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PubMedDate not supplied

Health care privacy: preparing for the brave new world, Part II.

Are you ready to talk privacy with your patients? Physicians need to be. In the not-too-distant future, health providers will be required by federal law to describe their information-management practices to most people who seek care. In addition, new regulations require specific types of informed patient permissions--notably written "consents" and "authorizations"--before certain information may be used or disclosed. This article, the second of a four-part series on how federal privacy regulations will affect the day-to-day lives of physicians and their staffs, outlines what you need to know about notices and permissions for these "informed discussions."

Confidentiality↗
PubMed2001

The impact of HIPAA's privacy rules on multiemployer group health plans.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposed a number of requirements that affect multiemployer group health plans, among them the Privacy Rules, with which most group health plans must comply by April 14, 2003. Because the Privacy Rules are complex and carry significant penalties, multiemployer group health plans and trustees should begin preparing for them soon.

Confidentiality↗
PubMed2002

Ready for HIPAA? Take steps to protect patient privacy before it's too late.

The Health Insurance Portability and Accountability Act (HIPAA) will become effective April 2003 and will require you to address patient privacy issues throughout your ED. Use sign-in sheets that conceal the patient's name. Give patients beepers instead of calling out names in the waiting room. Use a special code to give patients additional privacy.

Confidentiality↗
PubMed2002

[Evaluation of Swedish and Finnish web portals for physicians. The usability is considerable but there are problems with privacy and ethics].

A critical overview of Swedish and Finnish medical web portals for doctors is presented in this article. Three Swedish and three Finnish portals were analysed using 54 dichotomous questions, derived from the guidelines of the American Medical Association (AMA), and 17 technical heuristic questions for web usability. 34 portal features were cross-tabulated with all portals. None of the portals did adhere to the AMA guidelines perfectly. Several problems with advertising, sponsorship, and website privacy were observed. Besides professional functionalities, the portals provided services for personal communication and entertainment features. The incomplete correspondence between the AMA guidelines and the current praxis of Nordic web portals for doctors may have many reasons. However, it is safe to conclude that Swedish and Finnish portals for physicians have some severe publicistic or ethical problems. Every physician should note that website privacy is not enough respected.

Advertising↗
PubMed2002

HIPAA standards for privacy of individually identifiable health information: an introduction to the consent debate.

On March 27, 2002, DHHS published proposed amendments to the Privacy Standards under HIPAA. The most controversial of these changes is the removal of the requirement that providers obtain patient consent before using or disclosing protected health information for treatment, payment, and healthcare operations. Some see this change as a rejection of privacy rights, while others see it as an acknowledgement of practical reality. This comment introduces the reader to the issues that are debated immediately following in the articles by Geralyn A. Kidera and Kristen Rosati.

Access to Information↗
PubMed2002

HIPAA: the patient privacy challenge.

The HIPAA privacy rule, slated to take effect in April, guarantees patients access to their medical records, gives them more control over how their health information is used and disclosed, and provides recourse if their privacy is compromised. Providers need to understand their responsibilities and rights. Our fold-out guide will help providers understand the rule so that new policies and procedures can be implemented without interfering with access to quality care.

Confidentiality↗
PubMed2003

HIPAA privacy rules and compliance with federal and state employment laws: the participant authorization form.

Although HIPAA privacy rules do not apply directly to employers or to employment records, they do apply indirectly to employers because employer-sponsored group health plans and all health care providers are covered. HIPAA privacy regulations overlap with federal and state employment laws, and liabilities for breach of confidentiality can be substantial. Employers can use a participant's authorization form to comply with employment laws and company policies. Sample authorization forms are provided at the end of this article.

Confidentiality↗
PubMed2003

Time is running out--the burdens and challenges of HIPAA compliance: a look at preemption analysis, the "minimum necessary" standard, and the notice of privacy practices.

