Patient privacy protected and quality improved

By Jim Chase, President of Minnesota Community Measurement and Linda
Berglin, State Senator District 61

We read Kip Sullivan’s recent editorial on patient privacy with great dismay.  We believe it is time to stop using fear to justify bad decisions.  Sullivan is promoting fear of losing the privacy of our medical information as a reason to stop efforts that are improving the health of thousands of Minnesotans.  These efforts are supported and endorsed by the medical community because they know it is making a difference in the lives of their patients.  The health information being collected does not require a patient name or identifier to leave the physician office. Over 10,000 more diabetic patients in Minnesota will receive optimal care this year than five years ago, and we know from research that this will lead to thousands of fewer complications of this disease: fewer strokes, fewer heart attacks, fewer vision problems, and fewer amputations.  This will reduce health care costs as well as improve the quality of life for so many.

Mr. Sullivan distorts the risks of sharing quality information.  Data collected for many measures are summarized at the practice level and contain no patient specific information.  Files for the patient specific measures contain only the information needed for the measure, such as a blood pressure reading, and patient numbers are encrypted and protected.

The audit processes he questions have been successfully used for years to verify appropriate payments, something we can all agree must be done.
Now we use a similar audit process to verify the quality of care provided, something we believe is more important than the amount we have paid.  We know several dedicated nurses who provide these audit services who would be offended by Mr. Sullivan’s insinuation that they would not respect patient privacy, which they are required to do by law, and more importantly by the same professional ethics that bind the nurses and staff in the physician’s office.

We also must take issue with Mr. Sullivan’s attack on the poor.  He states that the poor “are less likely to comply with their doctor’s recommendations.”  This makes it sound as if poor patients choose to have bad care.  Low income people have worse results because they have greater barriers to care.  A new study from MNCM, sponsored by the DHS, using data that Mr. Sullivan would ban, has shown that some medical groups have been able to reduce the gaps in care for the poor by addressing those barriers.  The best doctors are not just recommending care and hoping patients will comply, but are helping patients find ways to achieve better results that work for them.  Mr. Sullivan misses the
point that risk adjustment is not about protecting physicians from
inaccurate reporting, but rather about how we can improve the care for those high risk populations.

Privacy of medical information is critical to all of us, but there is no reason we cannot maintain patient privacy and share information that helps improve the quality of care.  The only ones who should fear this are those who are satisfied with providing or receiving sub-standard care.