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Proposed rule could make it easier to share addiction treatment records

A proposed change to how addiction treatment records are shared by health care providers has raised concerns about the potential impact on patient privacy.

On Thursday, the Department of Health and Human Services proposed a new rule that would give doctors greater access to records of patients who are being treated for substance use disorder, in an effort to better coordinate care.

But Leo Beletsky, a law and health professor at Northeastern University and University of California-San Diego, said while more coordinated care is needed,“giving up privacy to get there is not a necessary trade-off.”

“We need to create more privacy protections to encourage people who use drugs to seek treatment, not less,” he said. Beletsky also directs the Health in Justice Action Lab at Northeastern University.

The rule change would alter a forty year law that governs confidentiality of patient medical records tied to substance use disorder treatment programs that receive federal funds.

If the rule is approved, doctors will be able to share a patient’s records more easily, cutting administrative paperwork in an effort to coordinate care across providers.

As millions of Americans struggle with opioid use, Health Secretary Alex Azar suggested this change would ease access to improved treatment across health care providers.

The existing law has blocked coordination between doctors, Azar said during a call with reporters. Under the change, he said care would improve, and costs would drop. This change would allow doctors to work together and treat a patient “as a whole person,” he said.

Patients would still have to give consent to have their information shared, Azar said.

“None of the changes we’re proposing today change the consent requirement for sharing information,” he said.

The original law was passed to protect patients, because at the time, law enforcement was seizing lists of patient names at methadone clinics and then staging raids, said Keith Humphreys, a psychologist and professor at Stanford University. But the law’s costs may now outweigh the benefits, he said, adding that he welcomes the new Trump proposal.

“We have clear examples of where people were asked, and they said ‘No,’ [to struggling with controlled substances] and people died,” Humphreys said.

He pointed to an example of a young man who needed knee surgery and falsely told his surgeon he had not used drugs when in fact he had consumed methamphetamine shortly before the operation. When medical staff administered anesthesia, the young man died, Humphreys said.

“The way we need to change how we handle addiction is, we need to move it into the health care system,” Humphreys said. “You have to let the rest of the health care system know what you do, and you have to do it as a team.”

Doctors cannot orchestrate more coordinated care if they cannot get the records, Humphreys said.