Your friendly neighborhood drug store--OK, more like the corporate colossus that runs it--is under investigation again. CVS Caremark Corp. announced yesterday that the Federal Trade Commission (FTC) is investigating the company's business practices, according to the Associated Press, but spokespeople did not disclose the details.

The probe may be related to complaints made by the Change to Win coalition, which raised questions regarding CVS' privacy practices, among other concerns. "We think there are serious issues with the company," Change to Win spokesman Ahmer Qadeer told the AP. "We think there's a real question of privacy problems, how they may use patient data, and real questions with this business model."

This isn't the first time CVS has been scrutinized. In February, the FTC and Department of Health and Human Services investigated the company following reports that employees were dumping consumers' private information, including Social Security numbers and medical records, in garbage containers. CVS shelled out a $2.25 million settlement, but continued to deny any wrongdoing.

According to the Wall Street Journal, the company settled a similar investigation by the Texas Attorney General in 2008.

(Editor's note: The following blog was written by Mark McGraw, an associate editor on staff at ADVANCE.)

It's movie night, and you're not interested in subtitles or surrealism.

Maybe next week you'll go for the one with the "Winner: Best Foreign Language Film, 2008 Venice Film Festival" sticker on it. But tonight you're in the mood for a poorly acted and painfully predictable slasher film; the one where the band of promising, carefree teens head for a harmless weekend retreat at idyllic Camp Killmore.

And there's nothing wrong with enjoying the sugar high that comes from such cinematic junk food. But it's also common to feel a bit ashamed when the buzz wears off, and you may not want others to find out about the B-movie bender you went on over the weekend.

A little embarrassment aside, would you feel comfortable knowing that total strangers could find out what flicks you pick on Friday nights? Or worse, they could take a look at your sensitive health information? If recent research is any indication, it may not be that difficult to get access to either.

Netflix, the popular online DVD and Blu-Ray disc rental service, recently held a competition to improve its recommendation software. Contestants received a training data set containing the movie preferences of 480,000-plus customers who had been "de-identified," according to a recent New York Times article.

A pair of computer scientists at the University of Texas at Austin (UT) recently conducted a privacy experiment to see if it was possible to determine the identities of those supposedly anonymous film buffs.

By comparing the preferences of some unnamed Netflix customers with personal profiles on Internet movie database www.imdb.com/, the researchers said they "easily re-identified some people because they had posted their e-mail addresses or other distinguishing information online," the Times reported.

The Los Gatos, Calif.-based service disputed the study's findings, claiming that Netflix had altered the data set before sending it to contestants, according to the Times. The researchers, however, said they were indeed able to positively ID Netflix customers by analyzing users' public postings and connecting them to their Netflix preferences, the article said.

In any case, the study adds fuel to the debate over how private electronic data -- including electronic health records -- can truly be.

"As our research shows, pretty much any information that distinguishes one person from another can be used to re-identify records," Vitaly Shmatikov, associate professor of computer science at UT and co-author of the study, told the Times.

A scary thought. With ARRA legislation signed months ago, and billions of that money earmarked to encourage the adoption of electronic health records (EHRs), we could be well on our way to building a health care system where medical errors are fewer, costs are lower, and fraud, waste and duplication are greatly reduced.

Indeed, the potential of EHRs to improve the delivery of health care has been well-documented. As have the shortcomings of current laws governing the privacy of digital health records.

Regulations currently in place require that patients be notified if their personal medical information has been released without their authorization, and the selling of protected health records is prohibited.

But "de-identified" health care data? That's still fair game, and can be sold without the patient's consent to interested parties such as insurance companies and pharmaceutical marketers, for example, to target very specific groups of patients -- some with illnesses or conditions they'd prefer to keep as private as possible. Online patient records can also be viewed by any and all individuals within the health care system allowed to do so by law.

So, while EHRs may ultimately offer patients and health care providers greater access to vital data, questions of how to best protect that information clearly remain.

