UCSD gives consent for sharing medical records without patient approval

I got an interesting letter from UCSD three days ago. It told me that I had consented to share my electronic medical records.

The trouble is--I had NOT given my consent. I never signed a consent form. I never clicked a box on the Internet agreeing to share my records.

And the letter from UCSD did NOT arrive in my home mailbox or even in my email. It was purely by chance that I found it on MyUCSDChart—NOT among the MyChart emails. If it had been among the MyChart emails, I would have received an alert about it in my regular email.

UCSD was definitely NOT trying to make sure that I found out about my “consent”.

Today, each time I have clicked on the link about sharing electronic medical records on MyUCSDChart, I found myself unceremoniously thrown back to the sign-in page. Automatically signed out. They really don't like it when I click on the link!

UCSD seems to be remarkably fond of both signing me in and signing me out--without my involvement--whenever it feels like it.

I found this page on the UCSD site about sharing electronic records. It seems that I am now part of two databases: The San Diego Beacon Health Information Exchange, and something called Care Everywhere.

It's not that I want to keep my records secret. In fact, I think sharing electronic records is basically a good idea. It's just that I've had problems with health providers hiding my own test results from me, so I'm sensitive about doctors violating the law regarding medical records.

Apparently the VA is also part of this system, but the VA has a more transparent consent process.

I've heard of falsified medical records, but this is the first time I heard of a falsified consent for release of medical records.



I found some interesting stuff about UCSD's informed consent process for patients in research projects:

iDASH Integrating Data for Analysis, Anonymization and SHaring

Informed Consent

Paper Consent versus Electronic Consent

Traditionally, paper-based consent has been the medium through which researchers and physicians conducted the informed consent process. The paper-based process consists of giving a hard copy consent form to a patient for him or her to review. Then a care provider answers any questions from the patient and in some cases assists the patient in reviewing the paper consent forms. The issues surrounding this procedure are that the paper-based consent form tends to be long and monotonous, and the retrieval of paper forms are often time consuming.

The new electronic consent forms use tablets or computers as the medium for communicating information and seeking consent from the patient...The iDASH team is also currently working on two systems, iCONS and iCONCUR, which are intended for such open source use in the future.

iDASH electronic informed consent management system

iCONS is a system currently being tested in a clinical trials environment at Moores Cancer Center Biorepository. The system supports informed consent electronically by enhancing the consent process for patients and researchers by acting as a consent broker and by adding multimedia aspects to the process. This consent process is opt-in, meaning no patient information is shared with researchers until the patient specifies what specific information he or she would like to share with researchers. The iCONS system creates a permission ontology to model the consent choices of the patient to assist in the process of releasing data and specimens to researchers for their consented uses.

iCONCUR is a pilot study within the University of California - San Diego Health System. This system transforms the sharing of electronic records from the opt-out system that is currently in place, meaning a patient’s record is automatically entered into the system unless the patient specifically requests to have their records taken out, to an opt-in system. The tool presents the patient with a taxonomy of his or her medical record allowing the patient to dictate what parts of the medical record to share and with whom it may be shared with.

HOSPITAL FAXED MEDICAL RECORDS TO PATIENT'S WORKPLACE

Tufts Medical Center sued for faxing patient records without consent
July 15, 2011
By Karen Cheung-Larivee
FierceHealthcare

Tufts Medical Center in Boston faces a lawsuit after a patient said the hospital faxed her medical records to her workplace without her consent, causing her embarrassment, reports The Boston Globe yesterday.

"I feel like I might have walked in (the office) naked," said patient Kimberly White.

White requested Tufts to send a form for a disability claim, but instead the hospital allegedly sent four pages of medical records about her hysterectomy to a shared fax machine at her workplace.

White filed a complaint in Plymouth County Superior Court. The hospital denies any wrongdoing, according to the article.

Tufts spokeswoman Julie Jette said, "In this matter, we complied with a patient's request to share information. We firmly believe we responded to the patient's request appropriately."

"I can't go back there," White said. "I am so embarrassed. ... I couldn't live with knowing what these people knew about me."

Earlier this year, another Boston hospital, Massachusetts General Hospital, faced accusations that an employee lost records of 192 patients on the subway. The hospital in February settled the federal case for $1 million, according to the article.

