Health IT privacy meeting

The first meeting of the HITE-CT privacy committee will be January 11th from 12:30 to 2pm at the LOB. This committee was created in response to legislative proposals to ensure consumers agree to protect their private health information on CT’s new electronic health information exchange. HITE-CT is the quasi-public entity federally funded to create an electronic health information exchange for CT. HITE-CT’s membership is dominated by providers and state agencies. Over the objections of consumers and advocates, in an opaque and unpublicized process, HITE-CT voted against an opt-in privacy process in which requires affirmative consumer consent to share health records. Instead, HITE-CT chose an opt-out policy in which all consumers’ information is shared by default unless they hear about and navigate the as yet undefined opt-out process. The process for opt-ing out and educating consumers about their rights has not been determined, but is severely under-resourced in the HITE-CT budget. All our surrounding states use an opt-in privacy policy in their successful exchanges and between 88 and 97% of consumers agree to share their information. Several states that used to have opt-out policies are converting to opt-in. In HITE-CT’s proposed policy, providers would be required to segregate any sensitive health information in patients’ records relating to ten conditions protected in law such as HIV and behavioral health status and treatment. Providers would also be required to accept liability for accurately and appropriately segregating all legally protected information.
Ellen Andrews

Overtreatment webinar slides and video posted

Slides and video from Rosemary Gibson’s webinar on What States Can Do About Health Care Overuse are posted. Rosemary Gibson has authored several books on the overuse of medical care, how it is harming our health, fueling health costs, and what we can do about it.
The next webinar is The Promise of Shared Decision-Making - Engaging Patients and Improving Care. with Shannon Brownlee, author of Overtreated, and Ben Moulton, from the Foundation for Informed Medical Decision-making January 10th at 1pm. To register, click here.

CER Webinars

Join us for two upcoming webinars on similar themes.

The first is next Wednesday, December 28th at 10am with Rosemary Gibson, author of The Treatment Trap. Rosemary will describe the Overuse of Medical Care and what can be Done to Prevent It. To register, go to https://www1.gotomeeting.com/register/828589337.

The second is the Promise of Shared Decision-Making – Engaging Patients and Improving Care, Jan. 10th at 1pm. Hear Shannon Brownlee, author of Overtreated, and Ben Moulton, from the Foundation for Informed Medical Decision-making, talk about how policymakers can help inform patients about all their options and avoid unnecessary treatment. To register, go to https://www1.gotomeeting.com/register/968183345

Electronic health record breaches up 32% this year over last

As more patient records move to electronic formats, the number of breaches, or losses, of that information is also up sharply rising 32% this year over last, according to the NY Times. Lost or stolen laptops and phones make up almost half the breaches. Nationally, 57% of office-based physicians use electronic health records. Breaches cost the industry $6.5 billion/year but can cost patients far more. Records lost can include name, birthdate, and social security numbers in addition to sensitive health information. Breaches of unsecured protected health information that affect 500 people or more are listed online by law. The site, called the Wall of Shame, includes seven breaches in CT over the last two years together totaling 170,339 people. Organizations that lost information included providers and insurers, and involved theft, loss and unauthorized access. Unfortunately, in only some cases are entities required to notify patients that their information was breached. This highlights the need for strong security of electronic records and, just as important, patient control over their information. Informed consent is the basis of a respectful partnership between people and the health care industry that keeps us well. A breach should not be the first time any patient learns that their information is being shared.

CT Insurance Exchange News

New on the CT Exchange Watch Blog – www.ctexchangewatch.org – Mercer finishes report to exchange board, more press and more calls for consumer voices in the exchange.

CEPAC meeting – comparing treatment resistant depression treatments

Friday’s CEPAC meeting in Providence was fascinating. We spent the day comparing the clinical and cost effectiveness of some common and some new treatments for people with treatment resistant depression (TRD). Between 13 and 14 million Americans experience clinical depression each year, but only about half seek treatment and only 20% of those get adequate treatment. Unfortunately about half of those who get treatment do not respond to medications. One study found that medical and disability claims from employees with TRD are more than double the costs for other employees with depression. Options for these patients used to be limited but technology has advanced in recent years. CEPAC is a New England regional public advisory group convened to consider the clinical and cost effectiveness of competing treatments. CEPAC includes clinicians, academics, patient advocates and (nonvoting) payer representatives. Friday’s discussion centered on Repetitive Transcranial Magnetic Stimulation, a new, slightly more expensive alternative to Electroconvulsive Therapy, which has been in use for over 70 years. There are some small studies with promising results suggesting rTMS may work better for some patients with fewer side effects. We discussed the impact on subpopulations, underserved populations, Medicaid and private payers, clinicians and, most importantly, patients and their families desperate for help. We reviewed evidence that everyone agreed was inadequate and conflicting. There are almost no studies that measured long term effectiveness. And then we voted.

Upcoming webinars on overtreatment and shared decisionmaking

Join us for two upcoming webinars on similar themes.

The first will be December 28th at 10am with Rosemary Gibson, author of The Treatment Trap. Rosemary will describe the Overuse of Medical Care and what can be Done to Prevent It. To register, go to https://www1.gotomeeting.com/register/828589337.

The second is the Promise of Shared Decision-Making – Engaging Patients and Improving Care, Jan. 10th at 1pm. Hear Shannon Brownlee, author of Overtreated, and Ben Moulton, from the Foundation for Informed Medical Decision-making, talk about how policymakers can help inform patients about all their options and avoid unnecessary treatment. To register, go to https://www1.gotomeeting.com/register/968183345