Questions & Answers

Why is protecting patient privacy so important to you?

While serving for ten years as the first Information Security Officer at The Medical Center Hospital of Vermont, (now Fletcher Allen Health Care), I met and spoke with many individuals whose privacy rights had been egregiously violated. These meetings left a deep impression on me.

For the past eleven years I have served as a consultant to several hospitals and health systems. In this capacity, I have advised my clients on how to handle serious breaches of confidentiality. In the process, I have been privy to some damaging violations of patient privacy. You just don't walk away from these incidents and not be affected.

Most importantly, protecting patient privacy goes to the heart of the physician - patient relationship.

In your talks, you often speak about the relationship between protecting patient privacy and quality of care. Could you briefly explain how you see this relationship?

When we trust our physicians and other health care professionals, we share with them our most personal information, our health information. As a result, we receive good health care.

But if we don't trust, we don't share. And, when we don't share, we compromise our care. It is really that simple.

When it comes to protecting patient privacy, has HIPAA helped or hurt the cause?

HIPAA has generated a national conversation about the importance of protecting patient privacy and that's good.

On the downside, I don't think many organizations are serious about meeting the requirements of HIPAA. Far too many are not in compliance with this federal mandate. One reason is because the federal government is not serious about enforcing this rule. Another reason is that the fears about using health informtion for marketing never materialized.

Do patients understand their rights?

All the evidence we possess indicates that patients do not understand their rights. When you consider the bulky Notices of Privacy Practices, it is easy to understand why this is so.

When you look back on your career as an information security officer, what was the most difficult moment you can recall?

There were several difficult moments. I'll share one.

Early in my career a nurse I'll call Karen was admitted to the Medical Center with a diagnosis of leukemia. She was treated at the Medical Center and at Dana Farber in Boston. When she was in our house it was hard to protect her privacy. Many staff felt entitled to look up her lab results and nursing care plans. I can't tell you how much time a few of us spent trying to protect Karen's privacy. It's hard to believe that health care professionals saw nothing wrong with violating Karen's right to privacy, particularly during this most vulnerable moment in her life.

What makes one hospital so successful in protecting patient privacy and another one less successful?

Hospitals are no different from other organizations. When senior management is committed to protecting patient privacy and communicates this commitment to others, you will find good policies and practices.

When you think about protecting a patient's right to privacy, what worries you the most?

For several years I have worried about safeguarding the health records of persons with HIV/AIDS. This is a group that continues to face discrimination in employment and health coverage.

While I still worry about HIV/AIDS patients, I am growing increasingly concerned about the number of individuals who have access to information that pertains to genetic testing and counseling.

On a lighter note, do you have any hobbies that take you away from this consuming passion of protecting patients' privacy rights?

When my father was thirteen years old he won first prize in a photo contest that was sponsored by Eastman Kodak. The year was 1924. In order to collect his prize, my Dad traveled by train from Baltimore to Cleveland. His father and sister went along and then later they settled in Cleveland. After serving in WWII, my father became a professional photo finisher. I worked for him during several vacations and somewhere along the way I developed a keen interest in photography. It is my one and only hobby, another real passion.

I also enjoy writing and during the past few years I have been a member of the Burlington Free Press Writers Group. I wrote Op-Ed articles on Vermont's people, issues and events.

Click here to read these articles.

What's on the bed stand?

I am reading The Nine: Inside The Secret World of the Supreme Court by Jeffrey Toobin.