Looking up medical info on the web poses a privacy risk

https://www.consumeraffairs.com/news/looking-up-medical-info-on-the-web-poses-a-privacy-risk-022315.html

Researchers found that nine out of ten visits result in personal health information being leaked to third parties, including online advertisers and data brokers…

The vast majority of these requests go to a handful of online advertisers: Google collects user information from 78% of pages, comScore 38%, and Facebook 31%. Two data brokers, Experian and Acxiom, were also found on thousands of pages…

Libert points out that the Federal Health Insurance Portability and Accountability Act (HIPPA) is not meant to police business practices by third party commercial entities or data brokers. The field of regulation is widely nonexistent in the U.S., meaning that individuals looking up health information online are left exposed and vulnerable.

The findings are reported in the article “Privacy Implications of Health Information Seeking on the Web,” appearing in the March 2015 issue of Communication of the ACM.

ACLU documents reveal police use of secret cell phone tracking program

https://www.consumeraffairs.com/news/aclu-documents-reveal-police-use-of-secret-cell-phone-tracking-program-022315.html

This secrecy is allegedly justified in the name of “national security” although, as the ACLU notes in the records it released yesterday, a detailed list of over 250 investigations from just one city’s police department showed not a single case related to national security…

In other words, police keep information about this program secret not only from the public they presumably serve, but from the judges who presumably are supposed to oversee those police to ensure their behavior stays within legal and constitutional guidelines. Indeed, authorities would sooner let an armed robber avoid jail than reveal any details of how they use Stingray…

“[Tadrae McKenzie] and two buddies robbed a small-time pot dealer of $130 worth of weed using BB guns. Under Florida law, that was robbery with a deadly weapon, with a sentence of at least four years in prison. But before trial, his defense team detected investigators’ use of a secret surveillance tool. … In an unprecedented move, a state judge ordered the police to show the device — a cell-tower simulator sometimes called a StingRay — to the attorneys. Rather than show the equipment, the state offered McKenzie a plea bargain.”

The ACLU’s records show that one Stingray customer, the city of Tallahasee, went on to use its Stingrays in 250 investigations over the six years spanning mid-2007 to early in 2014. As the Post noted, “That’s 40 or so instances a year in a city of 186,000, a surprisingly high rate given that the StingRay’s manufacturer, Harris Corp., has told the Federal Communications Commission that the device is used only in emergencies.”

The ACLU’s records also show that police have not been obtaining warrants before using these cell phone trackers to determine peoples’ locations…

DEA denies privacy concerns for PDMP

https://edsinfo.wordpress.com/2015/02/23/dea-denies-privacy-concerns-for-pdmp/#comment-3104

We disagree with that principle, called the “third party doctrine,” in many situations, because when people provide sensitive information to a third party for a specific purpose, they typically do not intend for law enforcement to have unfettered access to it. The principle is particularly offensive in this case…

A 2012 report by the Center for Problem-Oriented Policing (NY)

I’ve never heard of this group, but this is a pretty complete and accurate report.  And it gives pain patients a more overall look at why they’re being treated like criminals.

(Excerpts)

Prescription Drug Fraud and Misuse (2012)

Guide No. 24

2nd Edition (2012)

Prescription Drug-Related Problems

Medicaid fraud. Pharmacy workers sometimes commit Medicaid fraud, usually by substituting generic drugs for name brands, short counting pills, filling prescriptions without a refill, and then overbilling Medicaid. They may also bill Medicaid for drugs they never dispensed.1
Over-the-counter (OTC) drug misuse. Those who purchase OTC drugs to achieve a “high” are typically youth seeking cough and cold medicines, sleep aids, antihistamines, and anti-nausea agents.2 It is not known to what extent the misuse of OTC drugs increases the risk for prescription drug misuse and/or fraud, or illegal controlled substance use (e.g., heroin use).

This seems like it would be important to know, so one has to wonder why these studies haven’t been done.  Big Pharma has the power to keep these studies from being done right now, but eventually, parents will want to know if these easily-accessed OTC drugs are one of the reasons their children became addicted to prescription medications.  (Although this would be another version of the gateway theory, that has been debunked time and time again.)

