[ OUR OPINION ]
NEW rules aimed at protecting the confidentiality of patients' computerized medical records have been approved by the Bush administration, but they are unlikely to end the controversy. The rules, which will take effect next April, are an improvement over the current scarcity of laws assuring patient privacy. They will allow states to adopt stronger standards, and the Hawaii Legislature should review them for that purpose. Medical privacy rules
are adequate platform
THE ISSUE The Bush administration has approved new standards for protecting the privacy of medical records.
More than three years ago, Governor Cayetano signed into state law rules that were set aside after what Lt. Gov. Mazie Hirono described as "widespread confusion and anxiety." Hirono warned that the rules would paralyze the medical community and burden insurance companies with enormous paperwork, the same concerns directed at federal rules proposed by President Clinton.
Clinton's proposed rules, which he approved in the final month of his presidency, were to have taken effect last spring, but President Bush halted their implementation. At the core of the Clinton rules was a requirement that doctors, hospitals and other health-care providers obtain written consent from patients before disclosing patients' information for treatment or paying claims.
Pharmacists said that would have required written permission from a patient whose doctor phoned in a prescription to a pharmacist. The Clinton rules, "while well-intentioned, would have forced sick or injured patients to run all around town signing consent forms before they could get care or medicine," said Tommy G. Thompson, the secretary of Health and Human Services.
Under the Bush rules, health-care providers must notify patients of their privacy rights at certain points and make "a good-faith effort to obtain a written acknowledgment of receipt of the notice." Pharmacists will be allowed to fill prescriptions ordered over the phone, and doctors will be allowed to share information with specialists, addressing another concern about the Clinton proposal.
The new rules will prohibit pharmacies from selling personal medical information to a drug company or other businesses wanting to sell products or services. A drug company will be allowed to pay a pharmacy to be its agent in marketing its product without disclosing the financial agreement. That may annoy some patients, but it is not a privacy issue and should be addressed separately.
The rules also will allow patients to review their medical records, correct mistakes, learn who else has had access to them and seek penalties for misuse of the information. Generally, they allow medical records to be shared only to treat patients, pay bills and carry out "health-care operations." Patients' names are to be omitted when possible.
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