Time for a checkup

January 19, 2004

ON ARRIVING at a doctor's office, the patient signs a peel-off sticker that is immediately removed and the name transferred to a computer screen, hidden by privacy panels from waiting-room view. The new arrival takes a number, as at a bakery, because names are not called out by the receptionist.

Future appointments can't be made at the reception desk, within earshot of others, only later over the phone. A helpful spouse who calls to change or confirm the appointment is stonewalled. Laboratory test results are hand-delivered to the office instead of sent via insecure fax.

These cumbersome complications are among the ways that some well-meaning health care providers have been interpreting new national rules designed to protect patient privacy. The result has been exasperation and confusion, with an estimated compliance cost of more than $20 billion that will be paid by consumers.

Federal regulators claim there's been initial overreaction and extreme misreading of the regulations, finally issued in April for the 1996 Health Insurance Portability and Accountability Act. But the law makes unauthorized release of medical information a crime, with a possible prison sentence. Hence, the sensitive precautions - and the booming demand for shredders, document disposal companies and privacy consultants.

The law has had positive effects, allowing patients to get copies of their medical records, add information to those records, and find out who else is seeing them. Hospital patients can block the institution from disclosing their names or detailed conditions. Employers are prevented from using health information in employment decisions. The law also is supposed to standardize billing and allow people to keep their health insurance if they change jobs.

Meanwhile, patients sign voluminous forms agreeing to the new rules - forms they usually don't read. Clergy and florists may be blocked from making hospital rounds. And police encounter barriers to quick hospital information on victims or suspects.

The new privacy regulations were intended to curb the abuse and misuse of confidential patient information - a worthy goal. But what is most needed now to balance privacy concerns with efficient medical treatment is a healthy dose of common sense.

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