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Calls for Privacy, Quality in PCAST Report

July 19, 2010
by Jennifer Prestigiacomo
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Report recommends strengthening ONC authority

The healthcare IT workgroup of the President's Council of Advisors on Science and Technology met last Friday in Washington, D.C. to present a report that made recommendations to accelerate the ongoing efforts of health information technology made by the Health Information Technology for Economic and Clinical Health (HITECH)Act. The report was prepared by industry experts who included Christine Cassel, M.D., president and CEO of the American Board of Internal Medicine, University of Texas Professor of Computer Sciences William Press, and Microsoft's Chief Research and Strategy Officer Craig Mundie.

The report was approved by the council and will be posted online after revisions are made.

The report, which was approved by a vote at the end of the presentation, addresses a range of technical considerations that challenge the U.S. healthcare IT system both in terms of improving quality and safety. The report recommends strengthening the Office of the National Coordinator for Health Information Technology (ONC) to advocate and create standards both for health information exchange and privacy.

Dr. Cassel, in his remarks, noted the promise of medical research as a long term goal. “You're able to de-identify the data and aggregate it so that you can study trends and population health and understand where improvements can occur and where there are flags for when there are problems like with drug safety, for example,” Cassel said.

University of Texas’ Press spoke about privacy considerations with electronic health records and mentioned the saliency of a 2006 Marco Foundation survey in which 80 percent of those respondents said they very concerned about theft or fraud of electronic health records. “From the very beginning of our discussions and of the working group's discuss we realized that privacy and security couldn't be add-ons to any system of healthcare exchange,” he said. “They had to be engineered in from the very start.”

Press went on to say that many people feel that today’s paper records are safer than electronic records; however, he cited the proliferation of celebrities’ medical records on the Internet as an example of the insecurity of paper files. “Electronic security has to be designed with very strong technical protection against the kind of remote attack that compromises large numbers of records. Because paper records don't have this vulnerability and electronic records,” Press said. “And we reviewed a number of technologies and our report goes into details about how this is a very doable thing.”

Microsoft’s Craig Mundie commented on the increased interest and involvement of people in their healthcare, but their lack of access to detailed information about their own healthcare records. “The report goes into detail about an architecture that would allow something that more resembles the kind of access that people have in general for the Internet but can find very securely to the access of health information,” Mundie said. “And we think that those benefits can be extended across the range of the entire health care institutions, and ultimately, at least in the subset form to the patients themselves.”

Kaiser Permanente was mentioned throughout the meeting as an exemplar system that allowed patients to view their personal health record and make appointments online.