Social Security Administration Launches E-Health Info Exchange 114
Lucas123 writes "In what could be the start of a national health information exchange system, the Social Security Administration became the first federal agency to go live with a public-private electronic health records information exchange that will cut wait time for 2.6 million Americans who apply for benefits each year by weeks or months. The electronic exchange runs on a database operated by a non-profit organization in Virginia and open-source software deployed at the Social Security Administration. 'The goal of the NHIN effort is to enable secure access to health care data and real-time information sharing among physicians, patients, hospitals, laboratories, pharmacies and federal agencies ... regardless of location or the applications that are being used.'"
Miscategory? (Score:2, Informative)
This should be in politics, not science.
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With regards to celebrities' medical info being released, doesn't that happen already? Either voluntarily, or because someone got paid to out it, there are very few "stars" out there that don't get their private info displayed on national media on a regular basis. In any case, as you just said, they at least have the resources to pursue any offenders, so personally I couldn't care less..
As for "everyday" citizens' medical records being vulnerable.. Well, as more and more info is added onto everyone's files,
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You only need to get tested regularly if you are engaging in risky behavior. Sleeping with someone you are only marginally acquainted with is risky behavior.
Most people can wait to get tested until they notice symptoms.
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All I want to know is....How can I opt out???
Do not want (Score:3, Insightful)
Re:Do not want (Score:5, Interesting)
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There are other ways to accomplish that without a big centralized database that everyone has access to.
The insurance companies are going to love this.
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Re:Do not want (Score:4, Insightful)
The potential for abuse is far too high here. I'm sure that not all medical staff are happy with their current pay. Why not supplement it with some nice data grabbing? This also creates one very big target for attack. The more people's data you have in one place the more likely it is that someone's going to try and get it.
The GPs mention of the potential for abuse by insurance companies is right on. Look at credit - how easy is it to fix your credit score if it's been all jacked up? It's not. I can't wait for "health scores" that are similarly disastrous. That'll be all kinds of fun.
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Why shouldn't insurance companies be able to charge more for people who don't take care of themselves?
There are lots of good reasons for a wealthy society to provide medical care to everyone, but the current model where insurance companies don't get to act like insurance companies is pretty much insane (I'm young and healthy and not particularly inclined to engage in risky behaviors; if I have to pay more for people that are not healthy and take stupid risks, let's not call it insurance).
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You will not be young and healthy forever.
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Yes, but I'm advocating for reasonable discourse, not 'fuck the sick' insurance-based healthcare.
Convincing people that their current medical coverage isn't really insurance is probably a good step towards improving things.
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That's true, and a lot of people don't take care of themselves. I think that encouragement by one's doctor is probably a better tack than trying to hit them in the pocketbook (well, that, and fixing some of the way big business influences health boards - did you hear about lobbyists for American sugar interests preventing health standards advocating less sugar intake in a healthy diet from being established?)
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I understand the "if there's an emergency" argument but a country-wide health care information system would not solve that issue effectively.
There are very few (very, very few) true health emergencies where a physician spending time reading notes will be more helpful than hands on treatment. I am defining an emergency as "you'll be dead in 10 minutes."
Per your example: Allergy attack? There is a standard treatment. Allergy attack after life-saving procedure? There is a protocol.
MI/arrhythmia? There is
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And, certainly, you don't fly air craft or drive truck or bus for a living. I realize that if you were diagnosed MANY years ago that all of these restrictions may have felt like an undue burden but... well, once can never be too careful.
Dude, there is a reason why medical
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Re:Do not want (Score:5, Insightful)
States would probably do a worse job of it, and we'd probably end up with 50 systems that don't talk to each other (well, actually, more likely 14 done, 5 that never finished implementation, 20 stalled in legislature, ...).
It's most useful if it's seamless across the nation so if for some reason I'm injured in another state my information will be available with no fuss.
Re:Do not want (Score:5, Informative)
I'm not saying that having a national medical database is necessarily a good thing, but it's immeasurably better than having individual state repositories.
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I'm not saying that having a national medical database is necessarily a good thing, but it's immeasurably better than having individual state repositories.