What questions do you have? In your opinion, what should digital privacy laws entail? How can health care providers ensure that their patients' information is adequately protected? Leave a comment below, and tell us what you think.

If you've been following Jay's blog, "XY Files in and MT World," recently, you know there have been some frightening reports of medical records being sold overseas. It's enough to make you hunker down in the States and demand your records stay local.

On the contrary, some patients are ditching domestic services and seeking medical care abroad. Medical tourism is booming, and the ongoing health care debate has a lot to do with it. Sick of waiting for the public option, uninsured Americans are traveling to places like India, Singapore and Columbia to get treatment for a lot cheaper--like, 10s of thousands of dollars cheaper--than inflated U.S. costs.

A few months ago, I wrote an article about medical tourism for the Patient Resource Center at ADVANCE for Healthy Aging, one of our sister pubs. Ever the HIM inquisitor, one of my questions was, what about medical records? Patients simply request a copy (an oh-so-easy process, of course) and bring them to whatever facility they select for treatment. When the procedure is done and recovery in progress, the patient totes records from the foreign facility back across the border to their primary provider's hands.

It all seems a little, well, unsecured if you ask me; the record exchange would go a lot smoother if physicians were linked electronically. Of course, Microsoft pounced on that opportunity. The company recently announced that Bumrungrad International Hospital in Bangkok, Thailand, will begin offering electronic personal health records (PHRs) to patients both local and from afar. The hospital will use Microsoft HealthVault to share records with patients and their doctors back home. It's all in the effort to promote continuity of care--at least that's according to the bigwigs involved in the deal.

It's a fine idea and makes life a lot easier for the patient, who doesn't have to lug folders and X-ray in a compact carry-on, but there's still that lingering concern-HIPAA. I'm assuming the international hospital involved in the deal abides by privacy and security regulations, but legally speaking, U.S. law doesn't go beyond borders. Contracts may require protection of personal health information, but if business associate agreements are any indication, those clauses don't guarantee penalties will be assessed.

How do you feel about medical tourism? Offshoring is a big debate in the HIM industry, but what about patients who voluntarily go overseas for care? Should they know it means relinquishing HIPAA protections?

October is National Poppin' Popcorn Month, so naturally a few of us at the office decided to celebrate with a culinary nod to those explosive kernels. I went the semi-homemade route, popping a bag and mixing it up with marshmallows, chocolate chips, raisins and sliced almonds to make a sticky trail mix bar. Not my best creation.

I like to cook--no, I like to bake. Birthday cakes, cookies, brownies, no problem. Cooking, on the other hand, doesn't come so easy. Regardless, I'll spend hours browsing my favorite food blogs, picking out recipes I'd love to make but tabling them for the day I have a cabinet full of spices and the inane ability to know when meat is perfectly cooked. I've experimented with a few dishes--some good, some "eh"--but it's all part of the fun.

This weekend is also Homecoming at my alma mater (last year I baked cupcakes with school-themed icing, of course), which means my other favorite thing to do--cheering on our basketball team--is fast approaching. Alas, ever since graduation I've been banished from the student section, perched oh-so-conveniently behind the basket, to the nosebleeds. And I actually have to pay for those seats. But I take one for the team, and they usually don't fail to disappoint. 

In the off-season, I get my sports fix by watching friends play Frisbee and other intramural sports, occasionally dabbling in a game myself. My disc-flinging skills are pretty weak, but I've learned I can put up a mean defense on the soccer field. More often, I'm the team photographer at tournaments. If you've browsed any of our galleries from conferences, you know--I'm a big fan of photos.

So, what does this have to do with health information? Not much, but we all have to strike that work-life balance. It's Friday, you're bound to have some plans for the weekend and I'd like to hear about them. Our "Downtime" section--now online under the "Community" tab and in print--shares what HIM professionals do when they're not running meetings, reviewing policies or grumbling at malfunctioning systems (our current post features members from our Team of the Year winner and runner-up). It may not be the most pertinent news, but having a way to unwind is important to avoid burnout at work.

