Sell Your Own Data
There's a market for your prescription data. The Washington Post reported this week that insurance companies are buying prescription data collected from companies like Milliman Intelliscript and Ingenix to help them make insurance coverage determinations. Patients with particular drug profiles and whether to pay claims for other patients. Drug profiles are determined by the insurance companies, who assign them scores or color codes. In a red, yellow and green schema, red would correspond to an AIDS patient, who needs lots of drugs. Milliman Intelliscript, part of the Milliman company, collects data from Pharmacy Benefit Managers (PBMs) that are not covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II). Then insurance companies pay a small fee to obtain the data, which they use to deny or approve claim requests.
The Washington Post interviewed "an entrepreneur who built the database system that Ingenix acquired", who explained how it works. If someone is taking a high dose of cholesterol lowering medicine, said Richard Dick, then the insurance company would "know you had an intractable cholesterol test" and could deny "an expensive blood test".
Electronic records are necessary and will deliver a lot of the benefits and efficiencies. However as described, I'm sure doctors and patients are alarmed.
Richard Dick is an electronic medical record pioneers and electronic consent advocate who contributed to this Institute of Medicine (IOM) publication on the subject in1997. He currently serves as the Chief Technical Officer at You Take Control (YTC), which sells an electronic consent management system. He has a Ph.D. in Medical Biophysics and Computing from "the University of Utah's world-class Medical Informatics M.D./PhD program (equates to a Ph.D. in CS + first 2 yrs Med School)."
ACLU Concerns
The American Civil Liberties Union (ACLU) brought attention to this issue last month, voicing concern over H.R. 6357, the PRO(TECH)T Act of 2008. The ACLU says that
"Virtually all the pending bills lack important privacy and security protections for the online databases that would store patients' electronic health records and prescriptions."
Suggesting that lobbyists for the systems don't want privacy concerns to slow down system implementations, the ACLU asks Congress to "require strong privacy and security standards" to prevent "identiy theft; accidental publication of patients' sensitive or embarrassing personal information; discriminatory review by insurance companies or potential employers so they can avoid paying for people who might be expensive to insure or employ; invasive direct marketing to patients or doctors by competing drug companies; and commercial resale or misuse of personal health information." These concerns are clearly warranted.
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Acronym Required wrote about the probable fluidity of forthcoming
genetic information in What's
Your