I tend to agree, but I think you have a different definition of 'immeasurably' - my definition is "not measurable" because there ain't nothing there.
They say Mussolini made the trains run on time.
I think that this sort of information does not need to be networked. Sure standardization of formats is good, but networking is not. Put it on a usb fob that hangs off your keyring and password protect it.
Based on gut instinct alone, I believe that the number of people who will be unconscious in an emergency situ
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Yes, far better for one single, centralized system to not work or never be completed.
Brett
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it seems that this is just ripe for abuse, data theft, data loss, and misinformation.
Doctors and Hospitals don't exactly have the most secure networks,
which effectively guarantees that botnets will have access to their L:P's.
In other words, if it is accessible over the internet, just assume that it is public.
Re:Do not want (Score:5, Informative)
While I agree with your sentiment about doctors (after all, their expertise is medical (chemistry, bio), not technical). However, I am betting that your comment about hospital info security is borne from not having worked in such an environment.
Having run the IT side of a hospital's foundation, and having to interface with their network security, I can say that most definitely they are very competent with data security. Now mind you, this is in Canada -- but I doubt the competent sys admins are only born north of the border.
Hospitals (and the several sys admins I have known that run them) are very much on top of their game -- even the the point of being a pain in the ass to work with (which is both good and bad). Many doctors and nurses absolutely hated the arcane network security protocols in place, but they worked, and the hospital network maintained triple-9 uptime.
Take my anecdotal evidence with a grain of salt, but from my experience, hospital networks are QUITE secure.
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and I get blowjobs at 3 in the afternoon.
Does your wife know about this?
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Hospitals are pretty good, perhaps.
Individual practices not so much. I work with quite a number of smaller, 10 Physician and under, practices and without exception they are terrible at security.
Absolutely anything that inconveniences them or slows them down for 1 second, including a single extra mouse click, is immediately rejected as "taking too much time".
I hate to say it but the government needs to start wielding the HIPPA ban hammer so that these Doctors will start taking patient information and confide
Re:Do not want (Score:4, Insightful)
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But if they really want to do the job right, they'll shoot you AND change your blood type in case you live long enough to get a transfusion.
Value of Data (Score:5, Insightful)
There are probably many unscrupulous companies out there that would vet new hires based on health factors such as mental health history, insurance risks (for companies with private insurance), or simply the fact that the STD you have may indicate you are more likely to sexually harass coworkers.
Someone having your online banking account information can only steal the money you have at that time. Someone having your medial information can steal your ability to make money.
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Provided sufficiently strong security is used then I don't see how this is any different from online banking or credit card purchases through online stores,
LoL. "sufficiently strong security" isn't, unless you're going to create a medical version of SIPRNet [wikipedia.org]
Keyloggers and trojans make a mockery of any attempts at securing anything connecting to the internet.
So please, define "sufficiently strong security," because even the most secure backend is as weak as the weakest clients accessing it. And you know that 'secure' clients will never be mandated.
Re:Do not want (Score:4, Interesting)
A few comments on this:
1] Given the way records in private medical databases are protected (or rather, not protected), this system will at least have the sunshine of many eyes making sure its security, data loss prevention, and procedures to correct misinformation, is all up to date.
2] Invasion of medical privacy is only a major concern in the US because of the presently legal practice of insurance companies cherry-picking only the healthiest of people to insure. If the US had a national health care system like every other major first world nation, there would be little or no economic incentive to go sneaking peeks at people's medical records. So fix that instead.
3] This will both increase the quality and decrease the price of medical care. It is a step up.
4] Back to my point #2. This is one of the many kinds of efficiencies that are not dangerous only when you have a national medical plan. So long as we have economic incentives for doing bad things, those things will happen. Oh, but public-schools=socialism! libraries=socialism! public-health-care=socialism! It seems like the only thing that isn't socialism is covering the bad bets of right wing gamblers on Wall Street. All trillion dollars of it.
Competition between governments (Score:3, Insightful)
Don't you think western civilization is general would be stronger if we tried multiple approaches in parallel and saw which worked best?
