Health Privacy

How far would you go to protect your health records? Your privacy matters, of course, but consider this: Mass data can inform medicine like nothing else and save countless lives, including, perhaps, your own.

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June 10, 2017 – Online MCAT CARS Practice

Question: What is your summary of the author’s main ideas. Post your own answer in the comments before reading those made by others.

How far would you go to protect your health records? Your privacy matters, of course, but consider this: Mass data can inform medicine like nothing else and save countless lives, including, perhaps, your own.

Over the past several years, using some $30 billion in federal stimulus money, doctors and hospitals have been installing electronic health record systems. More than 80 percent of office-based doctors, including me, use some form of E.H.R. These systems are supposed to make things better by giving people easier access to their medical information and avoiding the duplication of tests and potentially fatal errors.

Yet neither doctors nor patients are happy. Doctors complain about the time it takes to update digital records, while patients worry about confidentiality. Last month the Association of American Physicians and Surgeons went so far as to warn that E.H.R.s could “crash” the medical system.

We need to get over it. These digital databases offer an incredible opportunity to examine trends that will fundamentally change how doctors treat patients. They will help develop cures, discover new uses for drugs and better track the spread of scary new illnesses like the Zika virus.

Medicine is famous for serendipity — scientists coming across important findings when they least expect them or aren’t even looking. I’ve often said that we may have all the drugs and therapies we need already to prevent, treat or cure most ailments, but we don’t know which ones can be used on which conditions and at which doses.

Case in point: Last year, a team led by researchers at the MD Anderson Cancer Center and Washington University found that a common class of heart drugs called beta blockers, which block the effects of adrenaline, may prolong ovarian cancer patients’ survival. This discovery came after the researchers reviewed more than 1,400 patient records, and identified an obvious pattern among those with ovarian cancer who were using beta blockers, most often to control their blood pressure. Women taking earlier versions of this class of drug typically lived for almost eight years after their cancer diagnosis, compared with just three and a half years for the women not taking any beta blocker.

The researchers are now preparing follow-up clinical trials of ovarian cancer patients. My guess is they will confirm the connection.

This information was lying in plain sight, no invasive procedures or testing required. We could have found it years earlier if we had had the data.

Here’s another recent example. In 2015, researchers at Stanford University and the Houston Methodist Research Institute analyzed more than 16 million clinical documents from some 2.9 million patients and discovered a connection between prescriptions of a certain kind of heartburn drug and heart attacks. One in 15 Americans takes these drugs, the so-called proton pump inhibitors (P.P.I.s) such as esomeprazole (Nexium), omeprazole (Prilosec) and lansoprazole (Prevacid). The study found that they can increase your risk of a heart attack by about 16 percent, regardless of whether or not you have an existing heart condition.

This conclusion came from simple data mining, and confirmed earlier research conducted in 2013 and published in the journal Circulation indicating that P.P.I.s could potentially lead to long-term cardiovascular disease by changing the lining of blood vessels. Patients who were prescribed another type of heartburn drug, however, had no increased likelihood of heart attack.

I get that patients are nervous about releasing their health records. Studies have shown that even anonymous strings of DNA data can be linked to individuals. Patients understandably don’t want their acquaintances and employers to know all their private health information. But we cannot let these fears suppress the powerful insights medical data can offer us. When I explain to my own patients what can be done with their information for the greater good in research, nobody has ever said to me, “Don’t use my data.”

We all go to a machine on the street where we insert a plastic card and cash comes out; we log into our online accounts to check our balances and pay bills; and we give credit card numbers that contain a key to our financial information to retailers without a second thought. But if I asked you to put your de-identified personal health information online, or share it and perhaps some bio-specimens with people other than your own doctors, you might panic. “Health data is not the same as financial data,” you might say.

We need to move past that. For one thing, more debate over data sharing is already leading to more data security. Last month a bill was signed into law calling for the Department of Health and Human Services to create a health care industry cybersecurity task force, whose members would hammer out new voluntary standards.

New technologies — and opportunities — come with unprecedented risks and the need for new policies and strategies. We must continue to improve our encryption capabilities and other methods of data security and, most important, mandate that they are used. The hack of the Anthem database last year, for instance, which allowed 80 million personal records to be accessed, was shocking not only for the break-in, but for the lack of encryption.

We also must block attempts to discriminate based on health information for work or other pursuits with continued legislation, and portray those who participate in the sharing of health data as heroes. In fact, they are heroes: They are part of tomorrow’s cures for themselves and their children. We also need to revisit the cumbersome and obsolete privacy rules enacted by the Health Insurance Portability and Accountability Act of 1996 to make it easier for patients to participate. One idea is to establish a trusted middle “broker,” such as a dedicated nongovernmental agency, that can ensure that every effort is made to keep records anonymous before their release for research studies.