Ms. Guthrie's paper involves the final Privacy Regulations promulgated by the Department of Health and Human Services pursuant to HIPAA. Her thesis highlights three burdensome requirements which remain significant obstacles to the compliance date of April 14, 2003: (1) the need to undertake thorough preemption analyses, (2) lack of clarity surrounding the "Minimum Necessary Standard," and (3) confusion regarding the "Notice of Privacy Practices." Ms. Guthrie provides a close analysis of these three areas and offers several viable and persuasive alternatives to the associated burdens. She concludes that HHS must make several integral modifications and provide substantial and continuing guidance to covered entities in order for the Regulations to effectively achieve their purpose.

Confidentiality↗
PubMedDate not supplied

Recognizing and reducing risks: HIPAA privacy and security enforcement.

With the passing of the Health Insurance Portability and Accountability Act (HIPAA) privacy rule deadline and the security rule deadline looming, many covered entities are left wondering if they are doing enough to prevent privacy and security breaches and what type of exposure their organization could face in the event of a breach.

Computer Security↗
PubMed2003

Secure communication and management of clinical and genomic data: the use of pseudonymisation as privacy enhancing technique.

The growing need of managing both clinical and genetic data raises important legal and ethical challenges. This article introduces some of the privacy protection problems related to genomic medicine and highlights the relevance of Trusted Third Parties and of Privacy Enhancing Techniques (PETs) in the context of e.g. research. Practical approaches based on two pseudonymisation models, for both batch and interactive data collection and exchange, are presented.

Access to Information↗
PubMed2004

Health information privacy and syndromic surveillance systems.

The development of syndromic surveillance systems to detect potential terrorist-related outbreaks has the potential to be a useful public health surveillance activity. However, the perception of how the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule applies to the disclosure of certain public health information might affect the ability of state and local health departments to implement syndromic surveillance systems within their jurisdictions. To assess this effect, a multiple-question survey asked respondents to share their experiences regarding patient confidentiality and HIPAA Privacy Rule requirements when implementing syndromic surveillance systems. This assessment summarizes the results of a national survey of state terrorism-preparedness coordinators and state epidemiologists and reflects the authors' and others' experiences with implementation.

Bioterrorism↗
PubMed2006

Protecting health information privacy in research: what's an ethics committee like yours doing in a job like this?

The Commonwealth and State legislation designed to protect the privacy of personal health information has attracted the criticism that the constraints imposed on the use of the information in research obstructs that research. A central and common feature of the legislation is the reliance upon the review by human research ethics committees of research that proposes to use personal health information for research without prior consent from those whose information it is. The origins of this reliance are explored and explained and it is suggested that this has proved to be an inappropriate policy choice. The extension of the reliance is then described and the conceptual, procedural, workload and structural consequences of requiring these voluntary committees to conform to legislative standards of review of issues of the public interest are critically examined. In recent reviews of the Commonwealth legislation, there is recognition of the underlying uncertainty as to the appropriate balance between protection of personal privacy and the promotion of beneficial research. In the further exploration of these matters that those reviews recommended, a close and critical examination of the wisdom of continuing to rely on ethics committees is needed.

Australia↗
PubMed1991

The uncomfortable community meeting and the privacy-urgency coordinate: discussion and case study.

The authors review the literature and describe factors contributing both to the value and to the discomfort of community meetings on an adolescent inpatient unit. The defensive use of an exaggerated estimation of meeting discomfort is discussed, and the concept of a "privacy-urgency coordinate," useful in analyzing group dynamics, is introduced. A case example illustrates the importance of balancing the need of patients for privacy with their need to resolve urgent problems on the unit.

Adolescent↗
PubMed1981

Disclosure of computerized health care information: provider privacy rights under supply side competition.

This Article explores the constitutional, statutory and common law privacy rights of physicians given the inescapable role of delivery data under supply side competition. The Article begins with a general review of the federal constitutional right of privacy. It then discusses the statutory protection given to physician-specific data under current federal law, and considers the insights gained from the controversy over physician data and the federal Freedom of Information Act. The remainder of the Article analyzes the usefulness of several common law causes of action to remedy the misuse of physician data, and concludes with recommendations which may obviate the need for litigation to protect against misuse of physician-specific data.

Civil Rights↗
PubMed1993

Blood testing without consent: the right to privacy versus the right to know (Part 1).