Paying higher taxes for more government service is good, people can move from the US to Europe or Canada. If you prefer to pay less taxes and get less, you can move from Europe or Canada to the US.
Re:Competition between governments (Score:5, Insightful)
But the US-like health system is widely available in most 3rd World countries, so there is no lack of alternatives.
Get a 1st World health care system. Those that don't like it can move to Sudan or Chad and be happy.
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As you mentioned, this system is available in 3rd world countries. Those third world countries are also different from western culture in other ways, such as respect for the rule of law, individual rights(1), etc.
(1) "Individual rights" in the sense of not being interfered with. You can argue that having people help you, for example, by paying for your medical care is an individual right too. But the US obviously does not respect those.
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you must be horribly misinformed about the state of real world outside the US
Well, I happen to live in that place, the "real world outside the US".
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"works best" isn't always clear in hindsight, and some solutions are abusive to even try. If we decided to provide very little healthcare to anyone except the very wealthy, provided very few services of any kind to people, and invested very little in quality of life, we might have a very economically efficient government that would have saved enough to have an edge over other governments, but this would be neglect. Investment in quality of life is worthwhile, even if it demands some sacrifices in economic e
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If the US had a national health care system like every other major first world nation
We do. Do you really want your health care to be like Medicare?
Besides, Obama is working on it. It's called "Health Care Reform".
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The thing that worries me is the amount of information sharing, it seems that this is just ripe for abuse, data theft, data loss, and misinformation. I would love it if just my doctor had access to my medical records instead of everyone and their brother.
Anyone can have my medical information, as long as only my doctor can associate it with me.
So is the open source backend using the OpenEHR data standards, or did someone re-invent the wheel yet again? I see no mention of OpenEHR in the article.
BBH
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Maybe your medical (and financial) records should be DRMed?
I'm only half joking. If you buy the music and movie industries' argument it's such a great idea, why shouldn't it be applied for the benefit of consumers?
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In reality though, the data will get stolen and then they'll tell people it's okay, because really what have you got to hide.
I can't wait though to gain access to all those SS numbers. Kind of like a government bailout plan for hackers.
Sounds good to me (Score:3, Insightful)
I realise that a lot of geeks care a lot more about their privacy than I do, and this might be bad news for them, but personally I would love not to have those endless forms to fill out every time I see a new doctor, and it would be very handy if I had access to all my medical records through a web browser.
The difference between having this and not having this is akin to investments/banks that provide web interfaces and those that don't - I have one credit union account that's not on the web and it's kind of irritating that I have to physically show up (or wait for a statement) to check the balance on it. All the rest are conveniently available to me whenever I want to bother logging in.
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Well, if you understand that I don't care too much about my privacy, you see that the negatives arn't very big for me. I also have the benefit of working for a university - my insurance is at a flat rate, they can't refuse me coverage, etc. I realise this isn't the case for everyone though..
In the long run I hope we reform our insurance system so that the coverage concern you raise can be addressed. Thanks for bringing it up - I had forgotten about that concern.
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Anyone with relevant life-saving data to provide to a doctor usually already has it hanging on their wrist or neck.
http://en.wikipedia.org/wiki/Medic_alert_bracelet [wikipedia.org]
These work even when the victim's wallet is stolen (no ID). A centralized database does not, unless you plan to also have a fingerprint/DNA identification database.
So:
$5 solution,
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If you are worried about insurance companies acting like insurance companies, you should just advocate for a switch towards some sort of universal payer system (because denying the companies the ability to discriminate based on the thing they are insuring means that costs end up shared anyway).
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You'll still have to answer all the stupid questions, they will just have the answers there to compare them to. I asked about this last time I went to see my doctor. I got a vague answer from the nurse, but it's probably CYA to avoid lawsuits. The mere fact that they have a list of what meds you were on yesterday and you say "same as yesterday" apparently isn't enough. I expect the medical practitioners' insurance companies and legal counselors require them to do this.
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How can you know before the system rolls out what the answer is going to be?
