martes, 26 de mayo de 2009

Ruling to haunt watchdog

[Nota previa del Editor: La salida de información clínica de pacientes procedente de sus historias clínicas hacia compañias farmacéuticas (en concreto el gigante farmacéutico Merck que pagó gustosamente por tan valiosa información) esta siendo objeto de investigación por los tribunales en Australia (por la Corte Federal de Melbourne).

La demanda inicial data de 2004, cuando la información acerca de ciertos pacientes fué enviada inapropiadamente a la firma de marketing CAMM Pacific (que no es otra que Cegedim Strategic Data) después de ser automáticamente extraída por el software "Medical Director desktop".

Por un lado se debate que los datos han sido extraidos de manera anonimizada, e incluso pudiera considerarse eximente el hecho de que el destino de los datos sea la investigación cientifica que a la postre pudiera redundar en beneficio de la salud de los pacientes, pero por otro lado se esta violando la intimidad de los pacientes y además con animo de lucro y sus datos clínicos de la misma manera también pueden llegar a manos de aseguradoras, entidades financieras etc.

También podemos pensar en si es adecuado la externalización de los datos clínicos de los pacientes, dejándolos en manos exclusivamente de empresas privadas, como se esta haciendo en la Comunidad de Madrid, sin control alguno por parte del personal informático propio de la conserjería de sanidad.

La historia clínica informatizada de atención primaria en la Comunidad de Madrid fué
adjudicada en Julio de 2006 por 6,3 millones de euros a la empresa Stacks, que muy pronto pasó a pertenecer a Cegedim.]

'A CONTROVERSIAL decision to dismiss concerns about a leading GP software package automatically extracting prescription records has come back to bite federal Privacy Commissioner Karen Curtis.

The Australian Privacy Foundation last week asked Ms Curtis to investigate two potential breaches in relation to the sale or re-use of medical records for drug marketing purposes, without patients' knowledge or consent.

In 2005, Ms Curtis rejected complaints that doctors were being paid to supply patient records under a deal with a leading software supplier and drug firms, on the grounds that the information had been sufficiently "de-identified".

At the time, health and privacy advocates said the decision gave a green light to the sale of patient data, while claims individuals could not be re-identified were not confirmed through independent testing.

The latest concerns relate to courtroom revelations that pharmaceutical giant Merck paid specialist nurses $500,000 to trawl through patient records for possible candidates for the firm's anti-arthritis drug Vioxx, now the subject of a class action in the Federal Court in Melbourne.

APF health committee chair Juanita Fernando also referred for investigation an unrelated story about AsteRx, a pharmaceutical data aggregator that hoped to gain access to GPs' prescribing data in exchange for a gift of free business software.

Ms Curtis said yesterday that she learned of these matters through media reports, and had reacted immediately: "The issues are sufficient for my office to determine that an investigation is appropriate, and to exercise my own motion powers to commence investigations."

Own motion powers allow the commissioner to conduct an inquiry without waiting for a complaint; however such investigations are conducted in secret. The initial complaint in 2004 that patient information may have been "inappropriately disclosed" to marketing firm CAMM Pacific after being automatically extracted from GPs via their Medical Director desktop software was eventually dismissed.

At the time, Ms Curtis said the patient information had been de-identified, "and therefore does not fall within the definition of personal information".

She commended the firms for "appearing to take privacy seriously", and for their co-operation.

CAMM Pacific is now called Cegedim Strategic Data Australia, and is part of the global pharmaceutical customer relationship business specialist Cegedim Dendrite. Medical Director software is provided by HCN, a wholly owned subsidiary of private medical group Primary Health Care.

Yesterday, Ms Curtis said it was "premature" to draw any comparisons: "An investigation will always involve ascertaining the actual facts of a particular event from relevant organisations, agencies or individuals. As the outcome will be dependent on its facts, it would be premature to draw comparisons with other matters, such as the CAMM Pacific case of 2005."

During heated debate on ABC Radio National's Background Briefing in June 2005, Ms Curtis conceded the office essentially relied on the goodwill of companies to reveal what they were doing with people's information. Staff who handled the complaint were not IT experts, and there was no independent examination of software or data collected.

"Our Privacy Act is based on the premise that privacy is not an absolute right, and has to be balanced against the free flow of information as well as other societal rights, including the rights of business to operate," she said.

Meanwhile, Gordon Renouf, policy director of consumer rights body Choice, said there was a real tension "between doctors making professional judgements about the best treatment options for their patients and being influenced by marketing".

"Now, doctors say they're not very prone to being influenced, but studies show that when doctors are subjected to high rates of marketing they do change their prescribing habits _ generally for the worse," he said.

"Clearly in the case of Vioxx, you didn't want your doctor influenced in that direction."

But the aggressive marketing in that instance was unlikely to be a one-off: "If a drug firm was behaving in this way in relation to one drug, there must be other examples out there that we don't know about."

Mr Renouf said the spectacle of drug companies paying GPs to hand-over their data obviously raised public concerns.

"Unfortunately, all this undermines the benefits that could come through a good e-health system or a secure and systematic national database," he said.'

Fuente: Australian IT 26/05/09

Versión traducida automáticamente: Traducción de Google

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