Hoyer Hasn't Given ‘Significant Thought’ to Whether Someone Can Exclude STDs, Other Problems from Health Record System He Voted to Create

By Matt Cover | September 30, 2009 | 7:10 PM EDT

House Majority Leader Steny Hoyer (D-Md.) (AP Photo)

(CNSNews.com) – House Majority Leader Steny Hoyer (D-Md.) says he has not given "significant thought" to whether someone should be able to exclude a sexually transmitted disease or other health problem from the electronic health records that Congress mandated by law in the stimulus package that was enacted in February.

Hoyer voted for the $787 billion economic stimulus law--the American Recovery and Reinvestment Act of 2009--which passed 246 to 183 in the House and 60 to 38 in the Senate, and was signed into law by President Obama on Feb. 17.
The law requires doctors, hospitals and other health care providers to create an Electronic Health Record (EHR) for every American by 2014 or else face deductions in their Medicare payments. 
The EHRs are supposed to be integrated into a national health care IT system where health care providers nationwide as well as the government would have the ability to access them when authorized.  The law says the EHRs are to include a person's "medical history and problems list."

Last week, Rep. Patrick Kennedy (D-R.I.) told CNSNews.com it would be up "totally up to the individual" whether they wanted an abortion they had undergone or an STD they had contracted listed on their EHR.

In speeches this summer, President Obama described the Electronic Health Records as being all inclusive of person's medical history, alleviating an individual from having to inform each new health  care provider of all the medicines they have taken in their life and all the health problems they have had--and thus saving the taxpayers money on health care and helping doctors avoid medical errors.
CNSNews.com asked Hoyer whether he understood the EHRs mandated by Congress to be as Kennedy described them or as President Obama has described them.
CNSNews.com asked: “A question on the electronic health records. President Obama said that they would be all inclusive. They would have to include everything. Rep. Kennedy last week said that it would be up to the individual as to what goes on that record. Obviously those were part of the stimulus bill. How do you see that? Is it something that you could leave off a drug addiction or an STD procedure off your record, or would everything have to go on?”
Hoyer said: “I have not given that significant thought because it hasn’t been an item of discussion. Having said that, it is a serious issue whether or not that would be included in the legislation or it would be included by regulation as to what needs to be included in records.”

“I haven’t really thought enough about it to give a really substantive answer,” said Hoyer. “Clearly, you need records sufficient enough to give medical personnel the opportunity to make wise and sound decisions. One of the most significant issues, as you know, has been with this whole issue, the issue of privacy.
“Clearly, medical records are very sensitive to every individual and need to be held private and need to be accessed only by personnel who are authorized to access them, and that includes medical personnel accessing.”
Hoyer continued: “It’s a very difficult issue, and I wouldn’t want to give you a snap answer to a question of that seriousness, but I think that the basic premise is the reason that you want to get these records accessible essentially worldwide.”
“I can access my bank account in Moscow, but I don’t know about that in Jerusalem,” he said. “And the fact is that if I had a heart attack there, frankly, I’d want the doctor there to be able to access as quickly as possible, and given the technology available today, they could do it over seconds to know what Steny Hoyer’s all about so they could treat me most effectively.”
The law mandating the Electronic Health Records aslo says the system carrying them must be one that “allows for the electronic use and exchange of information."  It says that this will enhance medical care and communication by doing the following:
“(7) improves public health activities and facilitates the early identification and rapid response to public health threats and emergencies, including bio-terror events and infectious disease outbreaks;
“(8) facilitates health and clinical research and health care quality;”
Both of these goals suggest that the government could allow individuals other than someone’s personal physician or health care provider to access the medical records.
The Health Information Technology (HIT) Policy Committee, which will make recommendations to the national coordinator for Health Information Technology--also created under the economic stimulus law--is required to formulate policies that both protect the privacy of such information and allow the release of personal health data.

Under the law, “the HIT Policy Committee shall make recommendations for at least the following areas:
“(i) Technologies that protect the privacy of health information and promote security in a qualified electronic health record … and for the use and disclosure of limited data sets of such information.”

The HIT Policy Committee will also make recommendations for allowing people access to their records, though it is unclear whether individuals could edit their records or correct errors or mistakes.
“[T]he HIT Policy Committee may consider the following additional areas:
“(viii) Methods to facilitate secure access by an individual to such individual’s protected health information.”
Inquiries made by CNSNews.com to Hoyer’s office for comment on the specific language of the law about EHRs, medical history and “problem lists,” were not answered before this story went to press.