By ROBERT ROWLEY, MD

The question of data security
in a “brave new world” of cloud-based Electronic Health Records (EHRs),
Personal Health Records, and iPhone and other smartphone apps that
could transmit personal health information, has attracted the attention
of many. Web-based services – so-called “cloud computing” – are not inherently secure.
Such technology is focused more on widespread reach and
interconnectedness rather than on making sure that the connections and
the data are foolproof. Yet much of our personal information, such as
banking information, is housed electronically and accessed through the
web – we have become so accustomed to it that we seldom think very much
about it. Personal health information, moreover, is protected by law:
HIPAA, which is focused around physician and hospital-centered
recordkeeping, and now ARRA, which extends HIPAA-like protection to
patient-centered Personal Health Records as well.In a previous blog post,
we reviewed (at a high level) the ways in which special attention to
security and privacy can create what is needed to house personal health
information in a hosted, “cloud”-based setting. In this series of
posts, we will dig a little deeper into these questions. This first
part addresses the issues of data safety, and protection against loss
and “down-time.” The second part will address the question of security
between connections (making sure “the pipes don’t leak”). The third
part will focus on privacy and ensuring that only the right people can
access the right data.

Continue reading "Medical Data in the Internet "Cloud" (part 1) – Data Safety"

By KATHLEEN M. BOOZANG

Health reform that focuses exclusively on health care finance — that
is, how we pay for universal access to insurance coverage — will not
produce successful reform.  Reform must be holistic, with a focus on
the entire system, as well as its component parts, including whether
the system is structured to deliver the right kind of health care
services in the most appropriate setting, whether we have sufficient
quantity and kind of health care professionals and technology
geographically dispersed to provide the health care services that
people will presumably have insurance to access, and whether the system
properly incentivizes health care professionals to make decisions that
are efficient, effective, and in patients’ best interests.  This is a
massive undertaking, with a tremendous risk that important components
will be overlooked precisely because of the size of the undertaking. 
The Stark Law represents the kind of on-the-ground healthcare delivery
problems that healthcare reform must tackle.

The American Health Lawyers Association’s Public Interest Committee today released a Whitepaper entitled: “A Public Policy Discussion: Taking Measure of the Stark Law” analyzing the ” Ethics in Patient Referrals Act” (and its progeny), more commonly known collectively as the “Stark Law“, after its primary sponsor, Congressman Pete Stark,
who now counts himself among the many who believe that while the
problem the law aimed to address is real, the statute and its
multitudinous exceptions have become a nightmare.

Continue reading…