Medical research is making progress every day, but the next step depends less on scientists and doctors than it does on the public. Each of us has the potential to be part of tomorrow’s cures.

Adapted from Nytimes.

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Jack Westin
MCAT CARS Instructor.
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18 Comments


  1. mass data increases in field of medicine. doctors and patients worry about time of update and privacy.
    author gives examples on how only simple data mining can benefit millions of people’s health.
    thus, data sharing should be encouraged. but as data increases stronger securities and policies should be enacted.
    author is + on data sharing. it is up to public’s effort than doctors to make our future better.

    Reply

  2. Main ideas are that EHRs are an amazing way to collect and study mass amounts of medical data and practice. There is no denying that the records kept can be analyzed and studied for many purposes. The author calls on the public and health care professionals to get over the fear of this information being public. Also introduces conversation for government and 3rd party involvement.

    Reply

  3. MI:EHR’s, though widely opposed by the public and doctors, can be beneficial to the field of research and should be more accepted.

    Reply

  4. This author argues for the rise of electronic patient records for better research for cures and treatment.
    The passage mentions reasons why this step is critical and argues why people should get over the “lacl of privacy” argument.
    In the end, the author provides solutions to how we can begin to move toward this direction.

    Reply

  5. mass data saves lives, EHR good + saves lives, patients nervous

    Reply

  6. (first 9 paragraphs) MIP: EHR = good + can help w/ cures; tone = +

    Reply

    1. • Privacy matters + Mass data saves lives
      • DD = use what we have (AU)
      • HR release = concern (AU) + greater good (CW)

      Reply

  7. M.I. These digital databases offer an incredible opportunity to examine trends that will fundamentally change how doctors treat patients.” Author tone: positive, persuasive. Structure: introduces argument, supports with 2 anecdotes. Ends with comment that with EHR regulation is encryption is necessary, but overall EHR more pros than cons.

    Reply

  8. MI: Collecting PHI is essential in determining new advances in medicine. More works can be done to protect this information.

    Tone: For collection of PHI

    Reply

  9. Theme: As a doctor, the author is advocating for the sharing of patient personal data so that the mass data can better inform medical professionals about illness and treatments which would not be that apparent in our daily lives. He is aware of the concerns about patient confidentiality and the misuse of personal information and strives to promote the benefits that come with data mining and sharing. (central)

    Electronic health record system facilitate the work of healthcare professionals (access to their medical information and avoiding….) However, doctors feel that it is time-consuming to keep updating patient records and patients worry that patient confidentiality will be compromised. Author feels differently despite being a doctor (need to get over it….databases offer an incredible ….examine trends that will fundamentally change…help discover cures…new uses for drugs….better track the spread)

    Beta blockers found to improve overall survival in ovarian cancer patients and use of PPIs increase heart attack risk regardless of pre-existing heart conditions (anecdotes)

    Author is cognizant that patients do not want to release their medical information for personal reasons even if their data can contribute to the greater good in research. He feels that such information is no different from the financial information we provide to retailers but people are still antsy about it (association).

    Author is calling for more data security as data sharing become more prevalent in future (create a health care industry cybersecurity task force..hammer out new voluntary standarfds) and we must improve our encryption capabilities to safeguard patient data. He feels that it is wrong to discriminate base on health information (due to work, insurance, etc) and there ought to be a neutral third party agency that keeps information anonymous.

    Author feels that everyone has a role to play in shaping the healthcare system and improving the lives of patients.

    Tone: Encouraging and positive about how personal data can be used for the greater good, sympathetic to the concerns of people who are afraid of the risks involved in the sharing of information so provides suggestions and anecdotes to strengthen his case.

    Reply

  10. MIP: release EHR= data mining + new cure + increased cyber security.

    Reply

  11. MIP: mass data = helpful, medicine = surprising discoveries, patients = nervous BUT no fear

    Reply

  12. Mass data = saves lives. E.H.R = very useful. Patients = privacy concerns.

    Reply

  13. MIP: EHR = helpful, pts. = privacy concerns; positive towards EHR

    Reply

  14. MIP: EHR is a good method for medical records because it has, and can lead to many medical benefits ex) Beta blocker ex) Nexium

    Reply

  15. health data = people panic; people need to get over this. debate = data security; data = trends = change + discovery that can help medicine. Author = doctor who supports data sharing

    Reply

  16. MP: Using the data from human subjects can be useful, but we need to change the stigma of sharing medical information because it can benefit the future generation
    tone: (+) in the wanting to use medical information (POV from a doctor)

    Reply

  17. MIP
    (1) EHR = good + increase opportunity b/c lots of data = medical improvements
    (2) Privacy measures for pts must be taken

    Tone
    Positive towards EHR!

    Reply

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