Clarification to This Article
This article about lobbying over privacy in electronic medical records noted the sum of campaign contributions from the drug industry and health professionals to Rep. Roy Blunt (R-Mo.), who sponsored an amendment to legislation on the issue in the House, but did not do the same for Sen. Tom Harkin (D-Iowa), who sponsored an amendment in the Senate. Since 2000, Harkin has received $1 million in donations from the drug industry and $1.8 million from health professionals, according to OpenSecrets.org. Harkin, like Blunt, said through a spokesman that the donations had no influence on his position.

Lobbying War Ensues Over Digital Health Data

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By Ellen Nakashima
Washington Post Staff Writer
Tuesday, February 10, 2009

The Senate and House appear headed for a clash over competing visions of how to protect the privacy of patients' electronic medical records, with the House favoring strict protections advocated by consumer groups while the Senate is poised to endorse more limited safeguards urged by business interests.

President Obama has called creation of a nationwide system of electronic medical records fundamental to health-care reform, and both chambers of Congress have included about $20 billion to jump-start the initiative as part of their stimulus bills. But as with much in the stimulus package, it is not just the money but the accompanying provisions that groups are trying to influence.

The effort to speed adoption of health information technology has become the focus of an intense lobbying battle fueled by health-care and drug-industry interests that have spent hundreds of millions of dollars on lobbying and tens of millions more on campaign contributions over the past two years, much of it shifting to the Democrats since they took control of Congress.

At the heart of the debate is how to strike a balance between protecting patient privacy and expanding the health industry's access to vast and growing databases of information on the health status and medical care of every American. Insurers and providers say the House's proposed protections would hobble efforts to improve the quality and efficiency of health care, but privacy advocates fear that the industry would use the personal data to discriminate against patients in employment and health care as well as to market the information, often through third parties, to generate profits.

Resolving these competing visions will be the task of House and Senate negotiators. The outcome could determine, for example:

· whether a hospital or doctor can make a profit by selling people's medical data, without their consent, to pharmaceutical companies for research;

· whether a hospital or other provider must obtain patient consent before sending them fundraising letters.

Neither version is perfect, both business and consumer groups say. But where the House bill expands a patient's right to know who has been given access to his health information, the Senate would defer that issue to the Health and Human Services secretary. And an effort in the Senate to require health-care providers to notify patients if their records were unintentionally disclosed has been blocked.

"The Senate really did address many of our concerns," said Mary R. Grealy, president of the Healthcare Leadership Council and a spokeswoman for the Confidentiality Coalition, which includes the American Hospital Association, Aetna, Blue Cross and Blue Shield, CVS/Caremark, drug companies and other major industry players. "We want to make sure that privacy provisions don't become a barrier to improving quality and safety, getting information to patients that would be useful."

On the campaign trail last year, Obama touted electronic medical records as critical to reducing costs and medical errors and improving health care. As president-elect, he said he wanted every American's medical records to be in electronic form by 2014 and has urged that funding toward the effort be part of the stimulus package. Obama supported the privacy measures introduced in the House, but he is refraining from endorsing any particular version at this point, a White House official said.

In letters, testimony, meetings with lawmakers and media teleconferences, industry lobbyists have argued that some of the provisions Congress is considering would impede health research, might prevent pharmacists from sending out refill reminders, could restrict doctors from finding out about a patient's risk of dangerous drug interactions, and might force hospitals to spend billions of dollars to retrofit computer systems and still not be in full compliance.

Arguably, far more than $20 billion is at stake. For instance, hospital officials said that a House provision requiring providers to account for routine disclosures of patient data could cost billions of dollars industry-wide. The Senate version would require that the Health and Human Services secretary take administrative costs and burdens into account in drafting a rule on that issue.


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