UCLA HIPAA VIOLATIONS

UCLA Health System pays $865G to settle HIPAA violation charges
July 8, 2011
FierceHealthIT
By Ken Terry

UCLA Health System has agreed to pay a fine of $865,000 and to develop a correction action plan to settle potential HIPAA privacy violations involving improper disclosures of medical records at its three hospitals, the federal Office of Civil Rights (OCR) reports.

OCR launched the investigation in 2009, following complaints by two unnamed celebrities that their medical records had been compromised. The government probe revealed that from 2005 to 2008, "unauthorized employees repeatedly looked at the electronic protected health information of numerous other UCLAHS patients," according to an OCR press release.

The Los Angeles Times reports that violations allegedly occurred at all three UCLAHS hospitals: Ronald Reagan UCLA Medical Center, Santa Monica UCLA Medical Center, and Orthopaedic Hospital and Resnick Neuropsychiatric Hospital, which are regarded as a single unit.

The hospital had disclosed in April 2008 that it had discovered that several employees had snooped into the patient records of dozens of celebrities, including Britney Spears, Tom Cruise and Maria Shriver.

When the alleged violations came to light in 2008, the California legislature passed a law that imposed escalating fines on hospitals for patient privacy breaches. The state fined UCLAHS $95,000 in 2009, reportedly in connection with the medical records of the late Michael Jackson.

The UCLAHS settlement with OCR is much smaller than previous HIPAA settlements, including those involving CVS Caremark ($2.25 million) and Rite Aid ($1 million).

As part of its settlement, UCLAHS agreed to institute new security and privacy policies, improve employee training, take action against employees who violate privacy rules, and designate an independent monitor to oversee compliance.

In a statement, UCLAHS said, "The UCLA Health System considers patient confidentiality a critical part of our mission of patient care, teaching and research. Over the past three years, we have worked diligently to strengthen our staff training, implement enhanced data security systems and increase our auditing capabilities."


MEDICAL ETHICS--RESEARCH ON MEDICAL RECORDS WITHOUT INFORMED CONSENT

J Law Med Ethics. 2008 Fall;36(3):560-6. doi: 10.1111/j.1748-720X.2008.304.x.
Research on medical records without informed consent.
Miller FG.

Observational research involving access to personally identifiable data in medical records has often been conducted without informed consent, owing to practical barriers to soliciting consent and concerns about selection bias. Nevertheless, medical records research without informed consent appears to conflict with basic ethical norms relating to clinical research and personal privacy. This article analyzes the scope of these norms and provides an ethical justification for research using personally identifiable medical information without consent.

PMID: 18840249 [PubMed - indexed for MEDLINE]

Vast cache of Kaiser patient details was kept in private home

Kaiser won't let me see my own X-rays, and it falsified my medical records, but I'm apparently the only person Kaiser is trying to hide the information from.

Vast cache of Kaiser patient details was kept in private home
The case of Kaiser and Sure File Filing Systems underscores how patient information remains vulnerable in the hands of healthcare providers and outside contractors.
By Chad Terhune
Los Angeles Times
January 5, 2013

Federal and state officials are investigating whether healthcare giant Kaiser Permanente violated patient privacy in its work with an Indio couple who stored nearly 300,000 confidential hospital records for the company.

The California Department of Public Health has already determined that Kaiser "failed to safeguard all patients' medical records" at one Southern California hospital by giving files to Stephan and Liza Dean for about seven months without a contract. The couple's document storage firm kept those patient records at a warehouse in Indio that they shared with another man's party rental business and his Ford Mustang until 2010.

Until this week, the Deans also had emails from Kaiser and other files listing thousands of patients' names, Social Security numbers, dates of birth and treatment information stored on their home computers.

The state agency said it was awaiting more information from Kaiser on its "plan of correction" before considering any penalties.

Officials at the U.S. Department of Health and Human Services began looking into Kaiser's conduct last year after receiving a complaint from the Deans about the healthcare provider's handling of patient data, letters from the agency show. Kaiser said it hadn't been contacted by federal regulators, and a Health and Human Services spokesman declined to comment.

Kaiser said it remained confident that this patient information was never disclosed or accessed inappropriately. It said that some employees were disciplined because company policies were not followed and that it had informed regulators of the steps it had taken to ensure this type of incident didn't happen again.

"Kaiser Permanente is committed to protecting the medical and personal privacy of its patients," spokesman John Nelson said. "In retrospect, we certainly wish we'd never done business with Mr. Dean."