Theft from pharmacies, hospitals, and doctors’ offices. Pharmacy workers and healthcare providers, both of whom have easy access to prescription drugs, sometimes steal them…

The medical industry is very good at protecting their own, just like law enforcement.  There is little media coverage of incidents like this.  And while that’s how it should be, it leaves pain patients taking the blame for a lot of activity that they’re basically unaware of.

Other Drug-Related Problems

Some of the following problems related to prescription fraud and misuse are covered in other guides in this series, all of which are listed at the end of this guide:

Open-air drug markets
Drug dealing in apartment complexes
Marijuana growing operations
Rave parties
Clandestine methamphetamine labs
Mobile drug dealing
Drug-impaired driving

The National Survey on Drug Use and Health reports that fewer than 1 percent of those engaged in nonmedical prescription drug use in 2009 obtained those drugs through the Internet. One researcher concluded, “The assertion that the Internet has become a dangerous new avenue for the diversion of scheduled prescription opioid analgesics appears to be based on no empirical evidence and is largely incorrect.”

Purdue Pharma’s 10-Point Plan to Reduce Prescription Drug Abuse and Diversion

Educate healthcare professionals about the problem.
Create tamper-resistant prescription pads.
Implement programs such as Painfully Obvious, a prescription drug abuse awareness and education initiative for middle and high school students.
Provide opioid therapy documentation kits to physicians for pain assessment.
Distribute educational brochures about the problem.
Implement prescription monitoring programs.
Establish educational programs with the law enforcement community.
Conduct research on abuse, diversion, and addiction.
Work with the DEA to curtain cross-border smuggling.
Develop abuse-resistant drugs.
Source: Eworldwire.com.

Jurisdictions such as Albuquerque, New Mexico; San Diego, California; and Tarrant County, Texas, use FaxAlert to notify doctors, pharmacies, and medical clinics of drug diversion-related activity. Each month, the Tarrant County Medical Society also distributes a health-scam report. The Texas Pharmacy Association has set up an online system for reporting fraud or stolen prescription pads. The state of Colorado and Johnson County, Kansas, use a PharmAlert hotline for notification, while Abington, Pennsylvania, police handed out fliers describing the scam and including a photo of the suspect or fraudulent prescription. After implementing this strategy in 1991, Abington saw arrests of prescription fraud offenders increase from one per year to one to two per month…

An extensive study of Maine’s PMP found that prescribers have used PMP data to confirm doctor shopping, and make referrals for substance abuse. It also found that “a chilling effect has not occurred.”76 Michigan found that its electronic system reduced handling time and did not increase cost,77 and a satisfaction survey conducted in Kentucky revealed that “nearly 90 percent of prescribers have used a Kentucky All Schedule Prescription Electronic Reporting (KASPER) report to help with the decision to deny medication to patients” and 94 percent of police strongly or somewhat agree that KASPER is an effective tool for obtaining evidence in the investigative process…

These take-back programs may be seen as similar to the popular, but ineffective, “gun buy-back” programs of the 1990s. While there are similarities in that people are voluntarily turning in something that may be illegal, with no questions asked, they are different in that no money, vouchers, or goods are being given in exchange. Other possible similarities include that people dispose of their old, uninteresting drugs much in the same way that the majority of firearms turned in are antique and inoperable. Anecdotal evidence from the Reno Police Department suggests that drug take-back programs increased awareness of the dangers of prescription drugs and their potential misuse, but the medicines collected were not high on the list of misused or fraudulently obtained prescription drugs…

Because of the high number of prescription fraud offenders who are professionals (many in the healthcare field), police investigators believe this is an important factor in an effective response. Similar to the Drug Court concept is Nevada’s Pre-Criminal Intervention Program where an intervention officer from the Board of Pharmacy works with prescription drug users who have a high potential for misuse and fraud. Candidates are identified through PMP data and doctor-shopping criteria. A study of the program showed a large reduction in the average number of prescribers, dispensers, and prescriptions filled.83

