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Privacy Act of 1974; proposed implementation. Office of the Secretary, HHS. Final rule.

The Department of Health and Human Services is exempting a new system of records, 09-25-0213, "Administration: Investigative Records, HHS/NIH/OM/OA/OMA," from certain requirements of the Privacy Act to protect records compiled in the course of an inquiry and/or investigation and to protect the identity of confidential sources who furnish information to the Government under an express promise that the identity of such source would be held in confidence.

Forms and Records Control↗

HIPAA privacy: "individual rights" and the "minimum necessary" requirements.

This Article focuses on two key aspects of the proposed regulations related to health information privacy published by the Department of Health and Human Services ("DHHS") pursuant to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). These two aspects, the provisions regarding individual rights and the provisions requiring use of the minimum amount of information necessary to accomplish a given purpose, will be particularly burdensome for the healthcare industry. Furthermore, they are likely to generate a significant number of complaints to the DHHS Secretary relating to alleged violations of the regulations. This Article analyzes the proposed regulations governing these two issues and offers practical advice regarding steps that entities should take in anticipation of the final regulations.

Computer Security↗

Cost of privacy rules could dwarf Y2K, experts say.

It may not have generated the media hype that the Y2K computer bug did, but the Health Insurance Portability and Accountability Act could end up costing hospitals several times as much. The brunt of the expense is likely to come from the law's privacy standards, which experts say are so broad and complex that simply understanding which parts apply to your facility could represent a major undertaking.

Facility Regulation and Control↗

Property rights and privacy principles.

Healthcare consumers own their medical information. As paper medical folders become digital, protection of this private and confidential information falls to information specialists rather than the traditional care givers. On the basis of a nationwide market assessment study, the authors identify the key issues regarding protecting this personal digital property and outline the federal requirements stemming from the Health Insurance Portability and Accountability Act (HIPAA). Consumer informed consent over the use of specific medical data is a basic requirement, and is a concept supported by physicians and care givers who rely on consent to approve surgeries and treatment. The article concludes with a solution outline that places the patient in control of his or her personal information, meets security and privacy concerns, and facilitates the critical exchange of patient information among care givers.

Computer Security↗

Standards for privacy of individually identifiable health information. Final rule; correction of effective and compliance dates.

This action corrects the effective date of the final rules adopting standards for privacy of individually identifiable health information published on December 28, 2000, in the Federal Register (65 FR 82462), resulting in a new effective date of April 14, 2001. The change in the effective date delays, by operation of law, the compliance dates published in the final rules. The compliance dates in the final rules are revised accordingly.

Confidentiality↗

Cyberinfo: privacy and personal health data in cyberspace.

In this series of articles, the author discusses the potential risks, benefits, and liabilities in using electronic communications and computer-based record keeping for patients' medical data. Article #1 in this series reviews the foundations of privacy for personal information and the current practices of collecting disaggregated private personal and medical data made possible on the Internet by software and hardware configurations.

Computer Security↗

Privacy or life: how do women find out about screening mammography services?

AIM: This study investigated how women found out about the Waikato pilot breast cancer screening programme and what influenced them to participate. METHODS: A sample of 1085 women who had undergone screening mammography were sent survey questionnaires in 1999 to investigate how they had found out about the programme and what had influenced them to participate. Data from 599 completed questionnaires were analysed. RESULTS: The most common external sources of information about the availability of screening mammography were: letters of invitation (42%), family doctors (42%), television (32%), and newspapers (27%). The most important external sources of influence for attending screening were: letter of invitation (28%), and knowing someone with breast cancer (27%). CONCLUSIONS: Letters of invitation from the programme provide an important source of influence for attending screening mammography clinics. Up-to-date databases are needed to ensure that women receive information from the screening programme. There was an inconsistency between the government policy to provide a population-based screening programme and the operation of the Privacy Act 1993, which prevents use of other sources of information to update addresses for population groups most likely to benefit from screening. The high gone, no address rate reduced ongoing screening among women who depend on receiving regular recall notices.

Breast Neoplasms↗

The Health Insurance Portability and Accountability Act: practice of dentistry in the United States: privacy and confidentiality.

This paper introduces the reader to the Health Insurance Portability and Accountability Act (HIPAA) of 1996 legislation in the context of its relationship to the Electronic Oral Health Record (EOHR). Privacy and confidentiality issues for administrative data are addressed in terms of the broader relationship of such data to the EOHR leaving the HIPAA-defined administrative transactions and security issues for the entire practice for a subsequent presentation. Educational requirements are presented that aid the dentist and the practice staff in understanding the broad and long-term implications of the HIPAA legislation.

Confidentiality↗

Disclosing health information breaches of confidence, privacy and the notion of the "treating team".