So what do you do in your downtime? E-mail me at cmcevoy@advanceweb.com with your input. Do you rock climb or just like to settle down with a book? Either way, we'll be happy you shared!

Everyone's sick of swine flu (pun not intended, I swear), so apologies in advance for striking up yet another conversation about it, but I couldn't help posting when I heard about post-vaccine monitoring.

What? What's that you say? Monitoring? As in data, systems and overall management of what one might call "health information?" Surely this must pique your interest beyond the daily onslaught of who got H1N1, where they live and if you should invest in a surgical mask.

Here's the run down: With the H1N1 vaccine about to be distributed en masse, the Department of Health and Human Services (HHS) wants to know about side effects, pronto. Problem is, when you have a large amount of people being vaccinated in a short amount of time, any subsequent health problem is going to be flagged as a side effect. Can't say I blame them-I have a friend who's a nurse and got the vaccine. Her headache later that day? Vaccine-induced, we surmised.

To separate true potential side effects from those that are, well, a bit of an overreaction, the government is sponsoring several tracking initiatives. Johns Hopkins, for example, plans to send e-mails inquiring vaccine recipients about their post-dose health (do I hear "follow-up?"). The Centers for Disease Control is also encouraging patients to notify the government of any problems via the Vaccine Adverse Event Reporting System.

But perhaps my favorite is an initiative at Harvard Medical School, where researchers are using vaccine registries and insurance databases to identify vaccine patients who headed back to the doctor and the reason for the visit. And here's the kicker-it's in real time. (Yes! All those codes you assigned and electronic submissions you made are finally getting some recognition.)

As the Associated Press notes, those reported numbers are going to need some sort of baseline. How many cases of nausea is normal in a given week, for example? Or worse, heart attacks? The CDC, therefore, is collecting data and crunching numbers ever-so-quickly so they can target side effects that actually pose a risk and avoid adding to the panic that already surrounds H1N1.

It's another case for quality health information-but you knew that already. Coding errors that trickle through to claims databases could affect the reliability of any links between vaccine and side effect. At the same time, a thorough registry could help researchers contact side effect sufferers sooner, so those contemplating vaccination could know the full risks.

Are you involved in H1N1 response at your facility? Do you traditionally report vaccine side effects, and are you gearing up for H1N1-specific reports? Do you foresee any problems with using databases to flag potential side effects?

I'm about to head off to the final round of general sessions at the AHIMA Convention and Exhibit, which means it's time for some overall reflections.

The general consensus among attendees has been that this year's sessions have been particularly informative. It's no surprise given the abundance of issues that emerged in the past year. The ICD-10 final rule, HITECH Act and launch of the recovery audit contractor program all emerged after the close of last year's convention. It's a lot to juggle, but attendees seemed to agree the association did more than a bang-up job covering the issues.

If I had to pick a word to sum up the convention, I'd go with "account," in all interpretations of the term. HIM professionals will need to step up their ability to account for disclosures--a topic of several discussions at the convention. According to Harry Rhodes, director of practice leadership for AHIMA, who presented on new requirements for accounting of disclosure, few organizations have much experience with providing full accounts to patients, but they'll soon find it's a time and resource intensive process.

Accounting of disclosures feeds into a similar buzzword at the convention: accountability. As HIM moves into the spotlight, professionals will be under increasing scrutiny, and that means taking responsiblity for actions. As patients become more active participants in health care, there will be increasing pressure on HIM departments to deliver quality information--and those who don't will need to justify the lapse.

Finally, there's "account" in the sense of stories. Attendees were repeatedly urged to share their successes and failures with others. And when you think about it, that's really what conventions are about. Whether it was Dr. Blumenthal asking for HIM's continued support or a simple conversation between two directors at the Welcome Reception, stories were swapped, lessons were learned and ideas were exchanged. And--hopefully--it was all for the better.

During this morning's general sessions, AHIMA CEO Linda Kloss acknowledged the fine work of current AHIMA president Vera Rulon.

