While there appears to be consensus among political leaders and the populace that something has to be done about America's opioid addiction crisis, there is no shortage of controversy over what measures the government should take to address it.
One of the trickiest issues for policymakers is privacy.
Some advocates for stronger treatment initiatives say that health care providers are currently restricted from sharing crucial information about a patient's addiction history with other providers that might interact with the patient. They are backing a proposed rule change floated by the Department of Health and Human Services that will allow patients to authorize greater sharing of their records with other medical providers and accountable care organizations.
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But others worry that too much sharing might make patients vulnerable to records leaks that could alert employers, law enforcement, or friends and family of issues they want to keep private. They are concerned that patients who are in a fragile or desperate psychological state will be coerced into signing away their right to privacy, and that the potential negative consequences — job loss, for instance — could imperil their treatment efforts more than it helps them.
Kaiser Health News recently talked with a number of advocates to gauge opinion on the issue, and found that many who are campaigning for the same result — greater access to treatment — have very different views on how fiercely a patient's medical records should be protected.
"(W)e're substituting the interests of integrated delivery systems and accountable care organizations for patients' interests, when what we should be doing is asking patients what they want," Jim Pyles, an attorney and privacy expert who has recently worked on behalf of the American Psychoanalytic Association, told Kaiser.
Meanwhile, Matt Salo, who heads the National Association of Medicaid Directors, told Kaiser that too many of the providers responsible for treating drug and alcohol abuse operate in silos, isolated from others with whom they should be coordinating care. As a result, doctors are prescribing medication, for instance, that they might not give to a patient who they knew had drug abuse problems.
"These special silos are actually hurting people," Salo told Kaiser.
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