NHS Doctors compromise Patient Privacy by Accidentally Clicking on ‘cc’ Instead of ‘bcc’ when Emailing

Posted by PITHOCRATES - June 3rd, 2012

Week in Review

One of my favorite Winter Olympics were the 1992 games in Albertville, France.  In part to that montage at the end accompanied by a couple pieces from Carl Orff’s Carmina Burana.  And Charles Kuralt.  Who gave us charming slices of life in the Tarentaise Valley.  Farmers eating a breakfast of cheese and wine after finishing their early chores…before the sun had risen.  And people waiting for freshly baked baguettes in the crisp predawn hours.  Made by bakers the way bakers had baked bread hundreds of years earlier.  Because as Charles said, sometimes the old ways are the better ways.  It turns out that’s true in more ways than one (see Doctors ‘risking email privacy breaches’ by Caroline Parkinson posted 6/1/2012 on BBC News Health).

As the email whizzes off into the ether, dread strikes. It’s gone to the wrong person.

Normally, the worst that can happen is a little embarrassment.

But a medical advice body is warning that while trying to use modern technology to contact patients, doctors are sometimes revealing confidential information…

In one case a practice sent patients an email reminder for a flu vaccination clinic, but mistakenly pasted the email addresses into the “To” rather than the “Bcc” – blind copies – box…

The MDU is issuing advice to doctors about how to send out group emails, and what to do if it goes wrong.

“These are breaches of confidence. It shows those in the email group that other individuals are part of that practice, and part of that particular group.

“And, while you may not be directly releasing clinical information, it can be possible for people to make assumptions, especially in small communities.

“For example, on a flu jab reminder list, you may be on there because you are immunosuppressed, because you have cancer or HIV – or other reasons you don’t want people to know about.”

In the old days there were family doctors.  Who we knew all our lives.  And we paid them for the services they rendered.  In the days before heath insurance became an employee benefit.   And life was good.  Charming.  Folksy.  But now health care has grown into a great bureaucracy.  Where doctors have to spend more of their time being bureaucrats than doctors.  With the advent of employer provided health insurance there were no longer free market forces to determine health care prices.  Because someone else was paying the bill.  Then came the lawyers.  And the malpractice suits.  Changing medicine into a defensive action against frivolous lawsuits.  Further increasing health care costs.  And pulling health care providers further away from practicing medicine.  Instead spending their time managing risk. 

Now Obamacare wants to change this further.  By digitizing medical records.  Turning health care into production line care.  To process more people per hour to reduce costs.  Transforming the doctor-patient relationship to a patient-random government bureaucrat relationship.  Relying on the data in our records more than personal knowledge of a patient like in those folksy old days.  Which can really speed up treatment.  As long as an overworked, underpaid bureaucrat inputs all of the data correctly.  And no hacker breaks into the system to mess with people’s data.  Or steal it.  For it will be one large repository of names, addresses, phone numbers and social security numbers.  As well as intimate medical information.  Which people could use for whole sorts of reasons.  The mind shudders to think what may happen when this information is in the hands of the wrong people.  Especially when health care providers begin emailing each other.  With attachments.  Or their patients.  Like in Britain.  Accidents happen.  Especially when the technology makes it so easy for accidents to happen. 

Doctors are at risk of being in breach of both the Data Protection Act 1998 and the Privacy and Electronic Communications regulations 2003 – and the Information Commissioner would have to be informed.

A spokesman for the Information Commissioner’s office said GP practices, like hospital trusts and local councils had a responsibility to take care of the data they hold.

He added: “Bcc and group emails are a concern. If we find a breach related to Bcc, and particularly if that’s caused damage or distress, we would take enforcement action.”

As if doctors didn’t have enough to worry about in their busy day.  Being both bureaucrat.  And part-time doctor.  Now they have to worry about breaking the law when they accidentally click ‘cc’ instead of ‘bcc’ after a long, sleep-deprived day.

And this is a glimpse into the future of Obamacare.  Where we can only hope it will be as good as the NHS.  For as national health care systems go, it’s one of the best.  But it still doesn’t beat the good old days.  When we had warm familial relationships with our family doctors.  Who knew us better than we knew ourselves.  Who didn’t need digital records or emails.  And not only were we able to pay for our own health care but we liked our health care.

It’s like Charles said.  Sometimes the old ways are the better ways.

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The Only Way to cut Health Care Costs while Expanding Coverage is to Ration Services with Death Panels

Posted by PITHOCRATES - November 6th, 2011

Week in Review

Vermont has solved their health care problem.  To reduce costs they’re going to cover more people.  And in some other world of mathematics, this may actually make sense (see Report: Vt. public health care cost could top $9B by DAVE GRAM posted 11/1/2011 on the Associated Press).

New projections by the state of Vermont say a public, universal health care system would cost between $8.2 billion and $9.5 billion a year – roughly $13,000 to $14,000 per resident – by 2020, but that sticking with the current system based on private insurers would cost even more.

Without a health care overhaul approved by lawmakers this year, including a new law that could move Vermont closer than any other state to a Canadian-style single-payer system, costs would surpass $10 billion by 2020, the report said.

$14,000 per resident is a lot of money.  Which is why a lot of young, healthy people choose not to have health insurance.  Because they don’t consume anywhere near $14,000 per year.  Well, the young and healthy will be paying now.  Because that’s the only to pay for people who consume health care services.  By making the people who don’t consume them pay for those services.

“In a way we’ve been a victim of our own success,” said health care consultant Steve Kappel, who helped write the report. “As people get covered, spending will go up.”

Imagine that.  Cover more people.  And spending will go up.

The goal of this year’s legislation actually runs counter to that – a key target of lawmakers was to reduce cost growth while extending coverage to the roughly 10 percent of Vermonters still without it.

So, you want to reduce costs.  While at the same time you want to expand coverage.  Only one way to do that.  You have to give each person less.  Way less.

The largest category of projected savings would come from “changes in the care process,” the report said. The focus here would be on redoubling efforts to make sure necessary care is delivered and unnecessary care is sharply limited. Among the strategies: better management of chronic diseases like diabetes and getting patients to have regular checkups so they don’t end up in emergency rooms.

I won’t use the expression ‘death panels’ but what you have here is a bureaucratic panel approving treatment.  And denying treatment.  Not a doctor.  So a doctor may say that a certain treatment is necessary to save a patient’s live.  And these bureaucrats may deny that treatment.

If it looks like a duck, walks like a duck and quacks like a duck, it’s a death panel.  Because if you don’t pass muster with the bureaucrats you may be denied life-saving treatment.  Which is the only way to cut costs.  While expanding coverage.  You give each person less.  Way less.  That is, you ration services.  And if someone dies as a result the system will realize real savings.

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