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All very interesting articles, though I must point out that they mostly
address pharmacy/insurance company/drug company practices of buying and
selling prescription information - and physician outrage at these
practices - as opposed to physicians selling entire medical records
which is what your original post seemed to imply: "It is very normal
for a retiring doctor or clinic to "sell" medical records." And while
some physicians may be guilty of selling records, I think you paint the
profession with a very broad brush.
Yes, the selling of a private medical practice involves the transfer of
patient records to the physician taking over the practice. Would you
have the new physician treat the patients without any history? Or go
ahead and order all new tests to establish a baseline for continuing
treatment? Patients have a right to change physicians and obtain a copy
of their complete medical record to take to their new provider, but the
original hardcopy (or electronic) record belongs to the provider. It
is, in effect, the business record for the practice.
Liz Allan, RHIA
-----Original Message-----
From: Records Management Program [mailto:[log in to unmask]] On
Behalf Of Steven Whitaker
Sent: Friday, May 15, 2009 11:55 AM
To: [log in to unmask]
Subject: [RM] Fwd: Re: [RM] RAINdrip: When Google turns to
Gobble-Gobble...
Just a quick search on "selling medical records" brings up many, many
articles and examples on the subject. Including selling/mining
prescription data.:
<snip>
Medical and Public Health Law Site
------------------------------------------------------------------------
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Selling Medical Records
In most situations, the selling of a private medical practice is little
more than selling patients' medical records. While there may be costs
allocated to goodwill, this is meaningless when the practice is sold to
a physician previously unknown to the selling practitioner. Any premium
over the net present value of the furnishings, real estate, or lease
represents a sale of medical records.
Interestingly, there have been few legal actions against physicians who
sell medical records. In many states, it is illegal to transfer medical
information for nontherapeutic purposes without the patient's explicit
permission. In these states, the law would seem to require that each
patient be contacted for permission to transfer the records. If the
permission is denied, the selling physician will have to retain the
records. If the patient cannot be located, then the record might be
transferred under seal to the buying physician, to be opened only if the
patient contacts the physician in the future.
It is expected that HIV/AIDS will precipitate a reexamination of the
selling of medical records. This will be especially threatening in
states that make violations of patient confidentiality a criminal act.
Even in states that allow the transfer of medical records as part of the
sale of a practice, this transfer is limited to another physician, not a
lay practice broker.
<snip>
<snip>
Understanding the Lucrative Business of Selling Medical
RecordsPrinter-friendly format By: BY GLORIA BUTLER BALDWIN Buying and
selling certain health information isn't new. Since the 1940s, health
insuring organizations (HIOs) have bought prescription records from a
variety of sources, including through the claims process by managed care
organizations, pharmacy benefit mangers, and others, and then linked
with physicians listed in the Physician Master File of the American
Medical Association (AMA).
Pharmacy information, which includes physician and pharmacy
identification, prescription fill and refill data, product name and
quantity dispensed, authorized refills, cost, and payment and insurance
information, is compiled by the HIOs and sold to pharmaceutical
manufacturers for significant revenue. Approximately 2.9 billion
prescriptions are filled annually by pharmacists.
In the June 29, 2006 issue of The New England Journal of Medicine, Dr.
Robert Steinbrook addressed the lucrative business of buying physicians
prescribing data and the growing rebellion of physicians against the
companies using the information as marketing tools.
According to a 2005 Intelligent Manufacturing Systems (IMS) Health
annual report, operating revenue of $1.75 billion was derived from sales
to the pharmaceutical industry. Forty-eight percent was from "sales
force effectiveness offerings," which include "sales territory reports
and prescription tracking reports." In 2005, the AMA received $44.5
million in revenue * about 16 percent of its total revenue * from the
sale of database products.
Physicians are chomping at the bit because their personal prescribing
data is open book, when patient records are, for the most part,
protected under HIPAA.
To prevent losing license agreements with certain health information
offices, the AMA issued its Best Practice Guidelines for pharmaceutical
companies to follow when obtaining and using prescribing information to
ensure its confidentiality and prevent its disclosure to other parties.
The guidelines also say that using the data to pressure or coerce
physicians to prescribe certain drugs is "absolutely an inappropriate
use."
One pharmaceutical rep who talked candidly about how the data gathering
really operates, was reluctant to provide his name, saying "it would be
career suicide."
"It's all about marketing," said the source. "They say it's for research
and to some degree it is. But mainly it's used for research in how to
make more money. We get information about which doctors are prescribing
what drugs, and for how much so we can see which ones we need to go push
a harder. There's a ranking list of our best prescribing doctors.
Pharmaceutical manufacturers even use those reports to decide how much
to pay their sales representatives."
IMS Health uses the collected data from about 70 percent of all
prescriptions filled in community pharmacies and projects nationally
representative data.
State laws supersede the AMA guidelines. New Hampshire recently passed
House Bill 1346, which criminalizes the collection and disclosure of
information about the prescribing practices of physicians and other
healthcare providers.
