2010 AHLA Hospitals and Health Systems Law Institute: Hot 2010 Health Law Legal Topics

Although it is cold today in West Virginia - I'm hoping it will be hot in Florida in February.

I thought I would take a moment on this cold wintry day to write about the hot health topics that will be discussed at the American Health Lawyers Association (AHLA) Hospitals and Health Systems Law Institute scheduled for February 25-26, 2010 at the Doral Golf Resort & Spa in Miami, Florida (Conference Brochure PDF).

I will be speaking at the Hospitals Law Institute along with my colleague, Jody Joiner, Assistant Operations Counsel at Sisters of Charity of Leavenworth Health System. Our topic scheduled for Friday, February 26 is Hospital’s Friend or Foe: The Age of Social Media and Health 2.0 where we plan to cover:

• The social media technology tools used by health care providers and hospitals
• Pros/cons and legal implications of social media and health 2.0 services such as blogs, wikis, social networking, podcasting, video sharing, etc.
• Best practices and development of policies and procedures which address staff and employees using social media

In addition to our session there will be variety of "hot" health law legal topic covered at the conference that will interest hospital administrators and their legal counsel, including sessions on government data mining to identify hospital compliance, understanding the recent ARRA HITECH developments impacting HIPAA and EHR, hospital/physician collaboration and relationships, best practices in hospital practitioner credentialing, peer review and privileging, voluntary disclosure strategies, hospital clinical research issues, and much more.

The AHLA Hospital and Health System Law Institute overlaps with the AHLA Physicians and Physician Organizations Law Insitute which will be held on February 24-25.The Physician Law Insitute will include "hot" physician topics on on call payments, Accountability Care Organizations, HITECH, disruptive physician behavior intervention, Stark issues for physicians, hospital/physician mergers, FMV for physician compensation and much more.

You can register for one or both. As an AHLA Member I regularly attend the Physician/Hospital Law Institutes every year or so because of quality and breadth of health law related materials for those who work in the health care industry. More information, along with how to register, can be found at the AHLA website:
Hospitals and Health Systems Law Institute
Physicians and Physician Organizations Law Insitute

Google Health: Google Partners with Cleveland Clinic

The New York Times Technology Section reports on a pilot project between Gooogle and the Cleveland Clinic in an article, Google to Store Patients' Health Records.

The article indicates the pilot project will involve a volunteer patient group transferring their personal health records so that they are available via Google Health, a new health record product being developed by Google. The article quotes Pam Dixon of the World Privacy Forum concerning privacy issues under HIPAA (incorrectly referenced by the Times as HIPPA).

I don't necessarily agree with the scope of the comments regarding the applicability of HIPAA in this situation. Although I don't know the full details of the relationship for the proposed project but it would appear that Google in this situation might be serving as a business associate of the Cleveland Clinic for the project. As a business associate it is likely that Google would be held contractually to many of the HIPAA privacy standards.

Tip to Matthew Holt at Health 2.0 Blog for noticing the NYT article.

UPDATE (2/22/08): ZDNet's Larry Dignan at Between the Lines has more on the pilot project including the Cleveland Clinic's press release.

The comments to Dignan's post are interesting reading especially a couple with a legal perspective. The comment, two misconceptions, highlights the overall light enforcement efforts by OCR and lack of penalties, whether Google might fit the "healthcare clearinghouse" definition under the "covered entity" definition, entering into a contract with the health care provider (business associate requirement) and discusses the subpeona and marketing misconceptions.

Also, more from NYT's Steve Lohr, Google Health Begins Its Preseason at Cleveland Clinic which indicates that Google Health will be made available to the public following completion of the pilot project (appoximately 2 months). The article also has a quote from fellow health care blogger and CIO of Beth Israel Deaconess Medical Center in Boston, John Halamka, who indicates that the hospital is also interested in linking its EMR with Google Health. As a board member of the West Virginia Health Information Network I would like to explore the idea of utilizing and integrating Google Health into our statewide effort to bring about an integrated/interoperable health information system.

Jane Sarasohn-Kahn at HealthPopuli shares her thoughts and additional link commentary on the Google/Cleveland Clinic project. Jane highlights a recent report, Personal Health Records: Why Many PHRs Threaten Privacy, by the World Privacy Forum looking into privacy issues for PHRs.

Matthew Holt's follow up post taking a closer glimpse at the privacy questions, motives and opportunities both pro/con surrounding the Google Health project.

UPDATE (2/24/08): For the latest article covering the Google Health project check out Newsweek's article, Web Surfer, Health Thyself, out in the March 3 edition.

Also, MSNBC provides some additional insight on how Google Health will interact with the existing Cleveland Clinic EHR (or PHR) in Google Goes to the Doc's Office. The article describes the pilot project as follows:

. . . The Cleveland Clinic already keeps electronic records for all its patients. The system has built-in smarts, so that it will alert doctors about possible drug interactions or when it's time for, say, the next mammogram. In addition, 120,000 patients have signed up for a service called eCleveland Clinic MyChart, which lets patients access their own information on a secure Web site and electronically renew prescriptions and make appointments.

The system has dramatically cut the number of routine calls to the doctor and boosted productivity, though it has yet to effectively deal with information from an outside physician, Harris says. Those records are typically still on paper, and have to be laboriously added to the Cleveland Clinic system. It is a big problem, especially for the clinic's many patients who spend winters in Florida or Arizona, where they see other doctors.

Adding Google's technology lets patients jump from their MyChart page to a Google account. Once on Google, they'll see the relevant health plans and doctors that also keep electronic medical records. That means the patient can choose to share information between, say, the Arizona doctor and the Cleveland Clinic . . .

UPDATED 2/26/08: Scott Shreeve goes Giga over Google Health. Read his first impressions of the Google PHR after his test drive at HIMSS.

However, Dmitriy at TrustedMD makes some great points, including this quote:

Yet, even with free PHRs out there, consumers simply do not care for spending their time to learn and use them. Who would bother entering and checking their medical records if you are healthy and would rather go see a movie? And once you get sick, you do not want to enter them either. You just want your doctors and hospitals to hand your medical records to you. But you see, the providers have different priorities that a mere piece of software just cannot solve . . . PHRs' real problems are not technical, usability or even privacy. The real problem is consumer and provider motivation . . .

He ends his posts with some questions we should all be discussing. Until we see a reimbursement model that creates incentives for providers to look at more health information and consumers to care about and take an active part in their health -- I'm not sure the PHR/EHR initiatives will fully develop and mature.

Follow the latest news (blog posts) and the Techmeme reaction to the project.