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LOS ANGELES-Fifteen hospital workers have been fired and another eight disciplined for looking at medical records of octuplet mother Nadya Suleman without permission, hospital officials said Monday. Kaiser Permanente reported the violations of health care privacy laws to the state and has warned employees at its Bellflower facility to keep away from Suleman's records unless they have a medical purpose, said hospital spokesman Jim Anderson. "Despite the notoriety of this case, to us this person is a patient who deserves the privacy that all our patients get," Anderson told The Associated Press. Anderson would not elaborate on how the other eight employees were reprimanded, saying only that the punishments were significant. A similar privacy breach at UCLA hospitals led to celebrities' medical information getting leaked to tabloids in recent years, including details of Farrah Fawcett's cancer treatment showing up in the National Enquirer. Anderson said Kaiser does not believe any of Suleman's information was shared with the media, based on the results of their inquiry. The 33-year-old single mother of 14 gave birth to her octuplets on Jan. 26 at Kaiser's hospital in Bellflower, about 17 miles southeast of Los Angeles. Her attorney Jeff Czech said Suleman does not plan to file a lawsuit, though he suspects Kaiser employees were looking for medical information on Suleman's sperm donor. He said the name is not listed on the Advertisement medical records. "She trusts Kaiser and they said they'd look into it," Czech said. "We feel that they're on top of it and are taking care of it." Anderson could not provide details about when Suleman's medical records were accessed and by what kind of hospital employee. He said Kaiser had warned its employees about patient confidentiality rules before Suleman checked into the hospital in December. "Even though no one knew she was there, they knew she was going to have a lot of babies," Anderson said. "The extra monitoring he

"Kathy Silver, CEO of University Medical Center, learned three weeks ago that names, birth dates and Social Security numbers for at least 21 patients were leaked from the hospital - a crime being investigated by the FBI. But the hospital still has not disclosed the breach to the patients, Silver told a committee of legislators Wednesday. She spoke as if this was not a problem. The law allows 60 days from the time UMC learns of a security breach to inform patients, she said. One victim says that is too long to wait to tell patients they may be at risk of identity theft. The hospital should have disclosed the breach immediately, said a 40-year-old UMC patient whose personal information - the kind that can be used for identity theft - was leaked. The man, who went to the public hospital Nov. 1 after a motorcycle accident, learned his privacy had been breached only when a Las Vegas Sun reporter told him Wednesday afternoon. The man was stunned and angry to learn from someone other than hospital officials that his data had been leaked. Hospital officials should have notified him "way sooner," he said. "I would've given them two or three days after they initially found out. But this is a major thing - a priority thing!""

Four HIV-positive patients whose records were left behind on an MBTA train by a Massachusetts General Hospital employee are suing the hospital, claiming their privacy has been breached. In March the hospital notified 66 patients who received care at its Infectious Disease Associates outpatient practice that billing records bearing their names, Social Security numbers, doctors, and diagnoses had been lost by a manager who was riding the Red Line. She had brought the paperwork home for the weekend, but left it on the train when she returned to work the morning of Monday, March 9, according to hospital security reports. Last week two patients who are HIV-positive filed a suit in Suffolk Superior Court against the hospital and the unidentified billing manager. The unnamed plaintiffs have been joined by two other HIV-positive people. The legal action was first reported in the weekly newspaper Bay Windows. Their lawyer, John Yasi of the Salem law firm Yasi and Yasi, said in an interview he has filed a motion to make the suit a class action that could cover all 66 patients, a significant number of whom are also HIV-positive. "The damages that jump out are the emotional distress surrounding the loss of obviously very sensitive medical information and secondarily the loss of personal security information," he said. "A Social Security number in reality may lead to identity theft, which we all know is a nightmare."

"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.

