Thanks for your help with my story about medical record privacy. Working on the story was a real education for me, (getting to meet all kinds of interesting people is one of the main reasons why I'm a reporter) and I had a few good coincidences that added some "atmosphere" to the piece. I've included the entire script below. I hope I'm not being presumptuous. The show in which my 8.5 minute piece aired is called "The Communications Revolution, produced by the Telecommunications Radio Project, which is headquartered at KPFA-FM in Berkeley. The project is funded by the California Public Utilities Commission, through the Telecommunications Education Trust (TET), which is basically money that was overpaid to Pac Bell by its customers. Other TET grantees are Gregg McVicar's "Privacy Project", and Beth Given's "Privacy Rights Clearinghouse" in San Diego. Our project is a series of 13 one hour, live, satellite- linked panel discussion and call-in shows that air on about thirty stations around the country (but especially in California). show: HEALTH PRIVACY Matt Binder 11/12/93 draft FINAL **************************************************************** *** cut 1 *** dramatic reading of condensed version of Hippocratic Oath (Ed Markman) in: "I swear by Apollo Physician, by Asclepius, by Health, and by all the gods and goddesses that I will carry out this oath: into whatsoever houses I enter, I will enter to help the sick, and whatsoever I shall see or hear in the course of my profession, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets...." (then fade) **************************************************************** SINCE THE TIME OF ANCIENT GREECE, DOCTORS HAVE UNDERSTOOD THE SENSITIVE NATURE OF THEIR PROFESSION, AND HAVE RECITED THIS, THE HIPPOCRATIC OATH, AS A PROMISE OF CONFIDENTIALITY. UNTIL RECENTLY PHYSICIANS HAVE KEPT THE SECRETS OF THEIR PATIENTS IN THEIR HEADS, OR ON PIECES OF PAPER IN A FILE. AND THEY'VE BEEN THE GATEKEEPERS FOR OTHERS WANTING TO SEE THIS EXTREMELY PRIVATE INFORMATION. BUT NOW, FOR SOME VERY GOOD REASONS, THAT'S ALL BEGINNING TO CHANGE. ---------------------------------------------------------------- --- ambience 1 --- dialysis machine (2:00) ---------------------------------------------------------------- ---------------------------------------------------------------- --- ambience 2 --- ventilator (2:00) ---------------------------------------------------------------- ---------------------------------------------------------------- --- ambience 3 --- Dr. Ting talking to patient (1:30) (3 possible starting points) ---------------------------------------------------------------- AT THE DIALYSIS UNIT AT EL CAMINO HOSPITAL IN MOUNTAINVIEW CALIFORNIA, DOCTOR GEORGE TING USES A COMPUTER TO KEEP RECORDS, ORDER TESTS AND PRESCRIBE DRUGS FOR HIS PATIENTS. HE SAYS THE COMPUTER SAVES HIM HOURS EACH WEEK, AND CAN EVEN SAVE LIVES... **************************************************************** *** cut 2 *** Dr. Ting :15 in: "For instance if you're ordering a medication on a patient, it automatically gives you the most common prescribing doses and frequency. It does make it less likely that you're gonna make some major mistake, prescribing ten times the usual amount." (then fade) **************************************************************** ---------------------------------------------------------------- --- ambience 4 --- Nurse Holt working at computer (1:10) ---------------------------------------------------------------- ---------------------------------------------------------------- --- ambience 5 --- computer printer (1:05) ---------------------------------------------------------------- NURSE JUDY HOLT IS AN EVEN STRONGER PROPONENT OF THE COMPUTER. WHEN NEW DOCTORS COME TO THE HOSPITAL AND RESIST USING THE COMPUTER SYSTEM, SHE AND OTHER NURSES PRESSURE THEM TO GET WITH THE PROGRAM... **************************************************************** *** cut 3 *** Holt :17 in: "We're all anxious to help them learn how to