Verispan LLC joined IMS Health Inc., in a lawsuit in U.S. District Court
to protest the constitutionality of the New Hampshire law. IMS said the
new law goes beyond patient privacy and has created a special privacy
right for physicians at the expense of healthcare quality and patient
safety.
The AMA agrees that information "critical to improving the quality,
safety and efficacy of providing patient care through the application of
evidence-based medical research," should be shared, but not for
self-gain.
Other states are devising their own plans. The California Medical
Association, in conjunction with IMS Health, is conducting pilot testing
that will allow physicians who do not restrict access to their
information to see their own comparative data and educational material.
Pilot testing will be completed this year and may be available
throughout the state in 2007. Similar programs could take hold in other
states.
According to a recent article by Robert Musacchio of the AMA and Robert
Hunkler of IMS Health, the rules of the new program "allow the industry
to retain access to prescribing data for most purposes, but they require
companies to police their own sales forces."
They warned that unless companies "comply in letter and spirit with the
requirements," they "will sabotage the success of the program and pave
the way for legislation that imposes stricter measures on the industry."
<snip>
<snip>
Bill would let pharmacies sell medical records Elizabeth Fernandez,
Chronicle Staff Writer
Wednesday, May 28, 2008
------------------------------------------------------------------------
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Pharmacies in California would be allowed to sell confidential patient
prescription information to third-party marketing firms working for drug
companies under a bill expected to be voted on Thursday by the state
Senate.
------------------------------------------------------------------------
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The legislation would allow pharmaceutical firms to send mailings
directly to patients. Supporters of the proposal say the intent is to
remind patients to take their medicine and order refills. But consumer
privacy advocates are outraged.
"This bill would be a windfall for corporations seeking to track, buy
and sell a patient's private medical records," said Zack Kaldveer,
spokesman for the Consumer Federation of California. "This would
represent a significant intrusion by pharmaceutical companies into the
privacy of patients.
"By opening this Pandora's box, consumers could wind up receiving
mailings designed to look as if they came from the pharmacy yet conflict
with what their pharmacist or doctor has recommended. Such a scenario
would be a threat to their health."
The California Medical Association opposes the legislation, contending
that it could jeopardize patient safety and hurt doctor-patient
relationships. The mailings are particularly problematic for patients
with sensitive medical issues such as mental illnesses, says the
association.
People receiving medication for a litany of illnesses, including cancer,
diabetes, asthma, osteoporosis, depression, hypertension and heart
disease, could receive the letters.
"The point is to tell people to take the drug as prescribed and to
refill it," said Rocky Rushing, a spokesman for the author, Sen. Ron
Calderon, D-Montebello (Los Angeles County).
He said many people fail to follow medication directions.
Dr. Rupin Thakkar, a board member of the National Physicians Alliance,
considers the proposed legislation a pharmaceutical ploy to gain access
to important patient information.
"It's as if you were shopping in a supermarket and someone was following
you and saying for everything you buy, 'You should try something
different,' " said Thakkar, who practices in Edmonds, Wash.
"It's a horrible invasion of privacy - it amounts to marketing directly
to patients in their homes. One's health care information absolutely
needs to be private."
Last week, the Senate defeated the bill, SB1096, on a 17-17 vote, but
Calderon amended it to allow patients to opt-out when they pick up their
prescriptions.
"You pick up your meds and have the opportunity to opt out," said
spokesman Rushing. "It's similar to waiving your right to consult with
the pharmacist. We are trying to strike a balance. ... There was a lot
of concern about people being forced into a program where they had no
say-so."
But consumer groups say it's unfair to place the burden on patients to
halt a marketing practice.
"We're concerned that people won't notice it or won't understand what it
means," said Jerry Flanagan of Consumer Watchdog.
A primary backer of the bill is Adheris Inc, a subsidiary of a drug
marketing company that was sued several years ago under its former name
for privacy violations. Adheris is involved in a pending class-action
lawsuit in San Diego involving the same issues in the Calderon bill.
California has one of the nation's strongest medical privacy laws. Under
the Confidentiality of Medical Information Act, direct mail marketing to
patients by pharmaceutical firms is not permitted.
>>> Steven Whitaker 5/15/2009 11:43 AM >>>
Whether you want to believe it or not, it happens on a frequent basis.
Peter's raindrops postings have quoted many, many articles on these in
the past five years.
>>> [log in to unmask] 5/15/2009 7:50 AM >>>
"Look at the medical profession. It is very normal for a retiring
doctor or clinic to "sell" medical records. Happens all the time.
Your (and possibly my) medical records and charts now in the hands of
someone who probably wants to sell us something."
Although it is common for physicians/dentists to sell their practice
upon retirement, it is rare that the medical records or the patient
information is sold in the manner you imply.<snip>
Liz Allan, RHIA
San Jose, CA
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