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Remedies that hurt

Two proposals by state officials would weaken the security surrounding prescription records.

June 12, 2008

Medical records often contain excruciatingly revealing personal information, and yet they're also surprisingly vulnerable. According to Pam Dixon of the World Privacy Forum, there are about 250,000 cases of medical identity theft every year, many of them for the purpose of illegally obtaining prescription drugs. Nevertheless, state officials are pushing two initiatives that would weaken the security of California residents' prescription records. One is a bill by state Sen. Ron Calderon (D-Montebello) that would allow pharmacies to share information on prescriptions with contractors for the sake of mailing reminders to consumers. The other is a plan by Atty. Gen. Jerry Brown to give doctors, nurses, medical regulators and law enforcement officials access through the Internet to a database of prescriptions for controlled substances such as Vicodin and Ritalin.

Calderon touts his bill, SB 1096, as a way to help people with chronic ailments remember to take medications and refill prescriptions. Other states permit such mailings, and they reportedly have improved patients' adherence to courses of treatment. Nevertheless, sending letters hardly seems like the most effective way to jog memories. And the measure is selective, targeting only those suffering from 21 conditions.

Those shortcomings suggest that the bill's main beneficiary would be pharmaceutical companies, which spend billions of dollars urging consumers and physicians to use more prescription drugs. Although drug makers wouldn't be privy to patient records, the letters would give them a way to keep plugging their brands. Not surprisingly, the bill originated with Adheris Inc., a division of inVentiv Health, whose self-described mission is to "take pharma products from development through launch to commercial success." State law already allows pharmacies to send reminders if customers ask for them. Calderon's approach, which would require consumers to opt out, goes too far.

To help combat drug abuse and lethal drug interactions, the state maintains a database of prescriptions for narcotics, steroids and other controlled substances. Today, medical and law-enforcement personnel can seek information from the database by phone, fax or letter, but it can take weeks to get the results. That's why Brown is updating the system to provide instant access through the Internet.

The problem is that the supposedly secure system would be anything but. Thousands of doctors, nurses, pharmacists and investigators would have access to the records. The recent scandal at UCLA Medical Center is just the latest reminder of the security problems surrounding medical records. Add in identity theft and the frequency of errors in patient records, and you've got a prescription for more Californians erroneously being investigated or denied medication. Before Brown activates the new system, it needs better mechanisms for individuals to review their records and quickly correct mistakes.

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