The Firsthand Report ⌗3
In this issue: Landmark Garvey v. NYC decision against C19 vaccine mandate overturned, federal government proposes medical record data to make tracking adverse effects--and people--easier
☞ The October 2022 decision in favor of 16 sanitation workers in GARVEY V. NYC HAS BEEN OVERTURNED ON APPEAL. The DSNY workers who filed the lawsuit had been fired by the City for declining to take a COVID-19 vaccine.
In a decision handed down by New York's Second Department yesterday, the appellate court reversed the lower court’s decision without addressing the merits of the case. Instead, the court ruled that the lawsuit had been filed too late and that there was therefore no need to consider its arguments.
The lower court decision had found the City’s imposition of a workplace COVID-19 vaccine mandate with exemptions for professional athletes and entertainers to be arbitrary and capricious and unconstitutional under New York State law.
Garvey v. NYC petitioners and their attorney Chad LaVeglia talked with me at the courthouse after the October 24, 2022 hearing where New York State Supreme Court Judge Ralph Porzio decided in their favor (video above).
It ordered the 16 petitioners to be reinstated and invalidated the mandate for other New York City workers, but the decision was immediately appealed (and ignored) by the City and had no effect. The petitioners waited until April 2024 for a panel of four appellate judges to hear the case, and nearly two years more for yesterday’s decision to be issued.
None of the 16 sanitation workers were ever reinstated.
I’ll have more to say about this pivotal case. If this is the first you’re hearing about it, you can get up to speed with my courthouse reporting on the Garvey hearings and other coverage.
☞ You know how tech wizards like Larry Ellison and Kathy Hochul want your medical records to be available any time, anywhere? To make that possible, there’s a core data set called the United States Core Data for Interoperability (USCDI) that all of the computer systems handling medical records have to be able to support.
The standard is continuously being updated, and the Department of Health and Human Services Assistant Secretary for Technology Policy (ASTP) recently adopted version 3.1, meaning that government-certified electronic health record systems have to support it.
ASTP also released a draft of USCDI version 7, and it’s a big update. It includes 30 new proposed categories of patient data. There are a few that reflect the administration’s Make America Healthy Again orientation and should please MAHA supporters:
Nutrition Assessment and Nutrition Order can help doctors track and address how nutrition is affecting someone’s health. Adverse Event and Adverse Event Outcome build MECHANISMS FOR TRACKING ADVERSE REACTIONS to drugs, vaccines, and other medical interventions right into the core medical record system.
However, the Adverse Event and Adverse Event Outcome entries are getting pushback from The Alliance for Quality Improvement and Patient Safety (AQIPS), which says the analysis required to tie an adverse event to medical care can’t legally be part of a patient’s medical record.
In addition to tracking adverse reactions, the PROPOSED DATA ELEMENTS WILL MAKE IT EASIER TO TRACK PEOPLE according to their vaccination status and other health data. The new Patient Identifier category is designed to include one or more identifiers for each patient.
State and private health systems already use identifiers to accurately match individuals to their medical records, but adding them to the core medical record could make that easier to do across networks.
It’s currently against the law for the federal government to create a national health ID, but there doesn’t seem to be anything stopping the private healthcare industry from adopting a standard unique identifier that could function as a de facto national (or international) patient identifier entered in the Patient Identifier field. (Let me know in the comments if you disagree!)
As a commenter from the National Center for Immunization and Repiratory Diseases notes in the USCDI 7 draft, a standard Patient Identifier could be used to more accurately match detailed vaccination histories to individuals anywhere they go. That would be useful for avoiding duplicate vaccinations, helping public health officials plan vaccine distribution, and monitoring vaccine safety.
It would also be helpful for public health authorities who want to identify individuals who have not complied with mandated vaccinations. Core USCDI patient records are not just available to health care providers. They are also accessible by public health authorities through health information exchanges like New York’s SHIN-NY.