitches that you try to work out. It's difficult to foil every criminal that may want to do something against you." Although the hackers had threatened to sell the data if they did not receive payment by Thursday, the deadline passed with no immediate sign that they followed through. ad_icon State officials say it is unclear whether the hackers were able to view the patient records, as they have claimed. If the theft is real, it would be the most serious cybercrime the state has faced in recent history.

Another test of who owns what data, what can be done with it and the power of State's Rights.

IMS Health (RX) has built a lucrative niche collecting data on which drugs physicians prescribe, then selling the information to pharmaceutical companies. But legislators in more than 20 states have questioned whether the company has a constitutional right to do so. The Supreme Court could shine a spotlight on this topic in the next few weeks if it decides to hear a closely watched case IMS has been fighting in New Hampshire. The court's ruling would quickly reverberate beyond the pharmaceutical industry, affecting virtually any business that uses information about consumer buying behavior to guide its sales strategies.

"Drug store chain Walgreens now enables its pharmacy patients to download their prescription history from the Walgreens.com Web site to a personal health record on the Microsoft HealthVault platform. The Deerfield, Ill.-based chain announced last June it would link to HealthVault. Patients registered on Walgreens' site already can access their complete prescription history. Now, that history can also reside in a HealthVault PHR and be automatically updated. Patients can enroll with HealthVault directly from the Walgreens site. The partnership will promote stronger collaboration among patients, pharmacists, physicians and other providers, says Don Huonker, senior vice president of health care innovation at Walgreens. More information is available at walgreens.com/pharmacy and healthvault.com. "

Think twice before giving MicroSoft your personal health care information.

"For five days as her husband lay in his hospital bed suffering from kidney cancer, Regina Holliday begged doctors and nurses for his medical records, and for five days she never received them. On the sixth day, her husband needed to be transferred to another hospital -- without his complete medical records. "When Fred arrived at the second hospital, they couldn't give him any pain medication because they didn't know what drugs he already had in his system, and they didn't want to overdose him," says Holliday, who lives in Washington. "For six hours he was in pain, panicking, while I ran back to the first hospital and got the rest of the records." Despite a federal law requiring hospitals and doctors to release medical records to patients who ask for them, patients are reporting they have a hard time accessing them leading to complications like the ones the Holliday family experienced. 'What part of "Give us our damn data" do you not understand?'"

Privacy law matters in ways not readily apparant until they hit home.

"Sherry Natoli is followed everywhere she goes while shopping online, but she doesn't mind at all. Natoli, who owns a seashell business in Tampa, does all but her grocery shopping on the Internet and even opts in whenever she's asked whether she's willing to have her online movements tracked by websites." Companies have been monitoring our online behavior for almost as long as there's been an Internet, often using our online footsteps (cookies) whenever we search, browse or buy online. Tracking technology has advanced so much that everything from how long we linger over a product description to whether we are searching for sexual-dysfunction drugs can be collected and stored on individual profiles. Our profiles are numeric descriptions, not our real names, but in some cases, it's not hard to determine personal information behind the numbers. Privacy concerns abound, and several privacy and consumer groups are urging Congress to enact laws on what can and can't be collected and for how long.

Even a booster of electronic systems like David Blumenthal, who just started his Washington post as the national coordinator of health IT, points to a myriad of challenges when it comes to digitizing the nation's medical records. Just take a look at his piece this month in the New England Journal of Medicine, in which he cites technical concerns and worries about patient privacy, among other things. In an interview with the WSJ, he said problems can crop up if the systems are installed too quickly and without enough technical support. There are plenty of potential advantages that electronic records can bring, from helping hospitals and doctors get information quickly on patients' medical histories to making catches when two drugs are being prescribed that may interact dangerously together. But there are also risks: Take a look at a study in Pediatrics that cites the case of Children's Hospital of Pittsburgh, which initially saw a rise in the death rate for certain patients after computerizing its order-entry system, perhaps because it took longer to begin their treatment. (The hospital told the WSJ the study was "flawed," adding the mortality rate had fallen since then.) The WSJ also cites the case of a patient who was initially given an incorrect diagnosis based on a mix-up involving electronic records and a test result for another patient. Health Blog Question of the Day: What's been your experience with electronic records? Do they prevent safety problems or create new risks?

Last week, the government took another step toward closing a legal loophole in federal privacy and security rules for emerging Health 2.0 information technology applications by issuing proposed rules aimed at covering an estimated 900 companies and organizations offering personal health records and electronic systems connected to them. The Federal Trade Commission was careful to point out its new interim proposed rule on federal breach notification requirements for the developers of electronic PHR systems did not apply to covered organizations or their business associates as defined by the Health Insurance Portability and Accountability Act of 1996, heretofore the key federal privacy and security regulation. The FTC, operating under new authority given it by the American Recovery and Reinvestment Act of 2009, noted that its new rule seeks to cover previously unregulated entities that are part of a Health 2.0 product mix. FTC staff estimates that about 200 PHR vendors, another 500 related entities and 200 third-party service providers will be subject to the new breach notification rule. The staffers estimate that the 900 affected companies and organizations, on average, will experience 11 breaches each per year at a total cost of about $1 million per group, per year. Costs include investigating the breach, notifying consumers and establishing toll-free numbers for explaining the breaches and providing additional information to consumers. Pam Dixon, founder and executive director of the World Privacy Forum, said that this isn't the first involvement of the FTC in healthcare-related regulation, noting the consumer protection agency joined with the Food and Drug Administration in a joint statement on the marketing of direct-to-consumer genetic tests. The FTC also has worked in the field of healthcare competition. She noted the compliance deadline with the FTC's "red flag rules" on provider organizations that provide consumer credit to patients for installment payment