Even with tougher government oversight of medical privacy in recent years, this case underscores how confidential patient information remains vulnerable in the hands of big healthcare institutions and legions of outside contractors.

"Kaiser has shown extraordinary recklessness in this situation," said Beth Givens, director of the Privacy Rights Clearinghouse in San Diego. "Healthcare companies have to make sure their contractors adhere to ironclad security practices."

Federal and state laws impose strict standards on anyone dealing with patient information. The privacy rule of the federal Health Insurance Portability and Accountability Act, known as HIPAA, bans the unauthorized disclosure of individuals' medical records and requires healthcare providers and vendors, such as billing and storage companies, to protect the information.

Despite those rules, personal medical information of 21 million people nationwide has been improperly exposed since 2009, according to federal data. Last year, Blue Cross Blue Shield of Tennessee agreed to pay $1.5 million to resolve allegations it violated federal law after 57 computer hard drives with patient information were stolen from an outside facility.

In October, Kaiser sued the Deans in Riverside County Superior Court, accusing them of violating their contract by not returning all of its patient information two years ago when Kaiser picked up the paper records.

In court filings, Kaiser said the Deans put patient data at risk by leaving two computer hard drives in their garage with the door open. In response, Stephan Dean moved them to a spare room. On a recent day they sat next to a red recliner where Ziggy, the family's black-and-white cat, curled up for a nap. Dean said those hard drives contained spreadsheets on thousands of Kaiser patients, prepared at the company's request.

At one point, Dean told Kaiser he was planning to contact patients about the whereabouts of their medical information because he felt Kaiser hadn't taken proper precautions. The company sought a temporary restraining order against Dean, barring him from disclosing any confidential information. A Superior Court judge granted Kaiser's request until Thursday, when another hearing is scheduled.

Dean, 47, got his foot in the door at Kaiser from his previous work labeling paper folders for courthouses, hospitals and doctors.

But the demand for folders was slipping as hospitals and doctors used computers more. Kaiser was at the forefront of this as it invested billions of dollars in its HealthConnect system, which it bills as the largest private-sector electronic health record in the world. Kaiser, with more than 9 million customers, is the nation's largest nonprofit insurer and hospital system.

Dean said his small business, Sure File Filing Systems, got a big break when Kaiser acquired the Moreno Valley Community Hospital in 2008. The company needed to organize and clear out thousands of old patient files and it gave the job to the Deans, Kaiser records show.

In August 2008, the Deans started packing up thousands of files from Moreno Valley and moving them to the warehouse in Indio.

Hospital clerks routinely messaged Dean asking him to pull records on specific patients, emails sent by Kaiser to Sure File show. Dean said some Kaiser employees would put the patient's full name in the subject line of the email, and other messages listed the patient's Social Security number, date of birth, doctors' names and treatment dates. One message started, "Good Morning Sure File," and requested adoption records for a child.

Dean said Kaiser showed little concern for patient privacy in handling those requests. Only one out of more than 600 emails from Kaiser was password-protected with encryption, he said. Many medical providers use such technology so information isn't visible to others.

"Every one of these records is somebody's life," Dean said recently, scrolling quickly through what he said was Kaiser information on his computer screen. "We could have sold these emails to somebody in Nigeria, but Kaiser doesn't care about its patients' information."

Kaiser said that government rules don't require encryption and that "our vendors are contractually required to maintain secure environments for all records, and this includes Sure File."

The healthcare company awarded another job to Sure File in January 2010: to "deactivate" and store about 345,000 records from its West Los Angeles Medical Center for $206,000, according to Kaiser documents.

But within a few weeks, Dean said, he stopped working because he didn't have a contract yet for the West Los Angeles work. The two sides reached an accord in March 2010, and in a letter that month a Kaiser purchasing manager apologized to Dean for the confusion.

"We should have signed a contract prior to the commencement of this project," the manager wrote.

Three months later, in June 2010, Dean said, he stopped working for Kaiser again. This time, he said, he could no longer afford the insurance on the warehouse and $1,500 a month for gas for his file deliveries to Kaiser.

By July 2010, Kaiser had terminated the Deans' contract and picked up the medical records from the Indio warehouse, court files show.

The two sides signed an agreement in March 2011 to resolve their differences and Kaiser paid $110,000 to Dean, according to court documents. In its lawsuit, Kaiser said Dean was required to return or destroy "all the protected information of Kaiser members" as part of their agreements.

