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Physician Faces Jail Time For Looking At An Electronic Medical Record

July 5th, 2009 by RamonaBatesMD in Better Health Network, News

Tags: Arkansas, Curiosity, EMR, HIPAA, Jay Holland, Pressly

As we move towards EMR’s, the ability to know who has looked at the medical record may get more and more people in trouble.   While we are all curious about our friends, neighbors, and celebrities (local or global), it is important to respect each others privacy.  This local Arkansas story shows the importance of this respect.

Hospital emergency room coordinator Candida Griffin, patient account representative Sarah Elizabeth Miller and Dr. Jay Holland, a family doctor who worked part time at the hospital, each face up to a year in prison and $50,000 fine if convicted of the misdemeanor charge.

I would hope that all three of the people listed above would have “known better.”  When this story broke earlier this week, the staff in the OR and I had a nice discussion on who gets HIPAA training and how much each get.

I think as part of their punishment, they and perhaps the facility (St Vincent Health System) should have to do refresher courses on HIPAA privacy rules.

The hospital said in November that it fired up to six people for looking at Pressly’s records after a routine patient-privacy audit showed that as many as eight people gained access to them.

It was not immediately clear whether others fired from the hospital would face charges. U.S. Attorney Jane Duke declined to comment about the charges Tuesday.

With paper charts, there isn’t a trail proving you or I accessed the chart without need to do so.  With EMR’s there is but this trail is not fool-proof.  If I haven’t logged off and you look over my shoulder, then ….

If you haven’t logged off and I ask for a quick look at patient 007’s lab work and you do me a “favor” of checking quickly.  See, not perfect.  No harm was intended and patient 007’s info may never be “leaked” to the press, but someone who perhaps had no need to access it did so.

My circulating nurse in the OR during the discussion revealed that she had heard a lot of talk about the Ann Pressly case which she admits she should not have.  She didn’t access the chart.  She was working in another hospital’s ER.  It was the police and EMT’s doing the talking.  There is no trail to “prove” those violations of patient privacy trust.

We need to be more careful in discussing patients and cases.  We still need to be able to discuss difficult or unusual cases, but this can be done without breaking a patient’s trust or privacy.  Names and identifiers don’t have to be used when stumped by a rash or odd presentation.

Dr Holland had no malicious intent, just curiosity.  Be careful.

Arkansas Democrat Gazette article Doctor, ex-hospital employees charged over Pressly records (subscription required) written by Linda Satter

3 charged with getting TV anchor’s medical records by Jon Gambrell (no subscription required)

*This blog post was originally published at Suture for a Living*

Happy Canada Day From The Canadian Embassy In Washington DC

July 1st, 2009 by Dr. Val Jones in Announcements, News

Tags: Canada Day, Canadian Embassy, Fete Du Canada, Flag, Happy Canada Day, July 1, Party, Personal, RCMP

Canadians and their fans celebrated a great Canada Day (Fête Du Canada) at the Washington, DC embassy, July 1, 2009. Canada Day is America’s Fourth of July equivalent.

I enjoyed the barbeque, air puppets, kiddie tattoos, and a photo op with the RCMP (aka the “Mounties”).

God bless Canada… but please don’t bring their healthcare system here. 🙂

If you’re a Canadian (or someone who loves ’em) check out the Canada Day party finder here.

Addendum: just added a bonus photo taken with a Blackberry – me horsing around.

Dr. Val’s Close Call With The DC Subway Crash

June 22nd, 2009 by Dr. Val Jones in Announcements, News

Tags: Crash, DC Metro, DC Subway, Nearest Hospital, Walter Reed

Life is short… and you never know when your time will be up. I was about to get on the train right after the one that crashed today. On a friend’s advice… I might just go buy a lottery ticket.

For more information on the crash check here. Those who want to find out if their loved ones were on the train may call 202-727-9099. Or follow #DC Metro on Twitter.