Paperwork containing the personal medical information of at least 66 patients at Massachusetts General Hospital was lost this month when an employee apparently left it on an MBTA train. The hospital sent out letters last week to patients whose identities were included in the lost paperwork, telling them the information listed their names and dates of birth, and private medical information, including their diagnoses and the name of the provider with whom they met. The material constituted billing records for patients who attended the hospital's Infectious Disease Associates outpatient practice on Fruit Street on March 4. Deborah A. Adair, the hospital's privacy officer and director of health information services, said in a statement released yesterday that while the incident was regrettable, the hospital followed privacy laws by immediately alerting affected patients and authorities, including the state attorney general's office and the Department of Consumer Affairs and Business Regulation. "[Hospital] police and security are thoroughly investigating this matter not only with an eye toward recovering the missing information but also toward making sure that this will not happen again," Adair said. "Our information privacy and security policies and procedures are among the strongest in the healthcare industry, but incidents such as this remind us that we must continue to review and revise them, as well as continue to educate our staff on best practices to avoid incidents such as this." According to hospital security reports, a manager in the infectious disease center's billing unit told supervisors that she left the paperwork on a Red Line train the morning of March 9. The manager said she had brought the paperwork home with her to work over the weekend and left the material sometime between 7:30 and 9 a.m. The Transit Police were notified, but the paperwork was not found.

The Kaiser Permanente hospital in Bellflower has been hit with a $187,500 fine for failing for a second time to prevent unauthorized access to confidential patient information, state pubic health officials said today. [Updated at 3 p.m.: A spokesman for the hospital said the fine was part of the ongoing investigation into employees improperly accessing the medical records of Nadya Suleman and her children. Disciplinary action has been taken against the employees, said Jim Anderson, a hospital spokesman. All the incidents occurred in January; a previous post said they had occurred in April and May.] State officials said Kaiser Permanente Bellflower Medical Center compromised the privacy of four patients when eight employees improperly accessed records. This is the second penalty against the hospital, officials said. The hospital was fined $250,000 in May for failing to keep employees from snooping in the medical records of Nadya Suleman, the woman who set off a media frenzy after giving birth to octuplets in January. The fine was the first penalty imposed and largest allowed under a new state law enacted last year after the widely publicized violations of privacy at UCLA Medical Center involving Farrah Fawcett, Britney Spears, California First Lady Maria Shriver and other celebrities. "We are very concerned with violations of patient confidentiality and their potential harm to the residents of California," said Dr. Mark Horton, director of the California Department of Public Health. "Medical privacy is a fundamental right and a critical component of quality medical care in California."

California regulators have fined Kaiser Permanente Bellflower (Calif.) Medical Center $250,000 for failing to keep workers from peeking at the electronic health records of Nadya Suleman, who gave birth to octuplets at the hospital in January. The fine is the first under a new state law, which took effect in January, aimed at protecting patient medical records at hospitals and carries the maximum penalty allowable. Twenty-three unauthorized staff and physicians accessed the medical records, including some at other Kaiser facilities. Seven people viewed the records more than once, according to the California Public Health Department, which licenses hospitals in the state. Kaiser fired one person who peeked at Suleman's records, 14 others resigned and eight were disciplined.

The US government has now adopted a policy of fostering the adoption of electronic medical records (EMR). The policy is intended to increase the efficiency of the US healthcare system, thereby lowering costs and reducing the incidence of preventable errors. At the same time, through its The Health Insurance Portability and Accountability Act (HIPAA) privacy rules, the government has set minimum standards for the security of those records. These two goals-privacy and security of these records, along with their free interchange among medical providers-can easily wind up at odds with each other. A recent study that looked at the role of state privacy laws in EMR adoption suggests that the problem is very real, as state privacy laws seem to inhibit the use of EMR by hospitals located there. The authors, based at MIT and the University of Virginia, line up a variety of data that validate their suggestion that privacy and the use of EMR may require a careful balance. So, for example, they cite some highly publicized lapses when it comes to the maintenance of patient privacy: someone once offered the records of 200,000 patients for sale on Craigslist, while hospitals have seen their own employees attempt to get at the electronic files of famous patients. Perhaps more significantly, the authors suggest that the public, as represented by their legislators, has concerns about the privacy of EMR. They found that states that have passed their own privacy laws to supplement the HIPAA rules tend to have a higher percentage of their populace signed up for the Do Not Call Registry, indicating a corresponding individual-level interest in maintaining privacy. So, they looked at whether these laws had any impact on the adoption of EMR by hospitals located in each state.

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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?