Dean says those agreements covered only the return of paper records. On New Year's Eve, Dean said, he deleted the Kaiser emails and other patient information on the two hard drives.

Kaiser said "this is a positive step, although based on [Dean's] behavior we will be seeking independent verification of his promised performance." In court filings, the company said it had sought access to his computers and email account for inspection by a forensic consultant.

Dean said he offered to grant that access — if the company paid him $100,000. Kaiser said it already had fully compensated the Deans, paying them about $500,000 in all...

UCLA Radiology Department--Who's in charge of losing my X-rays?

I'm trying to figure out how--or why--ALL my digital X-rays got "lost" at UCLA.

[Update October 20, 2012: It seems that UCLA wants to protect Kaiser from having to answer questions about this problem at Kaiser Permanente's new Garfield Specialty Center in San Diego. My UCLA primary care doctor explained it to me, saying, "You need to forget about Kaiser." She was worried that I might "have a case against Kaiser."]

It appears that I have these people to thank for my X-rays being unavailable:

UCLA RADIOLOGY DEPARTMENT

Dieter R. Enzmann, M.D.
"Leo G. Rigler" Chair and Professor (What's up with that Cheshire Cat smile? He looks like he might have swallowed my X-rays.)

Brenda Izzi, R.N., M.B.A.
Chief Administrative Officer and head of Radiology Image Library
(310) 481-7516 (310) 794-8056
BIzzi@mednet.ucla.edu
(From the look on her face, I think she knows where those X-rays are.)







Brenda Jones, Director of Radiology Image Library


UCLA MEDICAL RECORDS DEPARTMENT

The head of the Medical Records Department won't even let employees give out his or her name. Perhaps the Los Angeles Times article at the bottom of this post explains the desire for anonymity.

Katherine Mair, special project manager (Her existence might be just a rumor, but I suspect she's simply too important to deal with missing X-rays.)

Erik Lozano--contractor (He had his door closed, and later was in a meeting.)

Pazzette McCray, contractor, manager 310 825 9381 (She ignored all my messages.)

Erika, contractor (She was the only one who would talk to me, but I don't think she was authorized to say much. I'm sure that's difficult for her. As far as I know, she's the only one earning her pay.)

See more information HERE.


UPDATE October 5, 2012

I got the following email this morning, but I'll believe that Ms. Izzi is sincere when I have the digital images in my possession. Erika Lee told me that the images can be burned to a CD within a day. That means they could also be sent in an email within a day. Anyone want to bet that I don't get all the digital images today? (Note to UCLA: it doesn't count if you print out an image, then scan it. You remove a huge amount of detail when you do that.)

Dear Ms. Larkins,
I am happy to look into any imaging provided by Radiology and ensure you can obtain copies of those studies. I have asked my Director of the Image Library to research your concern.
I will let you know what we uncover.
Sincerely,
Brenda
Brenda M. Izzi, RN, MBA
Chief Administrative Officer
UCLA Radiology


I SENT MS. IZZI THIS EMAIL IN RESPONSE:

Dear Ms. Izzi:

It is ridiculous for your department to claim that X-rays might have gotten misplaced inside Dr. Raz's office. The Chair of the Radiology Department, Dr. Enzmann, states "the Department of Radiological Sciences is completely digital." The digital images are available on your computers, and it's simply false to say that they aren't there.

Also, please don't print out a few images, then scan them, and then call them the original digital images. You remove a huge amount of detail when you do that. By law you must provide all the videos and all the original still images. Your department has been in violation of the law for almost two weeks.

It is also shameful for your department to claim that my September 18, 2012 Request for Images was not received. I have a FAX transmission report with a photocopy of the Request to prove that you received my Request on Sept. 18.

I assume you are talking about Brenda Jones when you refer to your Director. Surely she has been researching this matter for the past three days, since Erika Lee sent a FAX on October 2, 2012 asking that my request be prioritized? Isn't Brenda Jones the person who told her subordinates to tell me that no images were available? I suggest you look into this matter yourself, Ms. Izzi.

Sincerely,
Maura Larkins


THE PLOT THICKENS ON FRIDAY AFTERNOON, OCT. 5, 2012

Apparently Brenda Izzi and Katherine Mair and the mysterious head of Medical Records decided that the best response to the situation was to make up a bizarre story in which they would claim that images don't exist, and if they did, they wouldn't be able to release them.

