January 15, 2014 | LXXIII, No. 42

Doctor: Building a tool for CMC didn't breach privacy

One of the doctors who felt his reputation was unneccessarily harmed by a notice sent to his patients and placed in the newspaper, last week explained the work he had been up to.

In an interview, Dr. Andrew Castrodale said the “HIPAA” notice, made under the federal Health Insurance Portability and Accountability Act, implied the work had been about figuring out bonus pay, but was actually meant to devise a reliable tool for measuring and reporting the efficiency and productivity of health care providers at Coulee Medical Center.

Although it did not name Castrodale, the “Notice of Patient Privacy Breach” that arrived in mailboxes Jan. 3 and 4 said the doctor had improperly shared patient information with his wife.

Castrodale said his wife, Sherril, is an actuary, and was helping him build a standardized statistical tool that could be used by Coulee Medical Center.

“None of this has to do with anyone’s medical history,” he said.

“The institution is contractually supposed to provide us with a … report of our work level,” Castrodale said. “The problem was, their report was not timely … and, in my opinion, not accurate.”

Castrodale said he was trying to build a prototype report that would incorporate “relative value units,” a nationally standardized way of measuring health care providers’ work loads.

That’s important, he said, both for accurate assessments of performance, managing assignments, and for recruiting more physicians as proposed in the feasibility study used to get the financing to build the new hospital.

Castrodale said that study called for hiring a third physician in 2012 and another in 2014, “just to be feasible to pay the mortgage.”

As it is, either he or Dr. Jacob Chaffee must remain within 20 minutes of the hospital at all times. That’s leading to burnout and is risky, he said.

A pay scale proposal, authorized by the board of commissioners last summer and offered to doctors, is not acceptable and certainly can’t be used to recruit any more physicians, Castrodale said.

Devising a quick, accurate way of reporting provider work output that takes into account varied and unusual duties encountered at CMC would be a step toward objectively showing patient load across CMC’s work venues — the clinic, hospital, emergency room and more — and toward recruiting the physicians Castrodale believes are needed.

He suspects the HIPAA notice served another purpose.

“To me, it’s a smokescreen,” he said. “There are bigger issues that don’t have anything to do with me.”

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