This isn't going to go well for Pharmacy chains

[buckguy]

https://www.washingtonpost.com/technolo ... -abortion/

Here are some key quotes:

The nation’s largest pharmacy chains have handed over Americans’ prescription records to police and government investigators without a warrant, a congressional investigation found, raising concerns about threats to medical privacy.

Though some of the chains require their lawyers to review law enforcement requests, three of the largest — CVS Health, Kroger and Rite Aid, with a combined 60,000 locations nationwide — said they allow pharmacy staff members to hand over customers’ medical records in the store.

The policy was revealed in a letter sent late Monday to Xavier Becerra, the secretary of the Department of Health and Human Services, by Sen. Ron Wyden (D-Ore.) and Reps. Pramila Jayapal (D-Wash.) and Sara Jacobs (D-Calif.).

The members began investigating the practice after the Supreme Court’s decision last year in Dobbs v. Jackson Women’s Health Organization ended the constitutional right to abortion.

The revelation could shape the debate over Americans’ expectations of privacy as Texas and other states move to criminalize abortion and drugs related to reproductive health.

Pharmacies’ records hold some of the most intimate details of their customers’ personal lives, including years-old medical conditions and the prescriptions they take for mental health and birth control.

Only one of the companies, Amazon, said it notified customers when law enforcement demanded its pharmacy records unless there was a legal prohibition, such as a “gag order,” preventing it from doing so, the lawmakers said.

Because the chains often share records across all locations, a pharmacy in one state can access a person’s medical history from states with more-restrictive laws. Carly Zubrzycki, an associate professor at the University of Connecticut law school, wrote last year that this could link a person’s out-of-state medical care via a “digital trail” back to their home state.

[Alpha8472]

I work in a pharmacy. We protect patient information. We only give it out if a doctor calls to get the information or someone else with authorization.

What I am thinking is that people tried to scam information out of a pharmacy. There is no way to verify if a person over the phone is a doctor or not. Unless you ask the doctor to come into the pharmacy in person and you check photo ID.

If a doctor asks what medications a patient is using you have to give it out. You wouldn't be able to run a pharmacy if you asked each doctor to bring ID for each phone call.

You would never be able to give any information over the phone.

If the police come to a pharmacy you are not supposed to say anything. They need photo ID and legal documents.

[storewanderer]

This is a valid point to be raising. You have these giant 10,000 store chains who have sold the benefit of having all pharmacies "linked" to the customer (so the customer can go to any location, easily get medicine on vacation if forgotten, etc.) and someone if the graveyard shift pharmacist at store 14574 wants to look up the prescriptions of some customer across the country they can do that. I can see how the average customer may not be comfortable with that.

Where I see this going is certain states enhance privacy policies and may allow for some kind of feature to lock your records in some way. Maybe you lock your records so only your "home store" or the "filling store" can view your records. So you lose the benefit of the "linked pharmacy." The other giant benefit you lose is the drug interaction check that is built into a lot of the pharmacy softwares and they need all of your prescription data to run that query.

Personally I think the benefits of the drug interaction check far outweigh if some graveyard pharmacist across the country knows I am on mental health medicine or whatever else I took.

[Alpha8472]

At my pharmacy chain, the way our system works is that each store has its own separate records. You only see the records of patients at your store.

If someone wants to use a store while on vacation for example, the new store would have to search for the patient using name and date of birth. Then a copy of the patient's information is imported to the new store. It will not show anything except for name, address, phone number and insurance. To see a list of medications you would then have to search for the drug list.

All of this is tracked, so you cannot go looking for random people unless you have several pieces of personal information.

This system makes it difficult to search for people's personal information.

Customers can request their information be unlinked from store to store. That way they can maintain private records. Customers can also request that their information be hidden from insurance companies.

So a customer could pick up medications and pay out of pocket and hide those records from their insurance company.

Using prescription discount cards is a different story. With those cards, patients sign away all of their privacy rights to get the discount and the discount card companies get all of your information such as name, date of birth, address, medication lists, doctor's names, medical conditions, and email. This information can then be sold by the discount card company for a profit or even posted on the internet.

[veteran+]

I work in a pharmacy. We protect patient information. We only give it out if a doctor calls to get the information or someone else with authorization.

What I am thinking is that people tried to scam information out of a pharmacy. There is no way to verify if a person over the phone is a doctor or not. Unless you ask the doctor to come into the pharmacy in person and you check photo ID.

If a doctor asks what medications a patient is using you have to give it out. You wouldn't be able to run a pharmacy if you asked each doctor to bring ID for each phone call.

You would never be able to give any information over the phone.

If the police come to a pharmacy you are not supposed to say anything. They need photo ID and legal documents.

Don't you have to ask for the Doctor's unique I.D. Code or something like that?

[buckguy]

I think the point here is that records apparently are given to law enforcement without necessarily having a lot of scrutiny. Given the the battles over Mifapristone and concern about what may happen to contraception, this isn't going away any time soon. Beyond the legal issues, this also could put a crimp in chains' plans to use preventive health as a new source of revenue and the larger enterprise of the "Minute Clinic"-type places that they're establishing.

[Alpha8472]

Doctors can give a license number over the phone, but that license number can be found on the internet easily. You never know if a person on the phone is a real doctor unless you see their photo ID in person.

[buckguy]

Some additional detail from the Congressional hearings: https://thehill.com/business/4355894-ph ... t-warrant/

[Alpha8472]

Say for example a patient in a prison medical clinic and is dying. The doctor asks the pharmacy what medications is the patient currently taking. Is the pharmacy supposed to say, sorry we cannot give out that information. Please send us a warrant. Please also verify your identity with photo ID license numbers and the patient's signature release form.

What if the patient has just fled Texas to have an abortion is dying of complications in the prison? Where does this warrant requirement get us? There are so many questions.

[storewanderer]

Say for example a patient in a prison medical clinic and is dying. The doctor asks the pharmacy what medications is the patient currently taking. Is the pharmacy supposed to say, sorry we cannot give out that information. Please send us a warrant. Please also verify your identity with photo ID license numbers and the patient's signature release form.

What if the patient has just fled Texas to have an abortion is dying of complications in the prison? Where does this warrant requirement get us? There are so many questions.

Questions lawmakers who have never worked in a pharmacy and are probably not considering or even fully understanding the various questions you have posed, are going to decide the answers to.