According to a solicitation posted by the Department of Health and Human Services (HHS-Ed.) on Sept. 4, the CMS (Centers for Medicare and Medicaid Services) is commissioning the National Academy of Sciences (NAS) to study how best to add social and behavioral factors to electronic health record reporting.  Washington Free Beacon

So a non-profit online publication, which one would site on the conservative or libertarian side (part of the Center for American Freedom), breaks a huge story, way ahead of the mainstream media, which has major implications for privacy, data security, public health, how goes your doctor or hospital visit and the level of care you receive. Is this EHR TMI (too much information)? The Federal inclusion is being linked to Stage 3 of the Meaningful Use program and reimbursement under Medicare, Medicaid and the Children’s Hospital Insurance Program (CHIP). The NAS already is working on this with the Institute of Medicine to draft suggestions for collecting this behavioral data and identifying “core social and behavioral domains to be included in all EHRs.”

With linking the data to outside Nosey Parkers agencies such as public health entities, the possibilities for identified data becoming insecure or compromised increase dramatically. Will it be accessed (abused) by other entities involved in ACA such as the IRS, state Medicaid databases and Social Security? How much of this data will accidentially leak out in non-deidentified files? Will breaches of millions of non-encrypted records become the norm? Another important and oft-overlooked factor is the additional workload on already overworked hospital and clinical staff, who presently struggle to get comprehensive vital data correctly into multiple fields and screens on present EHRs–a major pain point among many speakers and participants at this past week’s iHT2 Health IT Summit. Finally, there’s the patient. He or she will be pressed to answer, due to penalties baked into the ARRA/HITECH MU3 incentives, the most personal questions about their life and behavior particularly if the diagnosis is one of what euphemistically was called a ‘social disease’. Having spoken this week to those in public health both at iHT2 and at Health 2.0 NYC, this Editor can see it as a deterrent to getting the care they need–or choosing evasion rather than truth with their doctor because there are no more confidences. Even the California Healthcare Foundation, hardly on the right wing, sounds an alarm in iHealthBeat.