Taking steps to curb health record sharing; Computer data: National regulations aim to protect privacy but tougher rules still needed.


AFTER years of delay by Congress, President Clinton is taking a necessary first step to protect the privacy of medical records.

The proposed regulations would restrict doctors, hospitals and health plans from using and transferring electronic medical data for purposes other than treatment or payment.

Current federal law permits the exchange of this confidential information -- without patient consent -- among doctors, pharmaceutical companies, employers, the credit industry, insurance firms and telemarketers.

New rules are needed because health care providers are sharing more records through computer data bases and insurers are requiring more information before paying medical claims. Computer technology and the growth of large health networks have accelerated this exchange of medical data.

Abuses are prevalent: Pharmacy chains have sold patient information to drug makers to be used for direct marketing of medicines to those patients. Insurance representatives have advised employers of employees with costly medical problems. Banks have denied loans based on medical information about the loan applicants. Health care systems have posted patient files on the Internet, available to all.

The proposed rules only cover the privacy of electronic records. Traditional paper records, such as doctors' notes or individual patient history folders, are not covered.

Physicians are among the strongest supporters of strengthening medical records privacy, noting that confidentiality is the basis of effective treatment. Medical groups are arguing for tougher protections, while warning that some data sharing can improve patient treatment.

Under the rules, health care providers would have to tell patients how they use medical records and advise them of any policy changes. Health organizations would have to set up strong privacy protections, such as preventing disclosure of a patient's entire file in handling a single case. Patients would have the right to see and copy their medical records and to request corrections.

There are state laws that cover health care confidentiality, but this patchwork system lacks the comprehensive protections and stiff penalties proposed by the White House.

Health care privacy is a fundamental right. Mr. Clinton's proposed rules leave Americans with only partial protection. Further protections, in a new law, are required.

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