HHS: Everyone Can Opt Out of Government-Mandated Electronic Health Records System

October 5, 2009 - 11:12 AM
The U.S. Department of Health and Human Services (HHS) says that everyone can opt out of having an electronic health record included in the federally mandated national electronic-health-record system created by the stimulus law enacted in February.

Health and Human Services Secretary Kathleen Sebelius (Photo by Penny Starr/CNSNews.com)

(CNSNews.com) – The U.S. Department of Health and Human Services (HHS) says that everyone can opt out of having an electronic health record included in the federally mandated national electronic-health-record system created by the stimulus law enacted in February.

The $787 billion economic stimulus bill, the “American Recovery and Reinvestment Act” signed into law by President Obama in February, calls for “the utilization of an electronic health record for each person in the United States by 2014.” The law says the records should include a person’s “medical history and problems list.”

The law also says the electronic health record (EHR) will become part of a “nationwide health information technology infrastructure,” accessible with authorization by health-care providers and the government.

To make certain this happens, the law provides for doctors, hospitals, and other health care providers to be given financial incentives to begin participating in the EHR system by 2014. Doctors, hospitals and health care providers that fail to make “meaningful use” of the system by 2015, the law says, will be penalized with reductions in their Medicare payments.

But individual Americans can opt to never have an EHR entered in the system, according to Dr. David Blumenthal, who is overseeing the development of the system as HHS's national coordinator for health-care information technology.
 
“We want to make it clear that no one will ever have to use an electronic health record, if they don’t want to, and that when you do have electronic health records, they’ll have every conceivable privacy protection that is compatible with a useful health care system,” Blumenthal told CNSNews.com during a telephone news conference last Tuesday on EHRs with Secretary of Health and Human Services Kathleen Sebelius. (Listen here.)
 
Rep. Patrick Kennedy (D.-R.I.) recently told CNSNews.com that it would “totally be up to the individual” whether a doctor could list an abortion or an STD on their EHR. CNSNews.com asked Sebelius if that was the case, and whether patients could also prevent a mental illness or drug or alcohol abuse from being included on their EHR. 

Blumenthal spoke up to respond to the question, saying that EHRs will be privacy-protected, that a committee is studying how to arrange the privacy protections, and that people will be able to completely opt out of having one.

“We are extremely sensitive to the need for privacy and security of information,” said Blumenthal. “It is one of our very top priorities. And we have, actually have a health-information technology policy committee of national experts. We held a hearing on this topic just 10 days ago. This very question came up. We’ve charged that committee with studying how to protect patient information and they’re going to be reporting back to us.

“We want to make it clear that no one will ever have to use an electronic health record, if they don’t want to, and that when you do have electronic health records, they’ll have every conceivable privacy protection that is compatible with a useful health-care system,” Blumenthal continued. “So, we’re going to wait to see what this panel reports back to us on in terms of the exact protections that we’re going to build in.”

Blumenthal was asked in a follow-up question to clarify if the EHRs were mandatory or voluntary.

“Let me say this again: No one will ever be forced to use an electronic health record if they don’t want to,” said Blumenthal. “This is always going to be between doctors and patients. Now--so, that’s a given and so that, by definition, makes them voluntary.”
 
Blumenthal did not say when the committee studying the privacy issue would complete its work, but indicated that the financial incentives for health-care providers to begin using EHRs do not begin for another year and a half. “We have a little bit of time,” he said.
 
As of Monday, Blumenthal’s office had not answered follow-up questions that CNSNews.com submitted last week. A spokesman for the press office indicated that it could take “up to two weeks” for the request to be considered by the agency’s press secretary.

White House Press Secretary Robert Gibbs (AP Photo)

When CNSNews.com asked White House Press Secretary Robert Gibbs last week whether the White House agreed with Rep. Kennedy that patients could opt out of having an abortion or certain diseases excluded from the ENR, the president’s spokesman said he had “no idea.”
 
“I’m not a health IT expert. I would direct you to somebody -- I have no idea,” he said.
When CNSNews.com followed up, asking whether just the concept of allowing omissions from the EHR was a good idea.
 
“I’m not a health IT expert, so I apologize,” Gibbs asserted.

 

 
Transcript:
 
CNSNews.com: Our outlet spoke last week with Rep. Patrick Kennedy. And he told us that patients will actually be able to stop a doctor from including abortions or STDS in their medical history that will be part of the government-mandated electronic health record in the national record system.  I am just wondering is that Secretary Sebelius’ understanding, that a patient would be able to stop such things from being recorded, and if that’s the case, could patients also prevent things like mental illness or drug and alcohol abuse from being recorded if they so desired?”
Blumenthal: “This is Dr. Blumenthal again. I think I will take I’ll take that question. We are extremely sensitive to the need for privacy and security of information. It is one of our very top priorities. And we have, actually have a health-information technology policy committee of national experts. We held a hearing on this topic just ten days ago. This very question came up. We’ve charged that committee with studying how to protect patient information and they’re going to be reporting back to us. We want to make it clear that no one will ever have to use an electronic health record, if they don’t want to, and that when you do have electronic health records, they’ll have every conceivable privacy protection that is compatible with a useful health-care system. So, we’re going to wait to see what this panel reports back to us on in terms of the exact protections that we’re going to build in.
 
CNSNews.com: Are electronic health records mandatory, or as you indicated, voluntary? Help me understand here.
 
Blumenthal: “Let me say this again: No one will ever be forced to use an electronic health record if they don’t want to. This is always going to be between doctors and patients. Now--So that’s a given and so that, by definition, makes them voluntary.”
 
CNSNews.com: And you talked about this panel. When will this privacy committee conclude with its work?
 
Blumenthal: We’re going to let them do a little bit of work and report back to us on how long it is going to take them. To be clear, the incentives that are associated with the adoption of electronic health records don’t go out for another year and a half. We have a little bit of time.