The Co-Knuckleheads of the Day Part One

There are knuckleheads raining down from the sky today. So much so I have four awards to give out.

The first winners today are New York City Health Commissioner Dr. Thomas Frieden and the NY City Board of health. They are ordering laboratories to pass along information to the cithy health department on individual blood sugar test results. All so as to help those with diabetes live longer as Dr. Frieden says.

What a grievous violation of a patient's privacy. I'm sorry but if a Health board is allowed to get this information on these grounds, they can get anything in a person's health record. Someone will say health departments get all sorts of private information on people like mothers having pre-natal testing. Its gone too far already. Diabetes is not contagious. This is no precedent to be setting, and I just hope our courts will put Dr. Frieden and his knucklehead co-horts in their place.

For wanting to violate the privacy of the citizens of New York City, Dr. Thomas Frieden and the NY City Board of health are co-Knuckleheads of the day.

Update- I gave five Knucklehead awards today.

Hat tip- Ultima Thule
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As part of a broad new effort to better understand how diabetics manage their illness, the New York City Board of Health is ordering laboratories to pass along detailed information on individual tests that measure blood sugar levels to the city's health department.

It is the first such reporting and tracking effort in the country, and it is being closely watched by public health officials nationwide wrestling with ways to better control the epidemic of diabetes.

An estimated 520,000 adult New Yorkers have been diagnosed with diabetes, according to the health department. It is thought that an additional 265,000 New Yorkers have diabetes, but do not know it. It was the fourth-leading cause of death in the city in 2003, the first time it made it into the top five.

Diabetics must control their blood sugar levels to prevent serious complications from the disease. The city wants the laboratories to report information from what are known as A1c tests, which are more detailed than the daily blood sugar tests patients perform on themselves. In the A1c tests, which diabetics are supposed to have done two to four times a year, a doctor is able to measure the average amount of glucose in the blood over a period of months.

By gathering data on the tests, the city hopes to coordinate intervention programs. Within six months, officials hope to use the information to reach out to local doctors and, in some cases, patients, to urge lifestyle changes and other measures to better control the disease.

"We're confident that this measure will help people with diabetes live longer and healthier lives," said Dr. Thomas R. Frieden, the city health commissioner.

While laboratories have long been required to pass along patient information on infectious diseases like hepatitis, this is the first time public health officials are trying to use similar techniques to control a chronic disease.

However, some critics of the effort worry that it is an invasion of patient privacy, especially since people will not be given the chance to opt out of having their information collected. There is also a fear that the information could find its way into the hands of insurance providers, who could, in turn, use it to discriminate against patients.

"I am shocked and dismayed to hear this news about A1c blood test results being given to the health department without patient knowledge or consent," said Robin Kaigh, a New York lawyer who has tracked medical privacy issues. She added, "In addition, this landmark step will cause other databases of sensitive patient information or disease registries to be seriously contemplated in the future."

In response to such concerns, Dr. Frieden said, "The utmost care will be taken to keep this information secure and confidential while we work toward improving patient care."

The health department, whose board voted unanimously yesterday to begin the program, hopes to collect data on at least 90 percent of those diagnosed with diabetes.

If the effort is successful, the department would collect and analyze data on roughly 500,000 patients, which would require a massive commitment of time and resources.