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There are compromises:
What about a system where you have a card with a chip on it that stores all your medical info (locally), but requires your fingerprint be read into a local scanner to decrypt it? That way, if someone stole your purse you wouldn't necessarily lose your privacy, but you'd have a convenient way of carrying the information with you. In case of emergency where you don't have your card, a special request could be put in (and would require your fingerprint to access the data that way as well)
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The compromises make more sense for other people - I don't want any information that I might lose or need to bring with me - I would prefer my health information be in a database that's backed-up and available to anyone in the medical profession that might need it. There are laws protecting against disclosure for these things.
I understand that others might feel differently, but I really don't care much about privacy. If someone else had HIV or were the victim of sexual assault, I wouldn't treat them much di
Pill Heads (Score:1, Troll)
Hopefully this will keep those worthless Baby Boomers from prematurely bankrupting Social Security with multiple prescriptions for their endless psychological disorders and sports injuries.
Re:Pill Heads (Score:4, Informative)
You were modded Troll, but you make a good point. Baby boomers have got to be the biggest pack of whiny, self-indulgent motherfuckers that ever lived on this planet. Even though they are all getting old now, they still act like a bunch of goddamn teenagers. The sooner they die off, the better America will be.
Re:Pill Heads (Score:5, Insightful)
Baby boomers have got to be the biggest pack of whiny, self-indulgent motherfuckers that ever lived on this planet. Even though they are all getting old now, they still act like a bunch of goddamn teenagers. The sooner they die off, the better America will be.
A correction: "Social Security" is OASDI, a "trust fund" of government debt that will start to be drawn down in 2017 and exhausted by 2041, at least according to the last projections by the Social Security Trustees [socialsecurity.gov].
"Prescriptions for endless psychological disorders and sports injuries" are covered by Medicare: a separately funded program. It in even worse shape -- the "trust fund" is expected to be exhausted by 2017 [hhs.gov].
Some of us baby boomers have been pointing out the problems with both programs for the last 30 years, and have been effectively told by previous generations to STFU. But at this point, Social Security alone has collected about $500,000 from me (assuming a modest rate of return).
I didn't plan to depend on Social Security benefits. But, my expectation is that I will need them just to pay the increased income taxes that will be required to fund the current administration's spending spree. So, I will offer you the same advice given to me when I was in your position: STFU.
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Another problem is the "tax base" thingy that effectively makes FICA one of the most regressive taxes in existence.
Taking a smaller slice of a bigger pie would make things fairer.
But oh noes, it would make the rich fatcats actually notice how much they are paying.
Get rid of the stupid cap and make sure the rich chip in their two cents. If you're freaking rich, a few thousand dollars in SS taxes will be to you what a handful of change is to the average joe.
In fact, if we got rid of the cap and made SS taxes
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Another problem is the "tax base" thingy that effectively makes FICA one of the most regressive taxes in existence.
Yes, about half of wage earners in the US pay more in payroll taxes (FICA and Medicare) than federal income taxes.
But oh noes, it would make the rich fatcats actually notice how much they are paying.
No, they would simply shift their compensation to non-wage income.
In fact, if we got rid of the cap and made SS taxes a mere 1 percent of your income, I would propose that there would be a net gain.
You would be wrong.
http://www.cbo.gov/ftpdocs/88xx/doc8885/EffectiveTaxRates.shtml [cbo.gov]
See Summary Table 1. Note the effective tax rate for social insurance taxes was already 1.7% for the top 1% of US taxpayers in 2005. Of course, if you are proposing that your 1% is actually 2% (1% from employee + 1% from employer), then
Current disability queue times (Score:5, Informative)
When you file for long-term disability with Social Security, they need to grab all of the recent medical records from your primary physician and all the specialists you're seeing. This process takes a long time, generates a ton of redundant paperwork (many dupes of lab work and such that went to multiple places), and isn't very accurate. I went through this a few years ago with my mother. One of the physicians didn't respond in time to the request they sent for more information, stuff that was pretty critical. We believe that was one of the factors causing her initial claim and first appeal to be denied.
That was over four years ago; her case is just coming up for the final review now. That's how big the backlog is here, and medical records processing time is one of the big drivers to the process.