use the computer because it saves us time, it saves the possibility of transcription errors, it saves: 'I can't read this doctor's writing, what on earth does it say,' and if three of us looked at it and can't figure it out, we've gotta call him..." (then fade) **************************************************************** BUT THE COMPUTERIZATION OF MEDICAL RECORDS HAS A DOWNSIDE: AMASSING HUGE DATABASES OF SENSITIVE INFORMATION COULD OPEN THE DOOR TO PRIVACY INVASIONS ON A SCALE UNIMAGINABLE WITH PAPER FILES. IT'S ALREADY HAPPENING. INSURANCE COMPANIES AND DIRECT MARKETERS, AIDED BY COMPUTERS ALL LINKED TOGETHER BY PHONE LINES ARE FINDING WAYS TO GET AHOLD OF MEDICAL DATA, AND THEY'RE SELLING AND TRADING IT ACROSS VAST NETWORKS. ---------------------------------------------------------------- --- ambience 6 --- Taylor answering door on Halloween (1:00) in: "Trick or Treat!..." ---------------------------------------------------------------- IT'S HALLOWEEN NIGHT AT THE HOME OF MARY ROSE TAYLOR IN SPRINGFIELD MASSACHUSETTS. TAYLOR RECENTLY FOUND OUT HOW EASY IT IS TO GET TRAPPED IN ONE OF THOSE DATA WEBS. SHE APPLIED FOR HEALTH INSURANCE BUT WAS REJECTED BECAUSE OF A COMPUTER ERROR AT THE MEDICAL INFORMATION BUREAU, OR MIB, A HUGE MEDICAL DATABASE KEPT BY INSURANCE COMPANIES... **************************************************************** *** cut 4 *** Taylor :20 in: "They had my name on a urinalysis that wasn't mine, and they refused to think that there was any kind of mistake or mixup, and I went without insurance for a year and a half, and had to literally go to my state representative, the insurance commissioner just to have it corrected." **************************************************************** TAYLOR TOLD MIB AND HER INSURANCE COMPANY THAT SHE'D HAD ONLY A BLOOD TEST, NOT A URINE TEST, AND THEREFORE THE ABNORMAL URINALYSIS COULDN'T POSSIBLY BE HERS. BUT THE INSURANCE COMPANY INSISTED THAT SHE GAVE A URINE SAMPLE, THAT IT SHOWED THERE WAS SOMETHING WRONG WITH HER, THOUGH THEY WOULDN'T TELL HER WHAT IT WAS... **************************************************************** *** cut 5 *** Taylor :14 in: "At one point the risk manager had me in tears (sniff). He was very nasty, really. You know, and his words, what he said to me was that computers don't make mistakes. I said I agree, but the people that feed the computer do. **************************************************************** ---------------------------------------------------------------- --- ambience 5 comes up full again --- more Halloween sound (then fades out completely before next cut starts) ---------------------------------------------------------------- **************************************************************** *** cut 6 *** Anonymous (ALTERED VOICE) :10 in: "I'm paying fifteen thousand a year for disability, personal disability and medical insurance, and that seems like a whole heck of a lot of money..." (then fade) **************************************************************** ANOTHER VICTIM OF A MEDICAL INFORMATION BUREAU ERROR IS THIS DOCTOR FROM SOUTHERN CALIFORNIA WHO WANTS TO REMAIN ANONYMOUS. WHEN SHE ASKED HER INSURANCE COMPANY WHY HER RATES WERE SO HIGH, THEY TOLD HER THAT HER MIB FILE SHOWED THAT SHE HAD ALZHEIMER'S DISEASE AND A HEART CONDITION... **************************************************************** *** cut 7 *** Anonymous (ALTERED VOICE) :23 in: "Here I am a physician who works sixteen hours a day, who's never been in the hospital has Alzheimer's disease and a heart attack!? That doesn't make sense. I don't think computers and the people who put information into the computer are advanced enough to have such control over our lives." **************************************************************** **************************************************************** *** cut 8 *** Binder stand-up at MIB :24 in: "I'm now standing outside the entrance to MIB Incorporated in Westwood Massachusetts. I've been trying for over two months to get