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A Larger Health Lesson from UCLA: For the Rest of Us, Tabloids Are Not the Problem

By Judy Dugan
Research Director
Consumer Watchdog
and OilWatchdog.org Project

It's amazing how fast Gov. Schwarzenegger reacts when it's his wife, Maria Shriver, whose medical records are being snooped. "This kind of practice has been happening all over the state, wherever there's celebrities involved" including himself, Schwarzenegger said at an unrelated news conference today. He reiterated that his administration is "working with UCLA," where the leaks were uncovered by an excellent LA Times investigation--and hadn't even been reported to state regulators.

Of course, UCLA never would have even checked access to its electronic medical records if it was me in the bed, instead of Britney Spears, Farrah Fawcett, Maria Shriver and 20-some other celebs being snooped. According to today's LA Times report, UCLA knew about the records breaches for nearly a year. Though it disciplined several employees in the Spears case, it didn't bother to tell the patients or the state, much less the district attorney:

“Dr. David Feinberg, chief executive of the UCLA Hospital System ... acknowledged that UCLA had not notified the affected patients, nor did it inform state health regulators or criminal authorities about the problems. The privacy of medical records is protected under state and federal laws, which carry such penalties as prison terms, fines or both for inappropriately accessing or selling such information. ...

“Kathleen Billingsley, deputy director of the state Department of Public Health's Center for Healthcare Quality, said the state learned about the Spears breach from the newspaper, not from UCLA, and was notified of the Fawcett incident only after a Times reporter asked questions of the hospital.”

To Schwarzenegger's credit, he told the Times after the Spears story that "a breach of any patient's medical records is outrageous" and that he had called on his administration to take action, "Patients' medical records should be private -- period," Schwarzenegger said. "No one should have to worry that an unauthorized person is reviewing their private medical records."

He sent the problem to his administration's health chief, Kim Belshe. Apparently deciding what if anything to do is a slow process.

“Belshé said her agency was reviewing whether the state needed tougher sanctions for violations of patient privacy or other tools to hold hospitals accountable.”

The logical follow-up to that might be: Why is the repeated violation of a patient protection law not enough of a tool to "hold hospitals accountable." By not reporting the crimes, didn't the hospital abet them?

Most of us have nothing to fear from the tabloids, but plenty to fear from insurers, mortgage lenders, potential employers or even an estranged spouse who'd love to have a back door to our medical records.

Such breaches didn't begin with electronic medical records, but the online records allow more wholesale viewing by anyone with the right access codes. Despite UCLA's bland assurances, we may never know if any hospital employee, in any of the UCLA breaches, was paid to take a look.

There's little question that electronic medical records can improve cost-efficiency and speed patient care in emergencies. There's also a downside in tightening access too much, since a hospital pharmacist needs access as much as your doctors and nurses. But in the UCLA case, much of the violating was done by a non-medical employee.

It's ridiculous that, for instance, a hospital billing office clerk can see your medical records, but that's one of the demands of our fragmented insurance system. Every insurer wants a record of every aspirin, every shot, every "procedure," or the hospital won't get paid.

It would all matter a little less if insurers couldn't deny individuals a policy on the basis of those records. If we all had Medicare-style health care, we could at least settle for worrying about the tabloids and the angry spouse.

Judy Dugan is the Research Director of the Consumer Watchdog , a nationally-recognized, California-based, non-profit consumer education and advocacy organization. She joined them in March 2006 and is a former Deputy Editorial Page Editor for the Los Angeles Times. She most recently served as Senior Editorial Writer at the Times and was the Editor of a Pulitzer Prize-winning series on California government in 2004. Since 1987 she has held editorial positions with the Times including Assistant Op-Ed Editor and Voices Editor.

Posted on April 08, 2008

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