The authors utilise cases collected during a randomised population survey to illustrate some of the legal and policy issues concerning routine transfers of information between treating practitioners. Their analysis suggests that implied consent for many routine uses of health information should not be assumed. An important part of consent to health information disclosure is the patients' ability to tailor its scope and content. This requires that they should be provided with additional information. Introducing the measures advised into the clinical setting would bring health information-gathering practices closer to compliance with the collection principles contained in Australian information privacy legislation.

Australia↗

The "GeneTrustee": a universal identification system that ensures privacy and confidentiality for human genetic databases.

This article describes a generic model for access to samples and information in human genetic databases. The model utilises a "GeneTrustee", a third-party intermediary independent of the subjects and of the investigators or database custodians. The GeneTrustee model has been implemented successfully in various community genetics screening programs and has facilitated research access to genetic databases while protecting the privacy and confidentiality of research subjects. The GeneTrustee model could also be applied to various types of non-conventional genetic databases, including neonatal screening Guthrie card collections, and to forensic DNA samples.

Confidentiality↗

Learning from experience: privacy and the secondary use of data in health research.

In this fast-moving age of data banking, data are a currency, and often a commodity. Electronic health records are being developed everywhere. Increasingly, data collected for various primary purposes are being re-used for research. With personal mobility, contracting of services, and telemedicine, health care data are crossing national borders, and therefore so are genetic information, biological materials, and reimbursement data. There is much public and legal concern about the implications. This article addresses the question: Under what conditions may data not collected specifically for research, such as primary medical data, be re-used for health research without compromising the privacy of the data-subjects?

Biological Specimen Banks↗

Application of amendments to the Privacy Act (Cth) 1988 as they affect private clinical practice.

INTRODUCTION: The amendments to the Privacy Act (Cth) 1988 came into force on 21st December 2001. These changes expand the impact of the Act to include the private sector and will have considerable consequences upon healthcare delivery in Australia. This paper reports the findings of a survey, which examined the implications of the Act for doctors in private practice. METHOD: Both Government and private agencies were canvassed to seek clarification of various aspects of the Act. Responses were analysed to determine what needed to be done to ensure compliance with the Act and were reviewed in the light of published material provided by commentators. RESULTS: Of twenty-one contacts, only ten responded of which five were Government agencies. Government agencies chose to deflect commentary and did not respond to specific questions. The Medical Defence Organisations (MDOs) provided the most useful commentary, highlighting various 'grey areas' of concern. DISCUSSION: Government agencies tasked with the enforcement of the Act were unhelpful in providing useful guidelines to specific questions. MDOs offered by guidelines to risk management obviate litigation. This survey emphasised the concept that legislation developed for general purposes required redefinition to be applicable to the medical profession and had the capacity to negatively impact upon patient well-being.

Access to Information↗

Curing the unique health identifier: a reconciliation of new technology and privacy rights.

The Health Insurance Portability and Accountability Act has mandated the assignment of a universal individual health identifier in 2003. Such an identifier can increase patient confidentiality, improve patient care, lower the cost of services to the patient, enhance administrative efficiency, and increase the opportunity for medical research. Nevertheless, national identification systems raise concerns about confidentiality and privacy. Instead of a mandatory, government-assigned number, this article proposes a technologically multi-tiered system that would be administered by a mixed government and private entity. Consumers could voluntarily opt-in to the system.

Confidentiality↗

The recent Italian Consolidation Act on privacy: new measures for data protection.

In the light of the new Consolidation Act on privacy, in effect since January 2004, the author has made some observations in relation to the protection of data concerning health. Special focus has been given to an overall view of the new regulations. "Sensitive data" are seen as differing from health data, while always respecting the rights, the fundamental freedom and the dignity of the person involved. A central role continues to be played by the Controller, who has regulating and control powers.

Computer Security↗

Federal health information privacy cases from 2005.

The federal Personal Information Protection and Electronics Documents Act (PIPEDA) governs the collection, use and disclosure of personal information. PIPEDA is important legislation for people living with HIV/AIDS as it establishes rules for the handling of personal information, including personal health information. PIPEDA applies to personal information handled by commercial enterprises in the course of commercial activities throughout Canada, except in provinces that have significantly similar laws. Complaints under PIPEDA are heard by the Privacy Commissioner of Canada (PC). This article reviews the interpretation and application of PIPEDA in complaints related to health information decided in 2005.

Canada↗

Privacy and confidentiality--old concept, new challenges.

This paper concerns a privacy and confidentiality problem in cases of exceptional situations. It is primarily aimed at using DNA samples, and at a breach of genetic data protection. European legal provisions are especially mentioned.

Confidentiality↗