Letters to the Editor Address EHR Funding in Stimulus Package
A New York Times editorial earlier this month stated that the goal of improving quality and lowering the cost of care with the $20 billion included in the Senate stimulus package for electronic health records is a "sound" idea, "but it also raises important questions about how to ensure the privacy of patients" (Kaiser Daily Health Policy Report, 2/2). The Times on Monday published several letters to the editor in response to its editorial. Summaries of the letters appear below.
- John Frey: "The public debate about electronic health records usually fails to understand that electronic systems are often incompatible, meaning they can't talk with one another," Frey, a professor of family medicine at the University of Wisconsin School of Medicine and Public Health, writes in a Times letter to the editor. "Health systems construct firewalls" that "keep electronic information from helping the doctor treat the patient," Frey writes. According to Frey, "Privacy, of course, is important, but the Obama administration must also demand 'interoperability' if we are to realize quality and savings from electronic records" (Frey, New York Times, 2/9).
- Brent Gendleman: Issues of patient privacy and commercial objectives hide other issues related to EHRs that "demand consideration," Gendleman, president and CEO of the software consulting and development company 5AM Solutions, writes in a Times letter to the editor. These issues include the "outrageous" cost of the U.S. health care system, the high number of uninsured U.S. residents, the foreclosures and bankruptcy resulting from medical bills, the estimated 10,000 deaths annually because of medical errors and the large discrepancies in access to care "across economic and geographic strata," Gendleman writes. According to Gendleman, EHRs and privacy concerns are "not mutually exclusive." As a result, the U.S. cannot let concerns over privacy "morph into paralysis." Gendleman concludes that "financing for electronic records will bring us technology innovation and job creation, better-educated patients, improved health outcomes and advances toward affordable personalized medicine" (Gendleman, New York Times, 2/9).
- Mark Merritt: The problem with EHRs "is not insufficient privacy protections ... but the anemic rate at which doctors use this life saving technology," Merritt, president and CEO of the Pharmaceutical Care Management Association, writes in a Times letter to the editor. EHRs can detect and prevent many medical errors while paper records "are often illegible, incomplete, unavailable or even unknown by the multiple clinicians who treat a patient," according to Merritt. Merritt concludes, "We must ensure that no privacy proposal exposes providers who use electronic records to even more litigation and red tape" (Merritt, New York Times, 2/9).
- Richard Rockefeller: "Paper-based medical records present much greater risks" to patients' privacy than "over-the-shoulder glimpses or the occasional lost or stolen files," as the Times claimed in its editorial, Rockefeller, a writer, physician and chair of the U.S. advisory board for Doctors Without Borders, writes in a Times opinion piece. Rockefeller notes that each provider's office "has its own scandalously incomplete and idiosyncratic version of a patient's history," which often results in providers sending the complete file "[b]ecause selecting the bits needed by another doctor or an insurer is so laborious." Rockefeller continues that, with paper documentation, patients "regularly, and often unknowingly, sign away their entire record." According to Rockefeller, "In a paper-based world, the fact that records are nearly indecipherable is the best guardian of patients' privacy -- though hardly of their health" (Rockefeller, New York Times, 2/9).