"Vera has served this organization with grace and spirit while blazing a path for years to come,"said Kloss.

Kloss went on to add that Rulon will be moving into a "Past-President" role for 2010. 

Rulon herself then introduced the 2009 AHIMA Board of Directors before continuing to acknowledge new board members for 2010, including new president-elect Bonnie Cassidy. She finished by introducing the featured speaker for the event- AHIMA's 2010 President, Rita Bowen, MA, RHIA, CHPS. "Few individuals have a greater passion for this organization that Rita," said Rulon.

Bowen thanked the audience by calling her appointment one of the greatest monents of her life, topped only by her 33 years of marriage to her husband Ralph who she acknowledged for his strength and love. She continued by encouraging all in attendance to fight on behalf of consumers.

"Now is the time to stand together and deliver," she urged. "Change is happening more rapidly than ever. There is no time for complacency."

Bowen concluded by furthering the idea of living for tomorrow. Yesterday is in the past, she stated, and HIM professionals are left only to face the myriad challenges that lie ahead.

"We have a once-in-a-lifetime opportunity to push the boundaries of what is possible," she said. "Together, we have the heart, brains and courage to change the face of health information!" 

At a news conference yesterday, the American Health Information Management Association (AHIMA) unveiled its Health Information Bill of Rights, a set of seven principles designed to protect and promote patient access to personal health information.

Craig May, AHIMA public relations, called the Bill of Rights "an extraordinary stride in patient protections." He plugged the provisions at Sunday's Student Academy, mostly saying the association planned to introduce a list that was unprecedented in the industry, but kept the details under wraps. Well, here they are (abbreviated for your quick perusal, of course):

1. The right to access your health information free of charge.

2. The right to access your health information during the course of treatment.

3. The right to expect accurate and complete health information.

4. The right to know who provides, accesses and updates your health information.

5. The right to hold health care professionals and others accountable for violations of privacy and security laws, policies and procedures.

6. The right to expect equivalent privacy and security protections, regardless of location.

7. The right to seek legal recourse for violations.

Wait, you say, that sounds a lot like HIPAA, and isn't the American Recovery and Reinvestment Act (ARRA) already beefing up privacy and security? Reporters thought the same thing. But according to AHIMA, the Bill of Rights are not meant to replace HIPAA but rather serve as "guideposts" to ensure privacy and security protections remain part of health care discussions. "HIPAA was a good start, ARRA was another nice step, but we still feel more could be done," said Wendy Mangin, AHIMA past president and chair of the Blue Ribbon Committee, which crafted the provisions.

The Bill of Rights went through a significant "vetting process" to validate the meaning and applicability of each measure. According to Linda Kloss, CEO of AHIMA, upholding privacy and security while expanding consumer access to information will become even more critical in the digital age. Patients and providers across the nation will need a "common understanding" of these rights to make health information exchange not only possible, but successful. 

For more information on AHIMA's Health Information Bill of Rights, watch our video interview with Mangin and Kloss, which will be posted Oct. 21 as part of our comprehensive post-conference coverage. In the meantime, leave your comments about the provisions below. The seven principles seem pretty straightforward, but according to Sandy Fuller, chief operating officer of AHIMA, a few of them could turn out to be quite controversial. What are your thoughts? Do you see any loopholes or potential hang-ups?

Well, my feet hurt, my brain hurts and I can barely keep my eyes open at this point, but it was all well worth it. My first day at the AHIMA 2009 conference did not disappoint. Busy is an understatement, and I even got a bit of a cardio workout in-with all the walking to and from the various meetings and sessions. This place is huge!

After a brief welcome from AHIMA President Vera Rulon, MS, RHIT, CCS, FAHIMA, and some opening remarks from Grapevine, TX, Mayor William Tate and the Texas HIMA President Carol Smith, MBA, RHIA, attendees were treated to an energetic keynote address from Doug Keeley, CEO and chief storyteller of "The Mark of a Leader."

