What's in *your* MIB?, part 2

A few weeks ago I linked to a video and post on the e-patient blog, about a woman who says she's been turned down for insurance repeatedly. According to Consumer Reports, she found out that the reason was an error in her MIB record. And as a consequence, her 401(k) has been completely drained by covering her ongoing health costs without insurance.

So I wrote my post, and for the time, that was that. But then I was contacted by an MIB official, and I had an extended exchange of emails with him. I asked the questions I posted on the e-patient blog:

• Is anybody, anywhere responsible for the accuracy of your MIB record?
• Is anybody liable for the consequences of reckless or negligent errors, or even for simple human mistakes?
• Is anybody required, under penalty of law, to correct such errors and make restitution for benefits that were wrongly withheld due to the errors?

In all our exchanges I didn't get direct answers to any of those questions, but here's the bottom line as I read it:

• Nobody (not nobody, not nohow) is responsible for whether their information in your MIB record is accurate. It's entirely up to you to detect and fix any errors. Most of the responses I got amounted to detailed repetition of how to request your MIB (during the hours that their robot phone answerer is turned on) and how to request a fix.
  
  
• Nobody (not nobody, not nohow) is responsible for any economic damage suffered by a patient as a result of such errors. Nobody, that is, except the patient (aka the victim).

In other words, the MIB and its contributors are not the least bit responsible for doing anything right, and if they don't, it's entirely and exclusively your problem.

I think you ought to contact them every year and get your annual free copy of what's in your MIB record, because it could be wrong, and it could cause you real harm.

But don't call right now - they shut off the phone answering computer on weekends and evenings, when most people are free to call and spend the seven minutes it takes to file your request through their robot.

Personally, I think the whole situation is disgusting, and I think some legislation would be in order.

What's in *your* MIB?

As regular readers know, the "e" in e-patient stands for "empowered, engaged, equipped and enabled." Usually we're talking about "power" in the sense of who has a say in a medical episode, but there's more to it than that: who owns your information, and who's responsible for keeping it accurate?

This is a story of a woman who's experiencing real harm from a doctor's condition coding error in her MIB record (Medical Information Bureau) and says her attempts to get it fixed were unsuccessful, leaving her in real financial trouble and completely powerless.

In the past I might have politely sat by and said "Gosh, that's bad news." But as an e-patient (empowered), I say "Hey, that's not right - that doesn't make any sense - can't we change this??"

I know the MIB exists to keep insurers from harm (fraud), but patients are vulnerable to harm, too. (Listen up; patient = YOU.) Looking into the story, I requested my own MIB record (like requesting your credit report) and was quite surprised at how one-sided the power is, in that world.

The full story, with short video, is over on the e-patient blog, where I also write.

Given the opacity of the system, I shudder to think about my chances of correcting any error.

See what happened after I spoke with them: part two of this series.

For more about the e-patient movement, see E-Patient? Yes, e-Patient.
For why I blog, with links to my excellent cancer story, see Why I Blog.

What's next - Google Health??

Well, what won't Google dip its (extremely large) toe into next? My, it's Google Health. Download your medical records from hospitals and pharmacies, and just give it all to Google and they'll take real good care of it.

Some of us get the creepies just THINKING of how much Google knows about our private stuff. Now "privates" could be more literally true than before.

Mind you, there's a large and legitimate move afoot to create some sort of universal (but private) form of medical records storage, some universally accessible database so when there's an emergency, physicians can treat you accurately and rapidly. (Heck, accurate and up to date information would be useful in non-emergency situations, too. It's amazing how difficult that is to achieve. Many healthcare bloggers have talked about it.)

When I attended a dinner meeting at BI-Deaconess last fall, we saw a new gadget that a patient can wear, a little USB disk drive containing all their medical records. If you were to be away from your usual care when an emergency befell you, this could be immensely valuable. It's a good thing. And if you read my cancer journal last year, you know I love online access to my medical information.

At work I spend a lot of time dealing with Google tools, particularly their "search engine marketing" tools. They write some amazingly good software.

But it'll be a cold day in hell before I hand them my medical data. Sure, they say I'll "own" it. But who could possibly police what they do with it?

Of course, the site says:

Google Health privacy policy: Google respects the privacy of your health information.

But I'm not comfortable that there's integrity behind that. See, there's this motto "don't be evil" that's espoused by CEO Eric Schmidt when discussing issues of privacy when Google reaches into your online underpants and reports its findings to the world. And I'll never forget 2005, when Google (particularly Schmidt) showed its real stripes on that issue.

CNet.com wrote a fairly balanced article about Google and privacy under the uncritical title "Google Balances Privacy, Reach." To illustrate the topic, the writer Googled Eric Schmidt himself, for just a half hour, and published what she found - about him, his salary, his neighbors, his political donations, etc.

And what was the response of The Goog? Why, CNet.com got its goolies chopped off by ... let me see... my, it was CEO Eric Schmidt! This CNN article relates how Schmidt banned CNet from getting any access to Google employees for a year. And when you're a tech news site, that's a major punishment.

GOOG's stock is doing great and I love their free tools, but there's no way in hell I'm giving them sensitive personal data, regardless of what their policy says. New motto for 2008: Don't Be Stupid.