So why would UCLA, a public entity, pay all these people in Medical Records and the Radiology Image Library to do nothing? Well, they don't exactly do nothing. They actually work very hard. It can't be easy to conduct phone calls like the following one.

THE CONFERENCE CALL

On Oct. 5, 2012 at 4:50 p.m. I became part of a conference call with Ms. P. M. and the elusive Mr. E. L. of UCLA’s Medical Records office.

When I had called the office on October 2, 2012, a receptionist had gone to ask E. L. to talk to me, but then she came back and told me that his door was closed.

P. M. had ignored my messages for several days, but when I called earlier today, she had picked up the phone and talked to me.

Only P. M. spoke in the beginning of our conference call, and I began to wonder if E. L. was actually on the line. "Are you there, E.?" I asked. Then I heard his voice for the first time.

From all this I concluded that E. L. must actually be P. M.'s superior, rather than her subordinate, as I had assumed when told that P. M. was the "manager." I figure the higher-ups tell their subordinates what to say, but they don't like to actually talk to patients themselves.

In fact, I suspect that there may have been others on the line during the call who never said anything. I think B. J. was probably on the line, since she called me back just minutes after the following call. I also think that the people who were calling the shots did not speak to me at all. I think E. L., P. M. and B. J. are all following orders.

Here's my transcript of the call:

P. M.: ...I called the physician [Dr. Raz] and was told that they don't make videos in that office.

[Maura Larkins comment: I knew this statement was false. I saw the videos myself on the computer monitor as they were being taken.]

P. M.: The X-rays are the physician's product to release. We're not experts and we're not able to release it. He's a private physician.

[Maura Larkins comment: I knew that all these claims were false, too. It says on the UCLA website that the Radiology Image Library releases images on CD for free, and that it does so within 5 days of the request--because this is what is required by California law. All X-rays at UCLA are digitized, and the Radiology Image Library has access to all X-rays. In further proof, Dr. Raz's office had given me the phone number of the Radiology Image Library and told me to call that number to get copies of my images.

Also, UCLA doctors are public employees, hired by the Regents of the University of California, NOT private doctors.]

Maura: No one in your department knows California law regarding medical records?

McCray: We can not provide patient information. Erika (Lee) was being kind in trying to help you out.

Maura: (repeating the unanswered question) No one in your department knows what California law is regarding medical records?

P. M.: We know the law.

Maura: Why are you disobeying the law?

P. M.: Miss Larkins, we do not release information from a private physician.

Maura: I didn't get everything you said written down in my notes here. P. M., you said you spoke to Dr. Raz?

P. M.: E. L. called Dr. Raz's office. The number he called was 310 794 0206.

Maura: E. L., did you speak to Dr. Raz? Did he say they don't make videos in his office?

E. L.: His office said that they don't make videos.

Maura: Who was it who said that?

E. L.: I don't have her name written down. A woman said they don't make videos. If they do make videos, we don't have access.

[Maura Larkins comment: I can't believe that anyone in Dr. Raz's office would claim that they don't make videos. But it does appear that for some reason Dr. Raz's office didn't want the videos released, and Medical Records came up with this cover story. Why wouldn't a doctor want a video of abdominal X-rays released? This is all very bizarre.]

Maura: E. L., are you a contractor?

E. L.: Yes.

Maura: P. M., are you a contractor?

McCray: Yes.


MAYBE I SHOULD ASK THE NATIONAL ENQUIRER TO GET MY RECORDS FROM UCLA; THEY SEEM TO HAVE BETTER LUCK

UCLA hospitals to pay $865,500 for breaches of celebrities' privacy
July 08, 2011
By Molly Hennessy-Fiske
Los Angeles Times

UCLA Health System has agreed to pay $865,500 as part of a settlement with federal regulators announced Thursday after two celebrity patients alleged that hospital employees broke the law and reviewed their medical records without authorization.

...Violations allegedly occurred at all three UCLA Health System hospitals — Ronald Reagan UCLA Medical Center, Santa Monica UCLA Medical Center and Orthopaedic Hospital and Resnick Neuropsychiatric Hospital, according to UCLA spokeswoman Dale Tate...The same month, the U.S. Department of Health and Human Services' Office for Civil Rights began investigating alleged violations of the federal Health Insurance Portability and Accountability Act at the hospitals, according to the settlement agreement.

Investigators found that UCLA employees examined private electronic records "repeatedly and without a permissible reason" in 2005 and 2008, including an employee in the nursing director's office, according to the agreement reached Wednesday.

