We do not live our lives alone. We live our lives in collaboration
with others. We communicate our needs and our goals, and together we
work to achieve them. This is exceptionally true for families and
individuals dealing with illness. Whether you’re dealing with
depression, or pain, or perhaps the fear and stigma of HIV, or the
impairment that comes from MS, Parkinson’s or ALS, what helps us the
most is when those around us reach out and share their support and
You would think that your ability to share would be as much your
right as speech, but is it? It’s not clear that is true in healthcare
today, nor is it clear that such a right will be protected tomorrow.
Privacy is also a right – a right to not share what you do not want
shared. It’s a fair and just expectation that the doctors and
clinicians you employ to support you in your illness will not share
your information without your permission. Today, I fear that privacy
has become much more than a right; it has become a goal. When that
happens, people begin to find ways to make it difficult to share in the
name of privacy.
More than once we have been asked by people in the medical system
whether patients are allowed to share information with each other like
they do on PatientsLikeMe.
In fact, in some countries you can read their rules in a certain way
and reasonably deduce that this type of sharing is not allowed. It is
vitally important that we do not let this become a reality in the U.S.
There are some that would take away your right to share because they do
not believe you are competent to weigh the risks and benefits of
sharing, and make a sound decision. Imagine being forced to sign a
document before you email a friend on PatientsLikeMe with a question
about a symptom? This could be a possible consequence of ill
intentioned privacy legislation.
We are working to ensure that sharing is preserved as a right. We
know that you share with us, and each other, because you trust that we
will do the right thing with that knowledge. At PatientsLikeMe, we are
working hard to ensure we earn your trust every step of the way. To do
this, we focus our energies on ways to help discover new things about
each disease here and support the research system. We do this in the
spirit of openness espoused in our Openness Philosophy. We work to be transparent
about our business model and our decisions, and try to be accessible to
you to answer your questions as you participate in our communities.
It remains our hope that you are wowed like we are about what is
possible when we work together to make our healthcare system, and our
lives, better. We have seen so much healing between all of you here on
PatientsLikeMe, and it is because we are all sharing together – not
PatientsLikeMe was recently asked to testify before the U.S. Department of Health and Human Services National Committee for Vital and Health Statistics
(NCVHS). The NCVHS Subcommittee on Privacy, Confidentiality and
Security is responsible for exploring these aforementioned issues as
they relate to healthcare, and ran a 3-day hearing to spur informative
dialogue about the future of e-healthcare. I was honored to represent
PatientsLikeMe, and the thousands of patient members of our
communities, as I testified on all of our behalf at that hearing.
As I said in the hearing, openness is what is and can help patients.
It’s what matters. We believe in the concept called “The Network
Patient” – an approach that puts patients first by giving you what you
need to know when you need to know it, and empowering you to act on
that information. As members of PatientsLikeMe, you have chosen to
embrace openness and take control of your health. You volunteer your
health information, your experiences, your life – all in an effort to
improve your care, support others, and move research forward.
Here are a few excerpts from our prepared testimony statement that
expand on privacy, openness and the future of our health system.
our experiences at PatientsLikeMe, we know patients are aware of the
issues. They understand and weigh the risks and benefits, and are
intelligently making rational choices about where they are comfortable
sharing information and how their information will be used to help. If
we infringe on this right to share or speak (in the interest of
preventing discrimination), we are preventing the flow of information
and, by our read, acting contrary to the values on which our country
Privacy is also more than
a legal concept, it is also a philosophical concept. A modern focus on
privacy as a goal, not as a right, has moved the line to the point that
medicine is slowed, treatments are delayed, and patients die for
failure to have what they need when they need it. We have substituted
real harm for mostly theoretical harm. We would even argue that the
philosophical focus on privacy is a bad thing. We believe that openness
is much more powerful concept than privacy in medicine, and one that
gives patients the power to take control of their health…
We have to begin to work
on building a society that allows the variation in human health and the
variation in human condition, one that allows people to be
philosophically created equal. We need to work on building a society
where information is not used to discriminate, but to assist and
support and improve. Restricting the flow of information will not
advance solving this problem.
This is not a simple
transformation, but we believe it is inevitable. The major privacy
issues are not only about health records, but the invisible trail of
“breadcrumbs” we leave behind us day to day in life. Health is not a
separate concept. It is an integrated concept and, in an integrated
world, we have to decide how to build a society that can handle the
reality that not all are healthy. We need to work together to get the
most productivity and life from all of us.
We believe openness can lead the way to such a society.”
The full testimony is available here and posted to the NCVHS website (along with audio archive
of the 5/20/09 hearing). A transcript will also be made available soon.
These hearings, and of course our blog, are open to the public for
comment on these issues. In the spirit of sharing, please share your
thoughts with us here.
Jamie Heywood is Chairman of PatientsLikeMe,
one of the leading Health 2.0 community sites. Jamie came into health
care trying to find a cure for ALS when his brother Stephen contracted
the disease. Now with his other brother Ben, Jamie is pushing the
boundaries of what patient communities can do. He recently testified on
patient privacy before the National Committee on Vital and Health
Statistics, and this article is what he told members of the
PatientsLikeMe community about that testimony on the PatientsLikeMe blog. We're running it on THCB because we think it's a very valuable addition to the too narrowly focused argument on privacy.