Tuesday, April 2, 2013

EMR and Troubles with Identity Privacy



So recently I received a bill from an out of the state medical clinic. The bill charges me with treatment that were obviously not rendered unto me. The bill contained my name and physical address.

I called them and they very quickly rescinded the bill.

However, there is one remaining issue, which is that the US has promoted Electronic Medical Records (EMR) system. In fact, it appears that there might even be a mandatory EMR system in the near future. Consider for a minute that such a thing happened when mandatory EMR system is in force. What would happen?
I may be rejected for health insurance on the basis of pre-existing condition based on treatment a hospital claim to have rendered. Is this possible? Well, I have a bill here from an out-of-state clinic that says YES they can make mistake like that and can affect my permanent medical record.

Mandatory EMR/EHR is a godsend for insurance companies. It means they can receive the full history of a person's past and perform sophisticated risk analysis that produce premium rates according to the person's risk for illness or injury.

One would react to a  $25 insurance premium by not buying insurance and react to a $5,000,000 premium by committing suicide. Because if it is entirely based on risk and incidence prediction a $25 bill means that insurance company expects to pay that or less for your treatment, and similarly a five million dollar bill would mean there are significant evidence that I will need to pay that much to live.

I had written a bit about how this company found my address and put me down for the bill, but I realize that by talking about it, I am letting the world know how that company found my personal address, and I don't want that, so let us not talk about the privacy problems here and move on to a larger issue:

The problem it could cause for us when an error is made is that our permanent record will be marred forever. I hate telling horror stories but let me tell this one:

4 months ago I leased my new 2013 Chevy Volt. California has a law that allows drivers of these environmentally friendly cars to drive in HOV lane using a "GREEN STICKER" which the DMV must issue. This is one of the main incentives that moved me to lease this car.

Needless to say it has been 4 months and I have not received the sticker to drive in the HOV lane. After two(3) series of phone calls and four(4) form submissions, I found out finally that my registration address had a problem from the start when I leased it from Boardwalk Chevy. I had a horrible experience leasing this car from them, being forced to sit through negotiation on a national wide promotional program with my eight-month(8) pregnant wife; being forced to sign contract three(3) times with numerous line items changing without due notice to me; the contract requiring me to pay upfront for 9 oil changes that must be used in 3 years(ON A FUCKING PLUGIN HYBRID that will not be burning gas most of the time); and then, after all that, having the wrong address entered into the computer so I cannot receive my green sticker.

But that is besides my current point, which is that there is a lot of racism and hatred and unkindness and merciless greed in this world added on top of legitimate human error and the Devil Satan. I do not believe we, as a species, have overcome these hurdles sufficiently to instrument an EMR system that will be central to our medical treatment.

If the address is wrong in my EMR, and I don't receive prescription or communication from the doctor, it could be a matter of life or death. I mean, having to sit in traffic for an extra 60 minutes every day is a matter of wasted life, but at least it is not something that caused the complete cessation of life as an EMR error of this sorts could cause.

I am against universal mandatory EMR in the United States any time this decade.

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