..."Our patients' health, privacy and well-being are of paramount importance to us," said Dr. David T. Feinberg, chief executive of the UCLA Hospital System. "...We remain vigilant and proactive to ensure that our patients' rights continue to be protected at all times."

Questions raised about Epic software – Kaiser official quits in flap on cost overruns

Questions raised about Epic software – Kaiser official quits in flap on cost overruns
November 13, 2006
By Jeff Richgels
EmpowerMed

Electronic medical records software from Verona-based Epic Systems Corp. is at the center of a controversy that has led to the resignation of a key executive at the nation’s largest nonprofit health organization.

J. Clifford Dodd, a senior vice president and chief information officer for Kaiser Permanente, resigned Tuesday, four days after another Kaiser employee sent a highly critical e-mail to most of the company’s 140,000 workers about his concerns over the $3 billion, high-profile technology project known as HealthConnect, the Los Angeles Times reported Wednesday.

In the e-mail, project supervisor Justen Deal said Kaiser’s switch to electronic medical records for its 8.6 million members was proving far more expensive and unreliable than anticipated.

In an interview with the Times, Deal said that cost overruns were common and that data showed the new Epic-based software system breaking down so frequently that doctors and patients were often left for long periods without access to medical records.

He told the Times that “the company is wasting hundreds of millions on the project and should consider scrapping it for a better one that can handle the scale of a company like Kaiser.”

Kaiser CEO George Halvorson defended the Epic system in an interview with the San Francisco Chronicle. He told the paper that power outages have caused recent reliability problems unrelated to the system, which is expected to be completed by 2009.

A Kaiser spokesman told the Times that despite minor problems, the HealthConnect rollout was exceeding expectations.

Epic spokeswoman Terri Leigh Rhody said today that the company, which recently moved to its new headquarters in Verona, declined comment and directed inquiries to Kaiser. Calls to Kaiser were not returned by deadline today.

Deal told Computerworld magazine that he has had access to “internal projections that show that we could lose $7 billion over the next two years. Losses of even a fraction of that amount could be destabilizing to the organization.”
Deal told Computerworld that he sent letters to Kaiser management expressing his concerns, but in internal memos, management said it had investigated Deal’s concerns and found them baseless.
Deal has not backed down.
“It’s chilling for anyone in the organization to see how far off-track this project has gone,” he told Computerworld.
Kathy Lancaster, Kaiser’s chief financial officer, confirmed to the Times that her office compiled the report last March but said it was only a “worst-case scenario” and that she expected cost-cutting efforts, as well as savings from the parts of the electronic medical records system now in place, to help.
Deal was put on administrative leave Monday pending an investigation and Kaiser said it is reviewing whether he violated company e-mail policies.
“What I’m doing is working to ensure the waste and abuse stops,” Deal told the Chronicle. “That’s not something you get fired for.”
Halvorson described the memo as alarmist and inaccurate, the Chronicle said.
“He has bits and pieces of information and has managed to construct a theory … but what he doesn’t have is any of the subsequent data about what we’re doing to manage those costs,” Halvorson told the Chronicle.
Kaiser has already started cutting costs, through measures such as hiring freezes, Halvorson told the Chronicle.
Kaiser faces the same cost pressures as other health care providers, and must find ways to reduce expenses rather than continuing to increase premiums for consumers, Halvorson told the Chronicle.
A Kaiser spokesman said Dodd’s resignation was not related to the e-mail but did not provide a reason for his departure, the Times reported. Bruce Turksta, vice president and program director of HealthConnect, has been named interim CIO, Computerworld reported.
Epic signed the 10-year, multimillion-dollar deal to provide its health care record management software to Kaiser in 2003.
At that time, Epic founder and CEO Judith Faulkner told The Capital Times that “I think that the Kaiser implementation would be challenging for any company, but I don’t think there’s any company better suited in the world to do it than Epic. It’s a matter of scaling it up and just hunkering down and doing the installations. There’s not much customization involved.”
Epic’s software handles everything from patient medical records and clinical information to scheduling, registration and billing. It also offers patients online access to their records and health care providers.
Kaiser began pursuing the vision of an automated medical record system in the 1960s, long before it was technologically possible, and had worked in the area for many years before contacting Epic in the summer of 2002, the Wall Street Journal reported in 2003. The paper said then that Kaiser expected to save $1 billion by going with Epic over its internal development path.
Oakland, Calif.-based Kaiser, the nation’s largest nonprofit health organization, is at the forefront of the electronic medical records effort, which Mike Leavitt, secretary of the U.S. Health and Human Services Department, recently said was “the most important thing happening in health care.”
Yet getting rid of pen-and-paper records is proving harder in practice than in theory. Only 20 percent of physicians today use electronic medical records, and many organizations are finding glitches.

