I saw this article in the Arizona Republic Monday about how the insurance companies are able to save money by gathering health care records electronically, make more accurate analyses of patients (also saving money) and be able to adjust premiums (i.e., make more money) based upon your poor health or various other things. You know, like ‘pre-existing’ conditions, or whatever concept they choose to make up.
Does anyone think that they will be offered an option? The choice of not providing these electronically? Not a chance. This will be the insurer’s policy, and you can choose to not have insurance, or turn over your records.
Does this violate HIPPA? To me it does, but since you are given the illusion of choice, their legal team will surely protect them with your ‘agreement’ to turn over these electronic documents. And why not, with all the money they saved through data analysis, they have plenty of money for their legal expenses.
Does anyone think that the patient will be allowed to see this data, verify accuracy, or have it deleted after the analysis? Not a chance. Your medical data will most likely have a “half life” longer than your life span. That stuff is not going anywhere, unless it is leaked of course. But then you will be provided a nice letter in the mail about how your data may or may not have been stolen and how you can have free credit monitoring services if you sign this paper saying you won’t sue. It’s like watching a car wreck in slow motion. Or a Dilbert comic strip.
Let me take another angle on the data accuracy side of this proposition. When I first graduated college, I walked down the street to open a checking account with one of the big household names in banking. For the next 12 months I received a statement each month, and not one of those banking statements was 100% correct. Every single statement had an error or an omission! My trials and angst with a certain cell phone provider are also well documented. Once again, charges for things I did not order, rates that were not part of the plan, leaked personal data, and many, many other things during the first year. I had one credit card for a period of 12 years, and like clockwork, a late fee was charged every 6-9 months despite postmarks and deposit dates which conclusively showed I was on time. I finally got tired of having to call in to dispute it, and just plain fed up with what I assumed was a dastardly business practice to generate additional revenue from people too lazy to look at their bills or pick up the phone and complain. I had a utility company charge me $900, for a single month, on a vacant home I had moved out of three months prior. One out of two grocery store receipts I receive is incorrect in that one or more prices are wrong or one of the items scans as something that it is not. Other companies who saved my credit card information, without my permission, tried to bill me for things I did not want nor purchase. Electronic records typically have errors, they are not always caught, and there may or may not be a method to address the problem.
The studies I have seen on measuring the accuracy of data contained within these types of databases is appalling. If memory serves, over 20% of the data contained in these databases is inaccurate due to entry or transcription errors, is incorrect logic errors in transformational algorithms, or has become inaccurate with the passage of time. That later item means each subsequent year, the accuracy degrades further. There is no evidence that Ingenix will have any higher accuracy rates, or will not be subject to the same issues as other providers, such as Choicepoint. They say computers don’t lie, but they are flush with bogus data.
Now think about how inaccurate information is going to affect you, the medical advice you receive, and the cost of paying for treatment! There is a strong possibility you could be turned down for insurance, or pay twice as much for insurance, simply because of data errors. And most likely, the calculation itself will not be disclosed, for “Pharmacy Risk Score” or any other actuarial calculation. If this system does not have a built-in method for periodically certifying accuracy and removing old information, it is a failure from the start. I know this is a recurring theme for me, but if companies are going to use my personal information for their financial gain, I want to have some control over that information. Insurance companies will derive value from electronic data sharing because it makes their jobs easier, but the consumer will not see any value from this.