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Psychiatric records contain sensitive personal information that should not be disclosed without a patient's consent, incoming APA Vice President Richard Harding, M.D., told a Congressional subcommittee last month on Capitol Hill.
Federal medical privacy legislation should also make physicians "a key part of the information-disclosure process to notify the patient of attempts to obtain private personal medical information or to inform the patient of potential consequences of disclosure," Harding testified before chair Steve Horn (R-Calif.) and members of the U.S. House Subcommittee on Government Management, Information, and Technology. The subcommittee reports to the Government Reform and Oversight Committee.
Harding is a member of the National Committee on Vital and Health Statistics, an advisory committee charged with developing the Clinton Administration's legislation for medical record confidentiality.
He later told Psychiatric News, "We do not want people signing blanket consents with a gun to their heads. They should not have to fear losing their jobs or health insurance."
The consequences of unauthorized disclosures of personal medical information, in particular psychiatric, can be severe, especially for public officials. Harding recounted in his testimony that many years ago voter support for a Congressman from Arkansas running for governor diminished when it was leaked to the press that he had alcohol abuse problems. More recently, in 1992, a Congresswoman's suicide attempt became headline news of a major newspaper.
To prevent these violations of privacy, Harding urged members of the subcommittee to support federal legislation that, like the Leahy-Kennedy bill (S. 1368) introduced last year, gives patients the right to partition personal health information from the rest of their medical record and to decide whether to release that information and to whom. The patient can also request that personal health information be kept outside of any computerized or electronic system, according to the bill's segregation provision.
The Leahy-Kennedy proposal also provides a minimum level of uniform protection for all confidential medical information; thus tougher state confidentiality laws would not be preempted, according to Harding's testimony.
He commented that many other bills in Congress do not provide the same type of consent and revocation of consent provisions needed to protect patient privacy. For example, the recently introduced Jeffords-Dodd bill (S. 1921) allows patients to revoke their consent, but health care plans can terminate their enrollment (Psychiatric News, May 15). Also, the bill neither allows for informed voluntary consent when personal health information is used for health care operations nor requires that the information be stripped of personal identifiers.
"The point I tried to make to the subcommittee was that electronic advances in health systems such as billing and medical research seem to be creating an insatiable appetite for more data. The requests for the complete medical record, however, should not outweigh a patient's right to privacy," said Harding.