Some progress in linking PMPs has been made through a pilot project called PMIX…

Enforcement crackdowns usually yield an immediate but limited impact and often do not produce long-term results. A police or medical-board crackdown on a specific doctor, pain clinic, or pharmacy prone to prescription fraud and misuse may put that doctor, pain clinic, or pharmacy out of commission, but prescription drug misusers will simply move on to the next doctor or pharmacy that does not have sufficient prevention measures in place. Given the inadequate amount of resources devoted to crackdowns on prescription fraud, the practice cannot be sustained as a means to prevent or reduce the problem.

Everyone knows that enforcement crackdowns do more harm than good, leaving thousands and thousands of pain patients without any access to health care or prescription medications — although this report doesn’t even mention that group.  (We have been forgotten.)  This is the story that’s not being sufficiently covered in the media — the stories of chronic pain patients. Really, all this report is doing is supporting the need for a PDMP system that is used the same way by every prescriber in every state.  I don’t know what else to call this except a blacklist.

https://painkills2.wordpress.com/2015/01/20/1222008-cvs-refused-to-fill-my-prescription-is-this-legal/

I have heard that CVS has a “black list” of doctors that they are refusing to fill.

https://painkills2.wordpress.com/2015/01/09/2009-the-influence-of-prescription-monitoring-programs-on-chronic-pain-management/

And it is my contention that the PDMPs are a blacklist for pain patients.

Wikipedia’s page for Blacklist (computing):  In computing, a blacklist or block list is a basic access control mechanism that allows through all elements (email addresses, users, URLs, etc.), except those explicitly mentioned. Those items on the list are denied access.

From a pain patient’s perspective, what I see in this report is an elaborate collection of information that actually proves that the PDMPs and all these law enforcement efforts are only making the problems worse.  (See the nationwide increase in drug abuse and poisonings.)  I understand that for a digital system like this to work, just about everyone has to use it.  And that includes all levels of law enforcement and other government agencies.  Next, more insurance companies like Express Scripts will want in on the action too, but they probably already have access anyway.

This is the Drug War, people.

Court Rules Warrant Is Required to Access PDMP (2014)

https://edsinfo.wordpress.com/2015/02/23/court-rules-warrant-is-required-to-access-pdmp/

http://www.akronlegalnews.com/editorial/12132

2/7/2015, Police officer who tried to get drugs from multiple doctors has appeal denied

In an opinion released recently, the 12th District Court of Appeals ruled that a former police officer did not have a reasonable expectation of privacy regarding her pharmacy records and prescription drug information…

The facts of the case state that Luken was working for the Greater Warren County Drug Task Force in April 2013 when he received a complaint concerning Myers. The complaint was from the Wilmington police chief and stated that Myers, who was working as a Wilmington police officer, told one of her supervisors that a physician had refused to treat her and accused her of “doctor-shopping.” Based only on that information, Luken launched an investigation into Myers and ran a query with the Ohio Automated Rx Reporting System…

http://www.namsdl.org/library/80E9F081-1372-636C-DD6F1FF841E2D12D/

PRESCRIPTION MONITORING PROGRAMS, PHARMACY RECORDS AND THE RIGHT TO PRIVACY (2011)

http://www.news-press.com/story/news/2014/07/15/prescription-drug-database-tougher-restrictions/12709347/

7/15/2014, Prescription drug database may get tougher restrictions [FL]

The Department of Health is floating a new rule that would lay out terms and conditions for use by law enforcement and investigative agencies after critics were unable to convince the Legislature to require court orders to access the database. The push for enhanced restrictions on the database came after the names and detailed prescription-drug histories of more than 3,000 people were released to defense attorneys after a multi-agency drug sting last year…

Last year, the Legislature allocated $500,000 — about the amount it costs to run the database for a year — toward the database. Last month, Bondi announced she was giving nearly $2 million from a previous settlement with Caremark to the Department of Health to keep the database operational for the next four years.

