Privacy, Security Concerns Small for Telehealth Technologies, Witnesses Say
Privacy and security concerns associated with telehealth technologies were largely set aside during the Senate Subcommittee on Communications, Technology, Innovation and the Internet’s hearing Tuesday. Though some senators raised concerns, the witnesses said privacy and security concerns were a much smaller problem with telehealth than lack of broadband access. Ranking member Brian Schatz, D-Hawaii, mentioned the Health Information Portability and Accountability Act and encryption use for telehealth technologies, but didn’t ask witnesses any direct questions regarding privacy or security concerns.
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Telehealth was born of necessity, as patients in rural areas have always lacked access to healthcare, said Dr. Kristi Henderson, University of Mississippi Medical Center (UMMC) chief telehealth and innovation officer. UMMC is the state’s only academic medical center, children’s hospital, transplant program and level one trauma center and also has the state’s only allopathic medical school, dental school and pharmacy school, Henderson said.
More than 10 years ago, the UMMC Center for Telehealth began a TelEmergency program that connected 15 emergency departments in rural hospitals to the UMMC, Henderson said. “Using real-time video and audio connection, UMMC’s emergency medical team is able to consult with rural providers regarding treatment options,” she said. Since the program's launch, rural emergency room staffing costs have been reduced 25 percent, unnecessary transfers are down 20 percent and patients are doing as well as those treated at the academic medical center, Henderson said. The program serves about 8,000 patients per month, Henderson said.
This year more than 125,000 patients who suffer stroke symptoms will be diagnosed by a neurologist in an emergency room using Tele-Stroke network, American Telemedicine Association CEO Jonathan Linkous said. Tele-ICU will oversee almost 500,000 critically ill patients this year, and 1 million patients who have an implanted pacemaker or who suffer from arrhythmia will be remotely monitored, he said.
Broadband-enabled technologies are being used on an almost daily basis and give clinicians and consumers more and often better tools for diagnosing illness and monitoring health, said Dr. Chris Gibbons of the FCC’s Connect2Health Task Force. A working prototype of a medical tricorder was announced at the South by Southwest conference in mid-March, Gibbons said. The prototype was designed to diagnose 15 different medical conditions and monitor vital signs for 72 hours and can conduct lab tests for illnesses such as diabetes, pneumonia and tuberculosis. A lipstick-sized attachment serves as an otoscope to examine ears or spirometer to measure breathing, Gibbons said.
Sen. Steve Daines, R-Mont., was the first to directly ask how patient information will be kept private. Privacy and security concerns are minimal issues when it comes to telemedicine, Linkous said. Encryption can and should be used in every program, he said. Linkous said privacy issues with telemedicine have more to do with a medical professional examining a patient’s chart or results on a monitor in an open area than with information being widely shared or hacked.
People want anonymity for mental health issues, Sen. Richard Blumenthal, D-Conn., said. With telemedicine, college students can go to the same health center as they would for a cough or cold to ensure it’s not obvious they're going to seek mental health help, Henderson said. The same challenges that apply to privacy and security for paper records apply to telemedicine, Henderson said.
A nurse used to take a file out of a locked drawer, hand it to the doctor and then lock the file back up once the doctor was done, Sen. Edward Markey, D-Mass., said. It was a very private world, he said. Now we’re entering an era where criminals just need a smartphone, not a crowbar, to expose private information, Markey said. The stakes are high, he said, because an individual could lose insurance coverage, a person's medical data could be sold or a live telemedicine visit could be hacked into.
Henderson said she set up her program in a secure and encrypted manner, and knows who has touched what information at all times. Not everyone follows the same standard, Henderson said, which is why she supports a federal entity to determine minimum privacy and security standards for telemedicine. Henderson said she hasn't encountered any breach of security with her program and Linkous said he hadn't seen any broad breach of security for electronic health records.
Congress and federal agencies should take a technology-neutral approach so they don’t “lock in” a limited set of solutions, Panasonic North America Chief Technology Officer Todd Rytting said. The technology industry is moving incredibly fast and telemedicine is essentially part of the IoT, he said. It’s difficult for industry to keep up with one-another, let alone for government agencies to keep up, he said. Industry should work with government agencies to make the best decisions possible, Rytting said.