IBM's new policy barring employment discrimination based on genetic information highlights major shortcomings in the United States medical records system, said a Duke University expert on business and health care.
The new IBM policy may be wise, but the fact that the company needed to make such a policy points out flaws in the current system, said Kevin Schulman, M.D., professor of business administration and medicine at Duke and director of the Health Sector Management program at Duke's Fuqua School of Business.
One shortcoming is the lack of privacy. Schulman said this comes from the country's patchwork system for medical records that allows input and access by a range of organizations, including physicians, insurers, independent disease management organizations and pharmaceutical benefits managers.
"This system exposes individual elements of the medical record to many different organizations, all collecting information for different purposes," Schulman said.
Another problem is that different pieces of information in an individual's medical record are owned by the different businesses (such as pharmaceutical benefits managers and insurance companies) that contribute to it, Schulman said. This raises the specter of corporations using ownership of genetic information as a competitive advantage in the health care arena, he said.
"We want health plans to compete on the basis of quality and cost of their services, not on the basis of ownership of individuals' private medical information, genomic or otherwise," Schulman said. "The policy issues highlighted in the genomic era are ones that already exist with other medical information. There is no reason why we continue to allow the development of business models based on third-party ownership of identified personal health information."