Others worry that digital medical records pose risks to patients’ privacy, pointing to cases like that of the Veterans Administration, which lost personal data including medical information on millions of veterans last spring.

Link: http://www.madison.com/tct/news/index.php?ntid=106932&ntpid=2
Published: November 10, 2006

Computer medical records stolen from Kaiser and from Sutter Health

After data theft, Sutter Health sued
By The Associated Press
Nov. 22, 2011

SACRAMENTO, Calif. — A group of patients are suing Sutter Health after more than 4 million patient records were stolen.

The Sacramento Bee reports ( http://bit.ly/sKNKT3 ) the class-action lawsuit was filed Monday in Sacramento Superior Court.

The suit alleges the health care provider was negligent in keeping patients' electronic data safe, and in notifying the patients within 30 days of the theft.

A computer containing the data was stolen in October from the Sutter Medical Foundation's headquarters in Natomas. The computer held descriptions of diagnoses, names and addresses.

Plaintiffs' attorney Robert Buccola says the company should have taken far more measures to keep the data safe.

Sutter "deeply regrets the theft," said spokesman Bill Gleeson. He defended the time it took to reach patients, saying Sutter had to figure out what data were stolen.



Computer medical records stolen from Kaiser
By The Associated Press
Jan. 12, 2010

SACRAMENTO, Calif. — Kaiser Permanente says a computer drive containing thousands of patient records was stolen from an employee's car.

Hospital officials said Tuesday the external drive stolen Dec. 1 held data on as many as 15,500 patients throughout Northern California, including the patient's name and Kaiser medical records number.

The records could have also included a patient's sex, birth date, phone number and other medical information.

All of the patients live in the Sacramento area, and Kaiser says they have notified those affected.

Hospital spokeswoman Kristin Chambers says the theft presents a "low risk to our patients."

[Maura Larkins' comment: That sounds just like what they tell people with conditions that are not properly diagnosed. Thousands of those people end up dead.]

The hospital has fired the employee, who was authorized to access the data as part of her work, and says it is unclear why she took the device home.

Information from: The Sacramento Bee, http://www.sacbee.com

Lack of record access drives up costs at L.A. hospitals for poor

Lack of record access drives up costs at L.A. hospitals for poor
L.A.'s safety-net hospitals are scrambling to match others nationally that use electronic records and integrated systems to manage care for low-income patients and cut costly hospitalizations.
By Noam N. Levey
Los Angeles Times
November 25, 2011

The emergency room at White Memorial Medical Center on Los Angeles' Eastside was buzzing when paramedics arrived on a Friday night with an elderly man slurring his words and complaining of aching bones.

The nurse in the receiving bay immediately ran through standard triage questions: "Are you diabetic? Do you have high blood pressure? Are you allergic to any medications?" Each drew the same response: "I don't know."

The hospital and doctors had no record of the man or his medical history. And with their only guide a piece of crumpled paper they found tucked into the man's pants that seemed to indicate he might have had cancer, doctors had to order a full diagnostic work-up, including blood tests and an EKG to check his heart.

It was another night of high-priced detective work at one of America's urban hospitals.

"We're mostly flying blind here," said Dr. Brian Johnston, the senior emergency room physician at White Memorial, shaking his head at the high costs generated by the lack of records and unnecessary testing.

Waste bedevils much of America's fragmented healthcare system, driving up already skyrocketing costs. As health spending overwhelms government budgets, the stakes are especially high for safety-net institutions like White Memorial that serve the country's poorest patients, largely at taxpayer expense.

The best safety-net systems — in Denver, Dallas, New York and elsewhere — have found ways to practice medicine more efficiently, using electronic records and integrated systems to manage care for low-income patients and cut costly hospitalizations.

In Los Angeles, Chicago and many other cities, local healthcare officials are now scrambling to catch up.

"There is really no system of care here," said Allen Miller, a Los Angeles consultant who is working with private hospitals, clinics and physicians on a potentially trailblazing initiative to link together medical providers that care for some of Los Angeles County's neediest patients...