Electronic medical recordkeeping may not cut the overall cost of care, but by eliminating redundant procedures and reducing errors, quality may be improved. When physician Andrew Wiesenthal needs to work out a problem, he runs around Lake Merritt, across the street from his Oakland (Calif.) office at Kaiser Permanente. As one of the main drivers behind Kaiser's decades-long, multibillion-dollar effort to overhaul the way patient health records are kept, Wiesenthal has had a lot of laps to run. Doctors and other medical professionals across the country will be working through similar challenges in the coming years. President Barack Obama plans to spend $17.2 billion to induce care providers to maintain patient records electronically, scrapping the current paper-based system. The Obama Administration wants electronic health records for every American by 2014. Obama's predecessor also made a big push for electronic recordkeeping, and many doctors and hospital administrators see upgrading recordkeeping as a good way to improve care. Yet, fewer than 2% of acute care hospitals have a comprehensive electronic health record system in place, with another 8% to 12% using a basic system, according to a study published by The New England Journal of Medicine in March. Adoption isn't much better among physicians. Only 4% have a comprehensive system in place, with another 13% using basic systems, according to a study published in the journal in July. Kaiser Permanente is one of the few exceptions. Today, all of its medical clinics and two-thirds of its hospitals operate in a paperless environment and the rest are scheduled to be completely digitized by next year. Across the system, about 14,000 physicians access electronic medical records for 8.7 million patients in nine states and the District of Columbia.

President-elect Barack Obama has promised to computerize all of America's medical records within five years. He made the pledge last week in a speech at George Mason University. "This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests," he said. "But it just won't save billions of dollars and thousands of jobs, it will save lives by reducing the deadly but preventable medical errors that pervade our health care system." But the road to digitized medical records will be a tough and expensive one, CNN Money reported. Today, only about 8% of the country's 5,000 hospitals and 17% of its 800,000 physicians use electronic medical records. There is also the issue of patient privacy. Numerous hospitals have faced security issues since moving to electronic medical records. The Industry Standard reported on a security breach at a Los Angeles hospital last month. And then there is the cost. Studies done by Harvard, RAND and the Commonwealth Fund peg the cost of the digitization plan between at least $75 billion to $100 billion, according to the CNN article. However, the health care industry spends $2 trillion dollars a year, so the $100 billion may be well worth the long-term savings.

Supercharging the HVA Engineering and Maintenance Risk Assessment in the Healthcare Setting Webinar Registration Hospitals have been under close scrutiny for years to insure they evaluate and mitigate risks and exposures that could impact their ability to deliver healthcare services under all conditions. A staple of this activity is the "Hazard Vulnerability Assessment". A traditional HVA looks at specific threats within four categories (natural, technological, human and hazardous materials). While the HVA is useful for auditors looking to confirm minimum compliance, it does not properly arm the organization to assess how risk, mitigation strategies and limited capital can effectively be deployed for maximum benefit. Come hear from leaders of Deaconess Health Systems Engineering and Maintenance team on how they partnered with Virtual Corporation to execute an effective risk assessment methodology and toolkit across the DHS enterprise. Participants will see examples of innovative risk mapping and reporting methods that yield high information density in simple, understandable format. Presenters: Mark Merrill, Facility Engineer, Deaconess Health System Tom Barnett, Manager, Engineering and Maintenance, Deaconess Health System Scott Ream, President, Virtual Corporation Webinar Registration Hospitals have been under close scrutiny for years to insure they evaluate and mitigate risks and exposures that could impact their ability to deliver healthcare services under all conditions. A staple of this activity is the "Hazard Vulnerability Assessment". A traditional HVA looks at specific threats within four categories (natural, technological, human and hazardous materials). While the HVA is useful for auditors looking to confirm minimum compliance, it does not properly arm the organization to assess how risk, mitigation strategies and limited capital can effectively be deployed for maximum benefit. Come hear from leaders of Deaconess H

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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One of the more interesting panel discussions at the IDC Cloud Computing Forum on Feb 18th in San Francisco was about managing the complexities of security, privacy and compliance in the Cloud. The simple answer according to panelists Carolyn Lawson, CIO of California Public Utilities Commission, and Michael Mucha, CISO of Stanford Hospital and Clinics is "it ain't easy!" "Both of us, in government and in health, are on the front-lines," Lawson proclaimed. "Article 1 of the California Constitution guarantees an individual's right to privacy and if I violate that I've violated a public trust. That's a level of responsibility that most computer security people don't have to face. If I violate that trust I can end up in jail or hauled before the legislature," she said. "Of course, these days with the turmoil in the legislature, she joked, "the former may be preferable to the later." Stanford's Mucha said that his security infrastructure was built on a two-tiered approach using identity management and enterprise access control. Mucha said that the movement to computerize heath records nationwide was moving along in fits and starts, as shown by proposed systems likeMicrosoft (NSDQ: MSFT)'s Health Vault and Google (NSDQ: GOOG)'s Personal Health Record. "The key problem is who is going to pay for the computerized of health records. It's not as much of a problem at Stanford as it is at a lot of smaller hospitals, but it's still a huge problem." Mucha said that from his perspective security service providers in the cloud and elsewhere are dealing with a shrinking security parameter or fence, which is progressing from filing cabinets, to devices, to files, and finally to the individual, who under the latest Health Insurance Portability and Accountability Act (HIPAA) privacy rules has certain rights, including rights to access and amend their health information and to obtain a record of when and why their Protected Health Information (PHI) record has bee