The sheer volume of amateur cellphone sex videos on the Internet's porn site - while certainly culturally edifying - illustrates the new truth about sex in the 21st century: don't let anyone record it, or everyone will be enjoying it. But sometimes, the all-seeing and voyeuristic eye of consumer video culture has a happy ending: a businessman who recorded himself having sex with a university student was recently cleared of the charges after the footage was shown in court. Before the footage was presented as evidence, the judge warned both the gallery and the jury: "You are going to see a clip which from what I have been told you may find extremely distasteful." Despite this warning, though, the defense failed to exhibit a scene from Dustin Diamond's sex tape, but instead a rather traditional recording of an enthusiastic coupling. After the tape had finished playing, the judge ruled in the favor of the defendant. "You and Mr Taylor were very familiar with each other and comfortable in each other's presence." There's the possibility, of course, that the judge made the wrong decision: there could have been drugs involved. But score one for the good guys. A lot is made, rightfully, of the eradication of privacy in the digital age, but when it can help a man avoid wrongful imprisonment and the total ruin of his life, there's a bright side. The moral? If you're actively swinging, pony up for a cell phone with a good camera. And PornHub commenters say, the more megapixels, the better.

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

Woonsocket-based CVS Caremark Corp., the largest U.S. drugstore chain, has agreed to pay $2.25 million to settle federal charges that company employees compromised customer privacy by throwing prescription records and drug bottles into open trash bins. The Federal Trade Commission said its investigation with the Health and Human Services Department followed media reports that trash bins behind CVS pharmacies contained pill bottles bearing patient names, credit-card and insurance information, and Social Security numbers. The company also did not have adequate policies for disposing of that information, and did not sufficiently train employees to dispose of the information properly, the agencies said. The items that were not properly discarded included pill bottles, medication instruction sheets, computer order forms, payroll information, job applications and credit-card and insurance information. Those labels and forms contained personal information including Social Security numbers and credit card and insurance information, and in some cases, driver's license numbers and account numbers. Names of the patients' doctors were also included. The settlement "will restore appropriate privacy protections to tens of millions of people across the country," FTC chairman William Kovacic said in a statement. "It also sends a strong message" that organizations "are required to secure consumers' private information," he said.

Better to settle with the FTC than get your company's reputation as consumer-friendly (deserved or not) dragged through the court of public opinion.

Sears Holdings has agreed to settle allegations it collected personal data from customers without adequate disclosures, the Federal Trade Commission said on Thursday. The FTC had accused Sears Holdings, created in 2005 with the merger of Sears and Kmart, of paying online customers $10 to allow the company to track their online browsing. But the FTC said Sears also collected information on non-Sears sites, such as online bank statements, drug prescription records and emails. "The software would also track some computer activities that were not related to the Internet," the FTC said in a statement. Sears did disclose all it would monitor in a lengthy user license agreement, but the FTC argued it was not enough. "The complaint charges that Sears' failure to adequately disclose the scope of the tracking software's data collection was deceptive and violates the FTC Act," the FTC said in a statement. Sears did not immediately reply to two telephone calls and one email seeking a comment. Under the settlement, Sears is required to destroy the data collected and make future disclosures more prominent.

Google never fails to surprise. It's the scope and scale of their ambitions that impresses me ranging as they do from relatively simple applications that are just way cool such as Sky Map, through their Chrome Web browser (which is now looking pretty stable), to the subject of this newsletter: Google Health. Google Health, which was launched as a beta (of course) in spring 2008, is a free repository for your personal health information. Using the service you can create online health profiles for yourself, family members or others you care for (these profiles can include health conditions, medications, allergies and lab results), you can import medical records from hospitals and pharmacies, share your health records with "your care network" (which may include family members, friends and doctors), and browse an online health services directory to find services that are integrated with Google Health. After you sign up you can import your medical records from Allscripts, Anvita Health, The Beth Israel Deaconess Medical Center, Blue Cross Blue Shield of Massachusetts, The Cleveland Clinic, CVS Caremark, Healthgrades, Longs Drugs, Medco Health Solutions, Quest Diagnostics, RxAmerica and Walgreens. What you'll wind up with if you update all of the sections is a pretty complete health profile, which means that privacy has to be a concern. Interestingly, because becoming a subscriber is voluntary it appears that the service is exempt from the provisions of the Health Insurance Portability and Accountability Act of 1996.

Yet another breach of sensitive, unencrypted data is making news in the United Kingdom. This time the breach puts Royal Air Force staff at serious risk of being targeted for blackmail by foreign intelligence services or others. The breach involves audio recordings with high-ranking air force officers who were being interviewed in-depth for a security clearance. In the interviews, the officers disclosed information about extra-marital affairs, drug abuse, visits to prostitutes, medical conditions, criminal convictions and debt histories - information the military needed to determine their security risk. The recordings were stored on three unencrypted hard drives that disappeared last year. The interviews were conducted to ensure that the officers "can be trusted with sensitive government information and property," the Ministry of Defense said. But the interviews have now become a huge security risk for the officers and the Ministry of Defence, which has proven itself to be untrustworthy when it comes to guarding sensitive information and property.