Junkfood Science: Electronic medical database update: Your insurance cards are like credit cards

February 23, 2007

Electronic medical database update: Your insurance cards are like credit cards

We regularly check our credit reports to ensure that there is nothing amiss that might indicate identity theft, but few of us think to carefully examine statements we receive from medical bills or health insurance companies. And when our purses or wallets are stolen, we notify those issuing our credit cards and driver’s license, but rarely think of our insurance cards.

But that’s where real risk can be, according to the office of Attorney General, Tom Corbett. Oftentimes people don’t realize they’ve been victimized by medical identity theft until they’ve been denied coverage for health care, been billed for things they never received, or turned down for employment or insurance because of medical conditions that appear on their own records that really reflect those of a thief.

Randy Griffith writes in the Tribune-Democrat:

Health risk: Are thieves after your medical records?

....The World Privacy Forum estimates as many as 500,000 people have been victimized – often without knowing it. Sometimes doctors and hospital employees are the criminals, raising the California-based organization’s fears of more abuse as electronic health records become the norm.

A hospital spokesperson disagreed, saying:

Used properly, electronic health record systems can help prevent identity theft. Driver’s licenses or other photo ID presented on admission can be scanned into the permanent record and checked against future admissions.

The article explains another angle behind medical identity theft. Although it remains a relatively rare occurance, it favors prudency on the part of consumers:

While some people get medical cards to receive free care, other scam artists tap into hospital records to get illegal financial reimbursements or drugs. All situations can create falsified health records for the victim, sometimes changing the patient’s blood type or adding medical conditions they don’t have. In an emergency, Gray said, false records can lead to dangerous mistakes, but changes can create issues with employment and life insurance....She also encourages members to protect insurance cards as they do credit cards.

As medical records are increasingly placed on electronic databases, professional and consumer organizations have cautioned that medical identity theft will become a greater risk. Privacy issues, how much and what type of information is becoming part of electronic databases, and how our personal information stored on them may be used are among the other concerns being raised, as discussed here.

The healthcare and insurance industry believes that computerized records could eventually make it easier to identify expenses, analyze the cost-benefits of drugs and treatments, and facilitate patient information sharing to increase efficiency, reduce human error and save costs. The transition from paper to electronic records, however, is where concerns for patient safety have been especially highlighted by medical professionals.

Despite potential benefits of electronic patient records, it appears prudent for patients to continue to be vigilant about medical treatments and medications they and their loved ones receive while in the hospital. Last week, in a Los Angeles Times article, “Kaiser has aches, pains going digital,” Daniel Costello reported:

Kaiser Permanente's $4-billion effort to computerize the medical records of its 8.6 million members has encountered repeated technical problems, leading to potentially dangerous incidents such as patients listed in the wrong beds, according to Kaiser documents and current and former employees.

At times, doctors and medical staff at the nation's largest nonprofit health maintenance organization haven't had access to crucial patient information, and system outages have led to delays in emergency room care, the documents show. Other problems have included malfunctioning bedside scanners meant to ensure that patients receive the correct medication, according to Kaiser staff.

Doctors in Pittsburgh analyzed the deaths among all children at their tertiary-care Children’s Hospital after a computerized physical order entry system was implemented. Their results were published in the December, 2005 issue of Pediatrics. They found that deaths among the children seen for specialized care during the 18-months following the computerized record implementation startlingly increased from 2.8% to 6.57% — more than three times, even after they adjusted for possible contributing variables.

The LA Times discussed a 772-page internal Kaiser report documenting the reliability of their computerized medical records initiative and over about nine months, nearly two dozen instances had been reported where patient safety may have been jeopardized. What may seem intuitively beneficial doesn't always prove to be so in reality. The writer shared valuable official company and employee perspectives on costs, effectiveness and potential for Kaiser's Herculean electronic database project. As consumers, healthcare professionals and politicians examine this emerging issue, looking at all sides may help ensure that efforts to save money will also save lives, and enable us to better protect ourselves and our patients in the process.

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