Panel: Medical records are poorly secured
A recent report from the National Research Council in Washington, DC, warns that computerized medical records are poorly secured and health care providers are doing almost nothing to correct the problem.
The council is the research arm of the National Academy of Sciences. It convened a 15-member panel of health and fraud experts in 1996 to look at electronic medical records, partly because the electronic format is on its way to becoming more common than paper records. The panel concluded that electronic records are necessary in the increasingly complex health care industry, but its members cite numerous threats to patient confidentiality.
Among the biggest threats, the panel says, is a part of the Health Insurance Portability and Accountability Act, passed in 1996, which requires universal patient identifiers. A single code linking all of a patient’s medical records could be misused to acquire access to far more information than can be obtained in a single misdeed today, the panel warns.
There is no evidence that electronic medical records already are being compromised to any significant degree, but the report notes that there also is no method for monitoring such abuses. In addition to citing the threats posed by electronic records, the panel’s report states that the health care industry is doing little to protect them. Providers have little financial incentive to protect the records, and government agencies are not demanding protection, the report concludes.
States may set different standards from EMTALA
To the editor: I read with interest the letter regarding EMTALA requirements that was published in your March issue. (See Healthcare Risk Management, March 1997, pp. 34-35.) The reader apparently took issue with recommendations relating to EMTALA compliance that appeared in your December 1996 issue. (See HRM, December 1996, pp. 155-157.) Specifically, she contended that "a recommendation that the patient always be examined before asking about insurance is overly cautious."
She may have a point, but only in regard to the federal EMTALA statute. Your readers should consider that their own state’s laws regarding emergency services may hold their hospitals to a different standard. For example, California’s Health and Safety Code (Section 1317) takes a more rigid stance with respect to making financial inquiries of patients than does EMTALA. Specifically, it requires that "Emergency services and care shall be rendered without first questioning the patient or any other person as to his or her ability to pay."
Clearly, this law precludes any inquiry about a patient’s insurance before providing an emergency medical screening examination. A California hospital that fails to abide by this stricter requirement risks running afoul of the state licensing authority, even if there was no "delay in treatment" that would violate the EMTALA statute.
As some state legislatures, such as California’s, have a fondness for embellishing federal laws and programs, I suggest that risk managers carefully review their own state’s laws regarding emergency services before adopting (or abandoning) protocols for EMTALA compliance. A word to the wise . . .
Mark Cohen, ARM Loss Control Consultant
Sutter Health, P.O. Box 160727, Sacramento, CA 95816-0727
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JCAHO home care resource
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