Privacy provisions threaten health IT bill

A health information technology bill that would strengthen privacy protections for electronic health records won the approval of a House subcommittee today.On a voice vote, the Energy and Commerce Committee’s Health Subcommittee approved the Protecting Records, Optimizing Treatment and Easing Communication Through Healthcare Technology Act of 2008 (H.R. 6357).The bill now goes to the full committee. However, there were signs that its path might not be as smooth as it was in the subcommittee.Several committee members, both Democrats and Republicans, offered amendments to modify privacy protections and other aspects of the bill. They withdrew the amendments under an agreement with the subcommittee’s chairman, Rep. Frank Pallone (D-N.J.). He is the bill's chief sponsor, although it has bipartisan support.Pallone said he will meet with the dissatisfied subcommittee members to discuss their concerns and possibly compromise on the sections of the bill they find objectionable. But he added that the bill had been drafted with input from lawmakers in both political parties.Rep. Nathan Deal (R-Ga.), the subcommittee’s ranking member, said he supports the bill but has concerns about the provisions regarding consent and marketing.The consent provision states that doctors, hospitals and other health care providers who EHRs “may not use or disclose such protected health information for purposes of health care operations unless the [provider] obtains the consent of the individual to disclose such information for such purposes, and any such consent shall be revocable by the individual at any time.”Rep. Steve Buyer (R-Ind.) also objected to the consent provision, calling it too broad and vague. Rep. Mike Rogers (R-Mich.) said its lack of clarity could hinder doctors’ adoption of health IT. He offered an amendment that he said had the support of 40 members of Congress.Pallone said he had negotiated the consent provision with Rep. Joe Barton (R-Texas), ranking member of the Energy and Commerce Committee. “I’m certainly willing to have further discussions,” Pallone added.The marketing provision would prohibit companies from using health records to market products and services to individuals. It would also ban payments to doctors or hospitals in exchange for their patients’ information if that information is to be used for marketing purposes.Other provisions of the bill would:

• Establish in law the Office of the National Coordinator for Health IT.
• Create a health IT policy advisory committee and another health IT standards advisory committee.
• Require federal agencies to use official standards in new or upgraded health IT systems.
• Create several grant programs.
• Strengthen enforcement of current privacy provisions and extend them to partners who receive health care information from medical professionals.