Senate votes to tighten patient-records security Medical database used to track costs

March 12, 1996|By Peter Jensen | Peter Jensen,SUN STAFF

Balancing efforts to track health care trends with patient rights to privacy, the state Senate last night approved legislation designed to ensure the confidentiality of records contained in a statewide medical record database.

The database was launched three years ago to document what kinds of health care state residents are getting and what they are paying for it. The information already has been gathered on a voluntary basis from many insurers, but soon the reporting will be required.

In recent months, that has raised questions about the privacy of those records. Although the records do not contain patient names or addresses, some people with sensitive medical conditions may fear seeking treatment for fear that someone might figure out who they are, critics have said.

The legislation, approved by the Senate in a 46-1 vote, attempts to ensure that records can't be traced back to patients. But it lacks a key provision sought by physicians -- the informed consent of patients.

Doctors and other health professionals argue that patients deserve to have a say over whether their records would be used by the state. The doctors want patients to sign a document agreeing to let their records be released.

"The general public is not being told what's going on," said Sen. George W. Della Jr., a Baltimore Democrat who supports informed consent. "People who seek mental health counseling may opt out if they think people are going to be looking over their shoulders."

But opponents say that requirement would ruin the data collection system by reducing participation and skewing the results. Some legislators suggest that some health care providers are trying to sabotage the database so it cannot be used to limit fees.

"Doctors ought to be telling their patients now that the information given insurance companies is not confidential and that has nothing to do with the database," said Sen. Paula Hollinger, a Baltimore County Democrat. "Their insurance information can be obtained by life insurance companies or by other health insurers, and it often ends up in the hands of employers."

The bill approved yesterday would eliminate a patient's day of birth from the records, retaining only the month and year. It also would exempt any information that might have been sought from patients who elect to pay for health services themselves.

The legislation stiffens penalties for disclosure of medical records, and it removes limits on how much money a person can receive in damages when they sue in connection with a violation.

The House Environmental Matters Committee last week killed legislation mandating informed consent. Supporters of the Senate bill said the House committee is likely to look more favorably on the revised version.

John M. Colmers, executive director of the Maryland Health Care Access and Cost Commission which collects the data, said he believes the system already ensures confidentiality. But the Senate bill will not harm the process, and beefing up the penalties for illegal disclosure of medical records helps the public generally, he said.

The commission expects to collect information on 60 percent to 75 percent of all medical procedures performed in the state. The data will help in tracking health care expenditures, documenting, for instance, what procedures are being used, how much they cost and the impact of health maintenance organizations on use.

"If we're going to be down here on policy matters, like whether new mothers should be guaranteed a 48-hour hospital stay, we ought to have more than the anecdotal information we have today," said Sen. Thomas L. Bromwell, a Baltimore County Democrat and chairman of the Finance Committee.

Pub Date: 3/12/96

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