Keeley shared a number of touching and amazing stories designed to inspire and challenge the membership to "Think Big, Then Do It."

Next the AHIMA Foundation Triumph Awards were presented. These national awards recognize a number of individuals who've made a difference in the HIM profession. We'll bring you full coverage and photos in the coming days, but here's a quick recap of this year's winners:

Distinguished Member Award - Mervat Abdelhak, PhD, RHA, FAHIMA

Champion Award - Mary "Mamel" McCain, MPA, RHIA

Community Outreach Award - PHR Community Education Coordinators

Educator Award - Sue Biederman, MSHP, RHIA

Educator Award - Rachelle S. Stewart, DrPH, RHIA, FAHIMA

E-HIM Award - Marion V. Swaim, RHIA

Legacy Award - April D. Robertson, MPA, RHIA, CHPS, FAHIMA

Mentor Award - Karen Lawler, MPS, RHIA

Mentor Award - Barbara Manor, MA, RHIA

Mentor Award - Dwan Thomas-Flowers, MBA, RHIA, CCS

Pioneer Award - Melissa D. Myrick, MSA, RHIA

Rising Star Award - Megan L. O'Neill, RHIA

As for the rest of my day, it was mainly spent in the exhibit hall while the other ADVANCE staff members attended numerous sessions and press conferences. I've updated our ADVANCE 2009 Industry Buzz news page on just a few of the announcements made today in the exhibit hall, so be sure to check that out.

And now, it's time to get some rest so I can do it all again tomorrow!

They say everything's bigger in Texas, and that even goes for their welcomes. Following yesterday's pre-conference events, attendees at the American Health Information Management Association (AHIMA) Convention and Exhibit were treated to a Welcome Reception at the Glass Cactus, a nightclub at the Gaylord Texan Resort. Set on the shores of Lake Grapevine, the Glass Cactus was a bit of a hike from the Convention Center, also on the Gaylord's grounds, but attendees could hop a trolley instead of hoofing it across the parking lot.

The Glass Cactus was the perfect place to wind down, with warm lights, smooth music and two floors of stone walls that evoked the open air of a hunting lodge. Despite a chill in the air, several conventioners soaked up the scenery on the outdoor deck; with 180-degree views of the lake, it was a backdrop too tempting to pass up. 

Attendees wined and dined on cheese, crackers and crudite as they discussed the events of the day and goals for the convention. Discussions ranged from recovery audit contractors to the ongoing debate about apportionment at the House of Delegates. But when inquired about the conference, most attendees had the same response: "We've only just begun."

The events--and hospitality--continued this morning with the official welcome from Grapevine Mayor William Tate. After sharing a glimpse of the town's history, Tate invited attendees to come back "real soon" and explore the golf courses, wine tours and lively downtown area Grapevine has become known for. Texas HIMA President Carol Smith, MBA, RHIA, also offered a warm welcome and urged attendees to take advantage of networking opportunities at the convention. Texas means "friendship," she said, so start making those connections. And speaking of connections, TxHIMA will be playing a major role in building the state's health information network. With such a large area to cover--and much of it rural territory--linking up will be nothing short of a challenge, Smith said. Here's hoping that hometown hospitality goes for health exchange, too.

My first day at the 2009 American Health Information and Management Association (AHIMA) Convention and Exhibit is off to a great start. I attended the Student Academy this morning, where Barbara Black, director of human resources, and Gwen Hughes, director of eHIM, Care Communications, shared the dos and donts of writing cover letters and resumes.

"Your resume should reflect your next job, not your current job," Black said. Be concise, factual and positive, she added, and focus on what your skills can do for the company, not the other way around. Instead of listing an "objective," try a "positioning statement" that summarizes your unique talents. Don't be afraid to toot your own horn, Black said, but never lie; a simple fib can come back to haunt you. Misrepresenting yourself can also land you a position you're not ready for, which only adds to stress and makes employer relations difficult down the road, Hughes added.