At the point where you're applying for Social Security disability, your medical records are no longer really private anyway. They're going to scour everything available to confirm that what's happened to you is both permanent and real.
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4 fucking years?
Are you serious? That's ridiculous to the point of being almost unbelievable. If I hadn't had to deal with a similar situation with my grandparents, I wouldn't have believed you.
In their case, it was resolved in just a couple months.
(which is also ridiculous)
From a government worker's perpective, what's the big deal? I mean, you go in day after day and do the same job. No reason to hurry, cause if you do then there's just more files going to be waiting for you. Just like the DMV. *sigh*
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I can verify what he says. Four years isn't hard to believe.
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I never knew why I'd go into stores and see cans for donations for so and so because they need this medical procedure. It took us over a month to get my brother moved over to a new group in Medicare and it was almost impossible to get care from the insurance companies for my Mother.
After endless hours on phones, driving to doctors offices, filling out forms, you begin to wonder if that can thing will work.
After dealing with
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Workers are mandated to clear work by a certain time period. In my experience, your characterization is not valid. The truth is that the workers are overloaded with work and can just barely keep up with the mandated clearing deadlines.
While I am no fan of government spending, if you're going to have these programs, investments in efficiency (whether that be IT, business process redesign, or just fixing stupid fucking government policy handbooks) are a good idea.
If we were talking about private industry, thi
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This new system will reject you in a much more timely matter so you no longer have to die of your illness without the headache!
All joking aside, I hope your mother gets the treatment she deserves.
The system is horrible. It is outrageous that they take our hard earned money our entire life and then we have to beg to get some it back for something we actually need.
Social security really needs to be voluntary. Right now the excuse is medical records. There'll always be an excuse for why they can't get you what
Just remember, ... (Score:2)
Social Security isn't a bank account. It is an inter-generational support system. The money deducted from your paycheck isn't for you later, it is for older people now. When you reach retirement, younger people will be paying for you.
The problem is, the system is predicated on the idea of there always being more young people to pay for fewer old people. As long as there is a high birth rate and the population is increasing, we're fine. Unfortunately, the population isn't growing due to a high birth rat
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So this is why the last administration didn't want to spend money on sex education, it was their big plan to save SS.
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The amount she's due is actually quite small, and doesn't impact her medical treatment--just her dignity as it leaves her relying on others for money more than she'd like. As someone who only worked sporadically before and after raising children, the monthly amount she's entitled to is approximately one week worth of what you get when collecting unemployment benefits for example. I can't decide if that makes that her case has been floating around for so long more or less outrageous.
Just another insecure system based upon SSNs (Score:2)
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Who's taking bets on how soon insurance and marketing companies get access? And then use it against you.
Just the other day I went to my doctor for a routine checkup. Then yesterday I visited my dentist to take care of a cavity.
Today I took my car in to get the oil changed and they gave me a sample bag with an air freshener, cavity fighting toothpaste, and penis enlargement pills.
Really, it's nobody's business that I get cavities!
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Remember all of those credit rating sites that ended up being nothing more than access points for "bill collectors" and arbiters? Same thing repackaged. Just wait for more random calls from some guy in Buffalo.
Equal screwing for all... (Score:2)
Who's taking bets on how soon insurance and marketing companies get access? And then use it against you.
Soon, it won't be but a mouse-click away for "Big Brother" to correlate and compare the triple-cheesburger purchase you made on you (G-Bank of Ameridebt) credit card with the G-Med records system that has the nasty doctors note about your bad cholesterol levels. Don't worry, they'll adjust your rate for you...weekly.
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LAMP for a high-priced Genie... (Score:2)
"...open-source software..."
"...enable secure access..."
"... regardless of location or the applications that are being used."
So in other words, it's the world most expensive installation of LAMP with SSL, isn't it?
If it's anything more complex than this, it probably shouldn't be, but since the Government is involved...well 'nuff said.
True purpose (Score:2)
Re:True purpose (Score:4, Interesting)
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The entire process of determining need is a perfect example of this waste. When you've known someone for 10 years or you live next door to them it's pretty easy t
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Now I just die in spirit.
line item opt out (Score:3, Interesting)
Has anyone ever anywhere suggested a line item opt out?