Cardiopulmonary Resuscitation (CPR) Training on iPhone

June 19th, 2009 by Berci in Better Health Network, News

Tags: Cardiopulmonary Resuscitation, CPR, Emergency Medicine, iPhone, Teaching

*This blog post was originally published at ScienceRoll*

Counterfeit Drugs: A Growing Global Health Crisis

June 16th, 2009 by Dr. Val Jones in News, Quackery Exposed

Tags: Counterfeit Drugs, Couterfeit Pharmaceuticals, Drugs, Fake Drugs, Global Crisis, Malaria, The Global Impact Of Fake Medicine

A resistant strain of bacteria –created by partially effective counterfeit antibiotics – doesn’t need a VISA and passport to get to the U.S.

–    Paul Orhii, National Agency for Food and Drug Administration and Control, Nigeria

I attended a conference in DC yesterday called, “The Global Impact of Fake Medicine.” Although I had initially wondered if homeopathy and the supplement industry would be the subjects of discussion, I quickly realized that there was another world of medical fraud that I hadn’t previously considered: counterfeit pharmaceuticals.

Just as designer goods have low-cost knock-offs, so too do pharmaceuticals and medical devices. Unfortunately, counterfeit medical products are a higher risk proposition – perhaps causing the death of hundreds of thousands of people worldwide each year.

It is difficult to quantify the international morbidity and mortality toll of counterfeit drugs – there have been no comprehensive global studies to determine the prevalence and collateral damage of the problem.  But I found these data points of interest (they were in the slide decks presented at the conference):

–    Pfizer Global Security raids resulted in seizure of 11.1 million counterfeit tablets, capsules and vials in 42 countries in 2008. Pfizer seizure of counterfeit drugs in 2008 were up 28.9% over 2007.

–    Within a 7 day period, 250 different Internet-based Viagra purchases were seized in a single mail center. After chemical testing, it was determined that 100% of the tablets were counterfeit.

–    Anti-malarial counterfeit tablets are common in East Asia and Africa, threatening to derail the US goal of decreasing malaria mortality by 50% in 15 countries. Chemical testing in Africa revealed that 20-67% of chloroquine failed content quality checks, and 75-100% of sulfadoxine-pyrimethamine tablets (for pregnant women) was not absorbable. Tests conducted in Cambodia in 2003 demonstrated that 27% of anti-malarials were counterfeit with quinine being 77% counterfeit and tetracycline 20% counterfeit.

–    Some “Canadian” mail order pharmaceutical prescriptions have very circuitous routes of manufacture, packaging, and delivery. One batch was manufactured in China transported to Dubai, then to London, then filled in Bahamas, sent to the UK, and then mailed to the US.

–    Counterfeit drugs are estimated to make up 30% of Kenya’s total pharmaceutical products, 20% of India’s, 10% of Russia’s, and <1% of US.

–    Most counterfeit medications found in the US supply chain seem to be introduced through Internet purchases.

–    The global active pharmaceutical ingredient production was estimated at $70 billion in 2008. China and India account for 60% of production

–    70% of all generic medications are manufactured in India. It is estimated that the Indian global generic business will grow to >$70 billion by 2009. India and China have much less stringent safety and regulatory standards, which provides fertile soil for counterfeiters.

–    25 years ago, most counterfeit medications were placebos. Today’s counterfeits have some active ingredients because sophisticated counterfeiters are looking for repeat business.

This conference provided a sobering account of the counterfeit pharmaceutical industry, tracking its exponential growth over the past two decades. That growth appears to be fueled by the outsourcing of pharmaceutical manufacturing plants to countries with limited regulatory oversight, and the sale of medications via the Internet.  So far, poor quality and contaminated prescription drugs are rarely found in US pharmacies – but that could certainly change. The FDA, US Department of Commerce, and US Agency for International Development are calling for an international public-private partnership to stem the tide of counterfeit drug manufacturing. But with little to lose (fines for counterfeit drug manufacturing are notoriously light) and much to gain (a slice of a multi-billion dollar industry), it’s unlikely that the counterfeiters are going anywhere anytime soon.

*This blog post was originally published at Science-Based Medicine*