E-Prescribing Pilot Tests Should Address Patient Opt-Out, Cmte. Says
This article was originally published in The Pink Sheet Daily
Executive Summary
National Committee on Vital & Health Statistics' Privacy & Confidentiality Subcommittee will suggest to the HHS Secretary in a March 2005 letter that e-prescribing pilots test patient ability to opt-out, as well as interstate operability.
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HHS should assess the feasibility of allowing some patients to opt-out of the electronic health records system as part of its electronic prescribing pilot tests, the National Committee on Vital & Health Statistics' Privacy & Confidentiality Subcommittee said at a Nov. 18 meeting. One guest speaker "said that she'd like to see the patients given the opportunity to opt-out of the e-prescribing use of their data, whether that's the full medical history or whether it's being able to isolate a portion of it and maybe even be able to pick and choose which providers get to see which information," NCVHS committee member Michael Fitzmaurice, PhD, said. "I don't think we know enough to know what the value or the harm is of all that, and it's possible that the pilots can tell us," Fitzmaurice, who is senior science advisor for information technology for the Agency for Healthcare Research & Quality, said. Among the issues to be answered are "Is the software sophisticated enough to do it? Is it a value to the patient? Is that value greater from the potential harm of the physician not knowing enough to really take the best care of that patient?" Fitzmaurice said. Under the Medicare law, HHS is required to begin the pilot tests by Jan. 1, 2006. Federal e-prescribing standards are scheduled to take effect in 2009. CMS plans to issue proposed standards by the end of the year (1 (Also see "Electronic Prescribing Initial Recommendations To Be Finalized By September" - Pink Sheet, 20 Aug, 2004.)). The committee also heard testimony that the e-prescribing system should "require consistency within and across states in security and privacy standards," Fitzmaurice noted. "There are states that are very difficult to do e-prescribing in. There are a couple that the National Association of Boards of Pharmacy said 'you just can't do it.' There are other states when the name of the state comes up people grimace," committee participant Geff Brown (Mayer, Brown, Rowe & Maw) said. "Georgia's a good example, where everything has to be printed out on paper, in addition to the electronic form. And each state has its own issue." The subcommittee will offer its suggestions as part of a letter the full committee plans to send to HHS Secretary Tommy Thompson in March 2005. A letter on the committee's first set of recommendations on e-prescribing standards was sent to Thompson Sept. 2. "One strategy that I have heard…is that we have a place in the…l etter that very concretely recommends that the pilots for e-prescribing consider the following issues and we discuss the things that we heard," Subcommittee Chairman Mark Rothstein (University of Louisville) said. Rothstein suggested that the letter would offer suggestions on the structure of the pilots. The expectation is that "once we tackle the broader issue of electronic health records that we will be able to develop the principle, if not the actual strategies, for implementing them," he said. The subcommittee also discussed public education efforts on electronic prescribing (see 2 (Also see "Public Outreach Efforts On E-Prescribing Urged" - Pink Sheet, 19 Nov, 2004.) ). - Andrew Shelton |