Addressing Generation Y in particular, Black urged students to Google themselves and remove any information online that could be unattractive to employers. Keep ringback tones and e-mail addresses appropriate, and rid your Facebook account of any incriminating photos, she said. But Black didn't forget those pursuing second careers or returning to the HIM field, either. Make sure your credentials are up-to-date, she said, and ditch the "References upon request" line at the bottom of your resume. Instead, hand potential employers a "Professional References" sheet before you leave an interview; hiring managers will be impressed with your initiative and you'll have more time to alert references that a phone call might be coming their way.

Despite the early morning start, students had plenty of energy and asked thoughtful questions throughout the session. I had the chance to sit with a few during the lunch break; they're excited to get into the field, but many said it's tough to find information about the industry. They turn to mentors, associations and other resources (hopefully ADVANCE!) to get the nitty-gritty on what it's really like to be in HIM. Career goals ranged from management to consulting, but no matter what direction they head, they'll likely encounter HIT. Luckily, they're prepared--every student at my table has worked with EHRs, and said they foresee the technology succeeding in the future.

I'm headed to Texas tomorrow and looking forward to meeting many of you attending the American Health Information Management Association (AHIMA) convention. I wasn't able to attend last year's meeting in Seattle, so I'm especially excited to get out there and mingle with so many of our faithful readers.

It will definitely be a whirlwind trip for me, as I'm arriving late on Sunday and returning home on Tuesday evening. (Duty calls, and I must get back to the office and start working on the October issue.) Although my time there will be short, yet jam-packed with meetings, I always come away from the AHIMA conference completely energized. I'm sure this year will be no different.

It's always so uplifting to talk personally with our readers, columnists, panel members and advertisers. The ADVANCE magazine and online edition exist for you, and because of you. Many of our columns wouldn't exist without your participation, such as our Say What?? collection of funny bloopers (which always make me LOL!), our Coding Q&A and Management Q&A, and the countless other contributions you provide to this magazine.

I always come away from the national meeting with new article and column ideas, new contacts and new friends. So, if you're attending this year, please be sure to stop by and say hi! I'll be at Booth # 1907. I'd love to hear your thoughts on the magazine and the Web site, and any ideas you may have for future articles, columns or blogs. If you're not able to attend this year's meeting, be sure to follow along with our Live 2009 AHIMA Conference Coverage. And don't hesitate to comment here below with your feedback and suggestions on how the magazine and Web edition can better serve your needs.

Anytime someone mentions this year's American Health Information Management Association (AHIMA) Convention and Exhibit, I immediately think of the song, "I Heard it Through the Grapevine," because, well, the event's being held in Grapevine, TX. Problem is, I only know that single line of lyrics, and as a child of the late ‘80s, I more often associate that tune with the California Raisins than Marvin Gaye.

Motown and dried fruit. Probably not the image AHIMA was going for.

Fortunately, the convention has plenty of opportunities to give new meaning to Grapevine. My days will be filled with talk of ICD-10, recovery audit contractors and the HITECH Act--and I'll bring it all to you via blogs, daily photos and even a live audiocast from the press room. It all starts with Sunday morning's Student Academy, where I'll be learning alongside HIM's up-and-comers.

I'm eager to hear what's mentioned at this year's general sessions. Last year, AHIMA cited the Genetic Information Nondiscrimination Act (GINA) as one of its greatest accomplishments of 2008. Lo and behold, the Office of Civil Rights announced a proposed rule yesterday that will enhance genetic protections under HIPAA, in accordance with GINA. Perfect timing for a pat on the back, or at least a mention, at this year's event. And with CEO Linda Kloss' impending departure next March, I wouldn't doubt there will be some sort of tribute or award when she takes the stage.

Sadly, I won't have much time to explore Grapevine, but the Gaylord Texan Resort and Convention Center will be a sight to see in itself. A sprawling, fountain-filled hotel, it's the perfect place to rub elbows with HIM's elite. Attendees can schmooze at the annual Welcome Reception and President's Premier Celebration, plus some alums have the additional chance to meet-and-greet at receptions sponsored by their alma maters. Of course, I'll be there to snap some shots for our Web site, so don't be shy!