Just days after President Obama signed a law giving billions of dollars to develop electronic health records, a university technology professor submitted a paper showing that he was able to uncover tens of thousands of medical files containing names, addresses and Social Security numbers for patients seeking treatment for conditions ranging from AIDS to mental health problems. Using peer-to-peer applications, which computer users download to share files, most commonly music and movies, M. Eric Johnson, director of the Center for Digital Strategies at Dartmouth College in Hanover, N.H., was able to access electronic medical records on computers that had the peer-to-peer programs stored on their hard drives. The medical files contained detailed personal data on physical and mental diagnoses, which a hacker could use to not only embarrass a patient but also to commit medical fraud. One of the largest stashes of medical data Johnson discovered during two weeks of research he conducted in January was a database containing two spreadsheets from a hospital he declined to identify. The files contained records on 20,000 patients, which included names, Social Security numbers, insurance carriers and codes for diagnoses. The codes identified by name four patients infected with AIDS, the mental illnesses that 201 others were diagnosed as having and cancer findings for 326 patients. Data also included links to four major hospitals and 355 insurance carriers that provided health coverage to 4,029 employers and 266 doctors.

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.

A third (34 per cent) of discarded hard disk drives still contain confidential data, according to a new study which unearthed copies of hospital records and sensitive military information on eBayed kit. The study, sponsored by BT and Sims Lifecycle Services and run by the computer science labs at University of Glamorgan in Wales, Edith Cowan University in Australia and Longwood University in the US, also found network data and security logs from the German Embassy in Paris on one purchased drive. Researchers bought 300 drives from eBay, other auction sites, second-hand stalls and car boot sales. A disk bought on eBay contained details of test launch routines for the THAAD (Terminal High Altitude Area Defence) ground to air missile defence system. The same disk also held information belonging to the system's manufacturer, Lockheed Martin, including blueprints of facilities and personal data on workers, including social security numbers. Lockheed Martin denies that the disk came from it. The arm manufacturer has launched an investigation that aims to uncover just how the sensitive data might have been wound up on the disk. Two discs bought in the UK apparently came from Lanarkshire NHS Trust, including patient medical records, images of X-rays and staff letters. Lanarkshire NHS Trust runs the Monklands and Hairmyres hospitals. In Australia, the exercise turned up a disk from a nursing home that contained pictures of actual patients and their wound photos, along with patient details. A hard disk from a US bank contained account numbers and details of plans for a $50bn currency exchange through Spain. Details of business transactions between the bank and organisations in Venezuela, Tunisia and Nigeria were also included. Correspondence between a member of the Federal Reserve Board and the unnamed banks revealed that one of the deals was already under scrutiny by the European Central Bank, and that federal investigators were also taking an interest. Yet anothe

Two Bronx men were accused Wednesday of masterminding a brazen bank fraud scheme in which they ripped off churches, hospitals and charities by recruiting 950 "soldiers" to cash bogus checks.

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.

"Can personal medical data that has been stripped of its identifiers to protect privacy later be used to identify a specific person? That is the question that the Health and Human Services Department is hoping a research contractor can answer. HHS intends to hire a contractor to demonstrate either the "ability or inability" to re-identify data from a data set that has been de-identified under the Health Information Portability and Accountability Act (HIPAA) Privacy Rule, according to a Jan. 4 notice on the Federal Business Opportunities Web site. De-identification and re-identification of patient data have become hot issues in the discussion about how to protect patient privacy while advancing adoption of electronic health records. The Obama administration is distributing at least $17 billion in incentive payments to doctors and hospitals who buy and use digital systems for medical data."