I know there are people out there who feel the need to keep health secrets. Probably they are clinically paranoid, but that's not the issue I'm discussing here (although I will make fun of them anyway).
Why not have a line item opt out?
Normal or highly extroverted people would not opt out of any line item because they don't care. Most old people I know seem to greatly enjoy telling everyone about their operations and such, so the old people's unwillingness to learn something new would be no problem.
People whom in my opinion are unbalanced would opt out of absolutely every line. And that's perfectly OK. Of course if a parent opts out a line for their kids stating they are allergic to bee stings, and the kid dies of a bee sting, who gets the blame?
Personally I couldn't care less if everyone on slashdot learns I am allergic to amoxocilian and I had a mild bout of pneumonia back in 04 that was cured in about 4 hours with a three pack of zithromycin. But IF I had something to hide, I'd just log in and click "hide" and away it goes like it never happened.
Doesn't seem like much of a technological challenge.
Another interesting option would be a nationwide registry of stuff you'd WANT to publicize, like allergies. Sign a release form and the dr will post it. That seems like a blindingly good idea in general.
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You aren't thinking that through at all.
You say only paranoid people would have an issue. So, I suppose a woman who was treated for a sexual assault and doesn't want everyone on the planet knowing about it would be clinically paranoid to want to opt out? I suppose a man who is HIV+ and doesn't want to broadcast his status for fear of social repercussions is paranoid if he doesn't want to share his records with the world? Are they "clinically paranoid?"
If the data gets stolen (and it will - we can't even kee
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here's one fall-out of this great 'dissemination of information' that we're being dragged into (quite involuntarily in many cases):
the chilling effect. yes, when you suspect or even KNOW that your info - your very private info - is going to be snooped or stolen or used against you - then you will STOP supplying such info whenever you can.
this will have bad effects. suppose someone should seek help for a medical or even psych disorder but is AFRAID of having that entry on his/her record? don't laugh - thi
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I'm curious why I never hear anybody suggest a strictly opt-in system, with a disclosure contract required at sign-up time. It should explain the risks inherent in any such system, as well as spell out in detail exactly who is going to be allowed access to your data. A purely opt-in should keep the privacy pundits quiet... relatively, anyway. Legislation could accompany prohibiting any agency from discriminating based on participation.
Likewise, they could implement some sort of temporary authentication m
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Has anyone ever anywhere suggested a line item opt out?
Yes - Canada has the Personal Health Information Protection Act (PHIPA) which has what is referred to as the concept of "Lock box." The idea is that you may direct a healthcare provider to not disclose certain data about you. When sharing data, the provider is allowed to disclose that there is additional "lock box" data.
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I know there are people out there who feel the need to keep health secrets. Probably they are clinically paranoid, but that's not the issue I'm discussing here (although I will make fun of them anyway).
let me guess, you're 20something or even younger. and in perfect health.
in 10, 20 or so years, you'll come to rely more and more on healthcare. you'll come to realize that its no one damned business but your own.
my views changed as I got older. I saw it happen and did not take the view that I now have. ti
Learn from the past: GJXDM, NIEM, N-DEX (Score:2, Interesting)
That's a LOAD! (Score:2, Informative)
Being someone that has just finished going thru the whole damn Disability process, this is mis-information designed to make the SSA look good.
The problem isn't that the records don't arrive in a timely manner, the real issue is the ridiculous way SSA goes about processing requests.
After filing my Disability Claim, two months later, SSA asks me to go see one of their "approved" Doctors. I arrived for my appointment, was taken to an exam room, and when the
Fire Sale time ! (Score:1)
SSA computer room is secure, right?
the reach of e-gov't (Score:2)
.
Funny, from that title (and article), I originally thought: 'so the SSA is taking over DHS' since they can't find one legit and sane person to run it. Then, SSA running healthcare? We sure F'ed now...
Then I read TFA and all was well again, back to regular politics.
Open Source? (Score:2, Interesting)
I can find no source, open or otherwise.
I can also find no mention of the standards that are being used.