Enjoy our live coverage now and make sure to check back Oct. 21, when we bring you comprehensive post-conference coverage, including articles, photos and video. Feel free to share your reflections in the comments sections!

Greetings! My name is Rob Senior, and I am the newest member of the editorial staff at ADVANCE for Health Information Professionals.

For the past eight years, I've worked at ADVANCE in a similar role for the Physical Therapists and PTAs magazine. In my new assignment, I'm learning about the "other" side of health care--the people developing, processing and correcting the medical records of the patients seen by physical therapists and other practitioners. 

Next week, I'll be attending my first HIM event--the AHIMA conference in Grapevine, TX. This is where I need your help--what issues pertinent to the profession would you like to see covered in ADVANCE? What advice do you have for someone just starting to cover your profession? Most importantly, what should I know about covering HIM?

I welcome any and all of your thoughts and opinions. I look forward to working with and writing about each and every one of you!

With all the prep for next week's American Health Information Management Association Convention and Exhibit and our HIM Team of the Year coverage (Yes, we have a winner!), I've been neglecting my Google Alerts. Well, I found some time this morning to browse the news on electronic health records (EHRs), and there's a whole lot of good, bad and ugly.

Boston researchers have identified yet another benefit of EHRs: flagging domestic abuse. According to the Boston Globe, the researchers examined 6 years of hospital admissions and emergency room visits, looking for cases that involved risk factors like injuries, poisoning and alcoholism for women and depression and psychosis for men. Using that data, researchers identified domestic abuse victims an average 2 years before the diagnosis was listed in a patient's chart, the report said.

The researchers developed an EHR-friendly module that could alert physicians when signs point to abuse. The screening tool could also be adapted to assess risk for other conditions, like diabetes and depression, all in the effort to provide what researchers called "predictive medicine." It doesn't guarantee a problem exists, but puts providers on alert in case one develops.

While the Boston study is all about keeping tabs on records, some patients may be looking to wipe theirs clean. The American Recovery and Reinvestment Act requires providers to participate in a national HIT network, but patients will determine which information doctors can access. Abortions and sexually transmitted diseases (STD), for example, could be withheld, according to Rep. Patrick Kennedy. "This is totally going to be up to the individual," he told CNS News.

Given the social stigmas, it's understandable patients could want to keep such conditions under wraps, but all politics aside, is that best for delivery of care? Coordination of care depends on having complete information-just ask a cardiologist waiting for hospital discharge notes-so if something as critical as an STD is left off the record, doctors might not deliver the most effective care.

And speaking of coordination, take a look at this communication debacle. The Tennessee Department of Human Services (DHS) is attempting to save face after a caseworker sent the wrong fax number to 100 providers who submit information for disability determination. So where did all of those social security numbers and private health details go? To a solar-powered fan manufacturer in Indiana, where the owner told reporters he's been receiving medical records for years.

Tennessee DHS owned up to the recent mix-ups, but said past problems are due to the department and manufacturer having similar fax numbers. The department's fax number is owned by the Social Security Administration, so Tennessee DHS can't change it, the report said.

One IT buff said it's a case for EHRs. Sure, digital systems would eliminate fax flubs, but it's probably just as easy to misdirect information with the click of a mouse. (C'mon, like you haven't sent an e-mail to the wrong person?) And let's face it, making all those operations paperless would be pretty darn expensive.

How expensive? Well, North Shore-Long Island Jewish (LIJ) Health System is spending a whopping $400 million to install inpatient EHRs at its 13 hospitals and partially subsidize costs for community and hospital-based physicians who go electronic. I frequented a North Shore-LIJ hospital as a kid (OK, not so much frequented as was born there and got stitches in the emergency room), so it's nice to know family members will be getting high quality care--or at least that's the hope. And with that multi-million dollar price tag, I'm sure executives are looking for a big payoff.