This issue has an interesting slant to it since it involves lab data used
in a public health context. It is an issue that I will submit to the clin
lab professional organization AACC whose Natl Office is in DC. In addition
note that The Amer Public Health Assoc Annual meeting will be in New
Orleans 5-9 Nov and they have one presentation on: "Public Health
Informatics: Overview of Key Issues"; the APHA Natl Office is also in DC.
This is an issue with respect to the NHIN and perhaps Nancy could bring
this to Brailer's office for attention as an issue for NCVHS (who also
meets in DC. I will also bring this to the attention of our AHIMA
colleagues with whom we are working to develop concerted efforts on behalf
of the health professional disciplines regarding the NHII. I dont know
which hat Nancy might want to wear in approaching ONCHIT but if it is
coordinated with several concerned organizations and with the ability to
provide guidance for the open efforts to adapt VistA, then it can provide
explicit examples of the principles that migyt be applied to regional
enterprise health information architectures. The NCVHS/NCHS is in
Hyattsville and I can provide contacts there also to get concerted
inquiries about the implications of these potential steps. I also have lab
contact in NYC who can contribute to probing this issue. Resolution of
this issue can provide guidance about the EAP steps in the Zachman
framework that each adopting healthcare enterprise must consider in
crafting its information architecture using VistA. Addressing the issue
also provides forums for VistA Community Members to attend various health
professional discipline meetings and explain how the VistA architecture
dealth with this issue.
My point is that the situation is not as scary as it may seem and offers
some real opportunities to the VistA Community
On Sat, 16 Jul 2005, Nancy Anthracite wrote:
Thank you VA. At least someone is looking out for patient's privacy.
The diabetics in NY should have to OPT IN, and the entity asking if they want
to opt in, should not be the City unless the message is delivered by the
party that already has the information and the permission to deliver that
message.
Since Dr. Berger is largely blaming this on obesity, the next thing you know,
60% of NYC residents will be in a "fat" registry because it puts them at
higher risk of developing diabetes.
I find myself still feeling just as outraged about this as the first day I
read this story.
On Friday 15 July 2005 10:04 pm, Cameron Schlehuber wrote:
At least the claim is that patients can opt out at any time. They could
also take a page from VA and only submit lab values along with hashed IDs
to the central system so that the only way to know who the person is would
be to go to the system sending in the data. VA has centralized databases
for monitoring WBCs weekly for each patient on clozapine, but no one can be
identified by looking at any data in the central database. The same hash
is generated at each facility (the hash algorithm must be kept secure) so
the same patient's data at different sites can be combined centrally. Only
by taking the hashed ID at the central system to a local system that sent
the data and has the association between the hash and the patient's ID can
the patient's identity be known.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Nancy
Anthracite
Sent: Friday, July 15, 2005 7:24 AM
To: hardhats-members@lists.sourceforge.net
Subject: [Hardhats-members] Now this is scary!
NYC Department of Health is asking to mandate that all of the city's labs
report A1C Hemoglobin values into a patient registry of Diabetics in New
York.
This is one of the things that concerns me about all of this enthusiasm for
a
Health Data Repositories. You may be told your information is private, but
then once it is stored like this, you can loose control of it for the
"public
good". This article does not suggest this is data they want is scrubbed of
personal identifiers. This is far too "Big Brother" for me, and this
doesn't
even involve a HDR yet.
I feel things are a little safer if the nationwide network were a database
to
where patient information might be found if the patient wants it to be
found.
http://govhealthit.com/article89548-07-13-05-Web
--
Nancy Anthracite
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