an interview with the president of the company, Neil Day. He says he doesn't have the time, and no one else can speak for the company. But he did admit during a telephone conversation we had that four percent of the 16 million computerized medical records in this building do have errors in them." **************************************************************** **************************************************************** *** cut 9 *** Smith :10 in: "I don't think MIB really needs the good will of consumers, as does a retail store, and in many ways the less known about MIB the better perhaps for insurance companies." **************************************************************** ROBERT ELLIS SMITH IS THE EDITOR OF PRIVACY JOURNAL IN PROVIDENCE RHODE ISLAND... **************************************************************** *** cut 10 *** Smith :23 in: "The ancient Greeks knew as others did that for medical care to work properly, you have to be totally candid to your doctor. But now instead of a one on one relationship there is a triangle among the provider, your insurance company and your employer, and medical information about us flows throughout that triangle without our participation. And that's the crisis we're in right now." **************************************************************** AFTER THE INSURERS AND EMPLOYERS, IT'S PHARMACEUTICAL COMPANIES AND DIRECT MARKETERS THAT ARE THE MOST AVID COMPILERS OF MEDICAL INFORMATION. SOME OF THESE COMPANIES HAVE TOLL-FREE TELEPHONE NUMBERS YOU CAN CALL TO GET FREE SAMPLES OF THEIR PRODUCTS. WHAT THEY DON'T TELL YOU WHEN YOU CALL IS THAT YOUR PHONE NUMBER AND OFTEN YOUR NAME AND ADDRESS AUTOMATICALLY POPS UP ON THEIR COMPUTER SCREENS, AND YOUR PERSONAL PROBLEM, WHETHER IT BE ALLERGIES OR HEMORRHOIDS GOES RIGHT INTO THEIR DATABASE. AGAIN THE COMPANIES THAT RUN THESE DATABASES REFUSED TO TALK ABOUT THEM. ----------------------------------------------------------------- --- ambience 6 --- Apter talking on phone ---------------------------------------------------------------- ONE MAN WHO'S NOT SHY AT ALL ABOUT HIS DATABASE SNOOPING IS JOE APTER, PRESIDENT OF TELEPHONIC-INFO INCORPORATED OF SAINT PETERSBURG FLORIDA. HIS COMPANY ACTUALLY HAS A PRICE LIST OF INFORMATION YOU CAN OBTAIN: $49 FOR SOMEONE'S SOCIAL SECURITY NUMBER; $299 WILL GET YOU SOMETHING CALLED A "MEDICAL PROFILE" THAT APTER WOULDN'T ELABORATE ON, BUT WHICH HE SAYS COMES FROM LEGAL SOURCES... **************************************************************** *** cut 11 *** Apter :24 in: "There are people out there that are providing medical records on an illegal basis. And the method they would use to obtain that would be a pretext into a doctor, and they'd have to know the doctor, or a pretext in the insurance company to get that information. We don't do that. or: *** alternate cut 11 *** Apter :24 in: "You and I are leaving threads as we go around, and we find those threads and we weave them together to get a picture. There are people out there that are providing medical records on an illegal basis. We don't do that." **************************************************************** **************************************************************** *** cut 12 *** Hippocratic oath (fades in under last cut, up full for a couple of seconds, then under next cut, then up again after next cut.) **************************************************************** **************************************************************** *** cut 13 *** Smith :22 in: "I think the answer is for patients to insist that doctors go back to that ancient ethical standard, and insist that they not disclose information about them without their informed consent totally. The concept of informed consent about the release of medical information seems to have gotten lost in the modern age." **************************************************************** (Hippocratic Oath comes up full again, then down briefly for soc out) I'M MATT BINDER FOR THE COMMUNICATIONS REVOLUTION.