There are a number of circumstances under which it may be argued that compulsory blood testing is justified. In the face of demands for the right to know, how does a hospital or other health care provider ensure that a patient's right to privacy is respected? Which right should prevail: the right to know or the right to privacy? This article reviews Canadian common law and Alberta legislation affecting blood testing for communicable diseases, considers the effect of the Canadian Charter of Rights and Freedoms (the charter) on legislation which imposes non-consensual blood testing and concludes that compulsory blood testing based upon reasonable and individualized suspicion of infection or demonstrated necessity may be upheld under the charter if it can be established that the results of such testing will be of significant use. However, in the majority of circumstances, it will be difficult to establish that non-consensual blood testing of patients is reasonably justified in a free and democratic society under the charter. Moreover, even if a health care provider could legally implement a mandatory blood testing policy, there are a number of good reasons not to do so.

AIDS Serodiagnosis↗
PubMed1993

Privacy beliefs and the violent family. Extending the ethical argument for physician intervention.

Privacy beliefs associated with the family impede physicians' response to domestic violence. As a private sphere, the family is regarded as sacred, separate, and hidden from public view. Hence, physicians who look for or uncover violence in the family risk defilling a sacred object and violating norms of non-interference. Privacy beliefs also obfuscate the ethical analysis of physicians' duties to intercede on behalf of battered patients. Ethical principles of beneficence and nonmaleficence have been invoked to justify physicians' duties to abused patients; however, the principle of justice has not been invoked. Ethical analysis of physicians' duties in this area must be broadened to include the principle of justice. Justice is at stake because establishing conditions favorable to self-respect is a requirement of justice, and the response physicians make to battered patients carries important ramifications for supporting patients' self-respect and dignity. If justice forms part of the ethical foundation for physician intervention in domestic violence, mandatory steps that do not transgress the confidentiality of the physician-patient relationship or infringe the patient's autonomy should be taken, such as requiring domestic violence training in medical education and following treatment plans and protocols to identify abuse and provide assistance to battered patients.

American Medical Association↗
PubMed1996

[Privacy and drug surveillance: a study of the viewpoints of medication users].

OBJECTIVE: To study the views of patients regarding privacy in relation to the procedures of postmarketing surveillance studies. DESIGN: A population-based cross-sectional study (survey). SETTING: Dutch community pharmacies. METHODS: From a source population of 1030 pharmacists 30 (2.9%) were selected at random; 28 (93.3%) of them co-operated with the investigation. Pharmacists were visited for one day each in their pharmacies during which visit their patients were asked to fill in a questionnaire. On the day of the visit, a random number of patients were asked whether the prescriptions were for themselves. Out of a total of 1277 patients in the 28 pharmacies, 849 (66.5%) used the filled prescriptions themselves. Of these 849, 669 patients (78.8%) co-operated and completed a questionnaire pertaining to their perceptions of privacy in relation to reporting of adverse drug reactions (ADR) and postmarketing surveillance studies. RESULTS: Of the 669 respondents 628 (94%) had no objection against the reporting of ADR to the Inspectorate for Health Care by their medical practitioner or pharmacist. 505 (77%) respondents did not object to the use of their medical data, even if these were not anonymous, as long as the data were kept strictly confidential. Most patients were of the opinion that such data could be used without asking permission. Males would more readily give their permission than females. CONCLUSIONS: Most respondents had no objections to use of their medical data for postmarketing surveillance studies. The large majority of patients did not object to the reporting of ADR to the Inspectorate for Health Care.

Adult↗
PubMed1996

The most personal information of all: an appraisal of genetic privacy in the shadow of the Human Genome Project.

The advent of genetics and genetic testing has given rise to unique problems for the family. The discovery of a predisposition to a genetic condition in one individual also reveals information about the genetic make-up and potential risks of family members. There is, therefore, potential for conflict over access to and control of such information. Traditionally the duty of confidentiality owed by a health care professional to a patient has provided an appropriate means by which personal health information has been kept secured. It is not clear, however, that the problems which surrounds genetic information in the familial milieu can be adequately dealt with using confidentiality. This article examines these problems and argues for the value of an appeal to the concept of privacy in seeking to resolve some of the more intractable issues.

Choice Behavior↗