State law requires pharmacists and other dispensers to enter all prescriptions for controlled substances, such as oxycodone, into the database but does not require physicians to consult the database before prescribing drugs for patients. Health officials credit the database, which now contains more than 87 million prescriptions, for a 51 percent reduction in the number of individuals who receive prescriptions from five or more physicians and five or more pharmacies in a 90-day period. Officials also say the database played a significant role in a nearly 41 percent drop in the number of deaths caused by oxycodone in 2012.

http://www.ihealthbeat.org/articles/2014/5/7/lawmakers-courts-limit-police-access-to-state-rx-drug-databases

5/7/2014, Lawmakers, Courts Limit Police Access to State Rx Drug Databases

However, Scott Reed, chief of the Criminal Justice division in the Utah attorney general’s office, said that requiring law enforcement authorities to obtain a warrant could defeat the purpose of such databases. According to the Utah Division of Occupational and Professional Licensing, the number of law enforcement searches of the state’s prescription drug database increased from 2,288 in 2007 to more than 19,000 in 2013.

Reed said, “It becomes another version of the chicken and the egg. … If I need probable cause to get into the database, then I can’t get into the database, and if I can’t get into the database, then I can’t show probable cause.”

https://axiomamuse.wordpress.com/2012/03/18/every-med-you-take-theyll-be-watching-you-prescription-monitoring-programs/

3/18/2012, EVERY MED YOU TAKE, They’ll BE WATCHING YOU – Prescription Monitoring Programs

Oklahoma is credited as the first state to begin using a prescription monitoring program back in the early 90’s. Now Oklahoma has raced to the top again with its high tech, electronic PMP that boasts real time prescription data sharing beginning this year [2006] … Under a statewide database program to be administered by the Oklahoma Bureau of Narcotics and Dangerous Drugs Control, authorities will track instances in which substance abusers try to fraudulently acquire prescription drugs…

With all of these firsts for Oklahoma in prescription drug monitoring, doesn’t it seem rather ironic that the state also boasts #1 status in prescription drug use and in painkiller abuse?

Here is some insight from a 2011 study that “. . .evaluated the association of PDMPs with drug overdose mortality rates and consumption of prescription opioid medications in the United States during 1999–2005.”

Conclusions. While PDMPs are potentially an important tool to prevent the nonmedical use of prescribed controlled substances, their impact is not reflected in drug overdose mortality rates. Their effect on overall consumption of opioids appears to be minimal.

…it can be said unequivocally that PDMP states did not do any better than non-PDMP states in controlling the rise in drug overdose mortality from 1999 to 2005.

Mr. Klearman’s concerns about the databases being hacked were born out in 2009. In May 2009, hackers gained access to Virginia’s Prescription Monitoring Program and held 8 million patient records hostage for 10 million dollars in ransom…

Help Could Be On The Way For Florida’s Pain Patients

http://www.pharmaciststeve.com/?p=9277

“Anyone experiencing this problem is welcome to contact a caseworker in my office so that we can assist.”  U.S. Rep. Gus Bilirakis

https://www.facebook.com/GusBilirakis

https://twitter.com/repgusbilirakis

http://www.congressmerge.com/onlinedb/cgi-bin/newmemberbio.cgi?member=FL12&site=congressmerge

This is help?

Healthcare IT Dangers

http://hcrenewal.blogspot.com/2015/02/former-onc-director-david-blumenthal.html

2/2/2015, ONC on healthcare IT and patient rights: These systems “have to be rolled out to know where the problems lie”

The threat of Medicare penalties is indeed “the only incentive” (doctors) have to make “it” happen, because the technology is not helping them, and is making their work harder and more risk- and liability-prone. But don’t take that from just me:

… A group of 37 medical societies led by the American Medical Association sent a letter to Health and Human Services last month saying the certification program is headed in the wrong direction, and that today’s electronic records systems are cumbersome, decrease efficiency and, most importantly, can present safety problems for patients.

http://hcrenewal.blogspot.com/2014/11/what-in-gods-name-is-going-on-with.html