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Electronic databases and privacy protection: issues for a free society.

More efficiently managed programs of health insurance claims processing and remittance with reduced costs and paperwork burdens hold out the potential for increased benefits to subscribers and health insurers alike. The computer/telecommunications systems and databases by which these efficiencies may be realized also hold great promise for improved services in other arenas. Early and candid recognition of the equally great potential for danger and abuse in those systems and the technology can guide the development and implementation of appropriate and necessary safeguards to individual privacy and to a democratic society in concert with system design.

Civil Rights↗

Privacy Act of 1974--HCFA. Notice of a matching program--between HCFA and the Wisconsin Bureau of Workers' Compensation--HCFA will receive information from the state concerning work-related injuries and diseases.

Section 1862(b)(2) of the Social Security Act (42 U.S.C. 1395(b)(2)) prohibits Medicare payment with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made promptly, under a workers' compensation law or plan of the United States or a State. HCFA has developed a model agreement to be used in negotiating individual agreements with State Workers' Compensation Boards. The agreement will allow HCFA to seek recovery of identified mistaken payments that are the liability of workers' compensation agencies. The matching report set forth below is in compliance with the Computer Matching and Privacy Protection Act of 1988 (Pub. L. 100-503).

Centers for Medicare and Medicaid Services, U.S.↗

Point of care and patient privacy: who is in control?

Public and patient access to medical records has been severely limited through policies limiting physical and timely access and intellectual understanding of content. New expectations of patient/public access and control have arisen accompanying the new paradigms of health care delivery and health information (computer-based patient records). Examples from these new paradigms are personalized and presented in information system contexts from bedside to community settings. Patient and family involvement in care delivery, education, assessment, and control of privacy are explored. A personalized confidentiality/security/privacy module of the computer-based patient record is suggested.

Computer Security↗

Health care and privacy law in electronic commerce.

As electronic data interchange (EDI) continues to gain acceptance and use, questions regarding protection of the confidentiality of private healthcare information have arisen. This article explains how a computer-based information system equipped with appropriate safeguards can be far better at ensuring privacy than a paper-based system.

Computer Communication Networks↗

Implementing data privacy and security (the Slovenian experience).

Data protection is carried out in two steps. The legislation covers data privacy in general as well as its projection in health care. Its purpose was to leave no personal data undefined within the national health care system. The regulations deal with procedures and anticipated corrective actions, rendering a so-called "organisational prescription". Its purpose was to assure data security through an appropriate information system.

Computer Security↗

Privacy on trial in Massachusetts: Commonwealth v. Stockhammer.

Health records are not always private. In this case, the court said that a defendant in a rape case could see certain medical records pertaining to the victim's hospitalization for an unrelated overdose that occurred months after the attack. This article explores the legal decision and its impact on medical privacy.

Adolescent↗

Public Health Service--Privacy Act of 1974. Notification of new system of records: "clinical research; records of subjects in intramural research, epidemiology, demography, and biometry studies on aging.".

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to adopt a new system of records. "Clinical Research: Records of Subjects in Intramural Research, Epidemiology, Demography, and Biometry Studies on Aging." DHHS/NIH/NIA, 09-25-0142. These records will be used to accomplish scientific research conducted by intramural scientists employed by the National Institute on Aging (NIA), and by hospitals, universities, research centers and research foundation under contract with NIA. These research activities aim at determining the health status of individuals and changes in health status over time, the incidence and prevalence of certain diseases and problems of the aged in certain populations, and changes that take place as the individuals age who are under study.

Aging↗

Privacy Act of 1974; new system of records--Department of Health and Human Services. Notification of new system of records. Mental Health Epidemiologic and Biometric Research Data.

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing a notice of a proposal to initiate a new system of records in the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA), National Institute of Mental Health (NIMH), entitled, "Mental Health Epidemiologic and Biometric Research Data, HHS/ADAMHA/NIMH." The purpose of the new system will be to maintain a data base for biometric and epidemiologic research in the area of mental health and mental illness. This system will allow the statistical analysis of research data to test hypotheses about relationships among the various items of information and generate new hypotheses to guide future research.

Confidentiality↗

Privacy Act of 1974; new system of records--Department of Health and Human Services; Public Health Service. Notification of a new system of records: 09-25-0143.

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new system of records, 09-25-0143, Biomedical Research: Records of Subjects in Clinical, Epidemiologic and Biometric Studies of the National Institute of Allergy and Infectious Diseases, HHS/NIH/NIAID. We are also proposing routine uses for this system. This system will be used to support (1) epidemiologic, clinical and biometric investigations into the causes, nature (morbidity and mortality), outcome, therapy and cost of infectious, immunologic and related diseases; (2) review and evaluation of the progress of these research projects, and identification and planning for improvements or for additional research. The population and statistical studies supported by this system may be conducted or managed by Institute staff as well as others outside the Institute. This system comprises records maintained in a number of distinct research projects. The number and specific nature of projects will change over time as new ones are started and as work on existing projects is completed.

Communicable Disease Control↗

Privacy Act of 1974; clarification of record system notice--Office of the Assistant Secretary for Personnel Administration, HHS. Notice of changes to routine uses.

The Department is giving notice that it is deleting some and clarifying other existing routine use disclosures, clarifying the categories of individuals covered by the system, adding a restriction of the policy on access to the system by non-record subjects and non-Employee Counseling Service staff, and updating the list of system managers for the Privacy Act record system notice: 09-90-0010-Employee Counseling Service Program Records, HHS/OS/ASPER. Records in this system contain information on employees who have been counseled by the Employee Counseling Services for alcohol abuse, drug abuse or emotional problems.

Civil Rights↗

Privacy Act of 1974; report of routine use--Social Security Administration. New routine use disclosure.

In accordance with the Privacy Act (5 U.S.C. 552a(e)(11)), we are issuing public notice of our intent to establish a new routine use of information we maintain in the majority of our systems of records. The proposed routine use will enable us to disclose information, as necessary, when utilizing a contractor or other Federal agency to assist in the efficient administration of our programs.

Civil Rights↗

Privacy Act of 1974; notification of new system of records--PHS. Notification of new system of records, "Health Resources and Services Administration Loan Repayment/Debt Management Records System.

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new system of records entitled "Health Resources and Services Administration Loan Repayment/Debt Management Records System, HHS/HRSA/OA," 09-15-0045. PHS invites interested persons to submit comments on the proposed routine use established for the new system of records on or before August 10, 1983.

Civil Rights↗

Privacy Act of 1974; annual publication of systems of records--FDA.

FDA is publishing this document to meet requirements of Pub. L. 97-375, the Congressional Reports Elimination Act. This new statute amends the Privacy Act (5 U.S.C. 552a, section 3(e)(4] to limit republication to revised system notices only. FDA has reviewed each of its system notices and has revised many of its system notices this year to enhance specificity and clarify the effects of reorganization. These revisions are minor and have no affect on the public's need-to-know. Therefore, FDA is not republishing any of its system notices at this time.

Civil Rights↗

Privacy Act of 1974; system of records--PHS.

In accordance with the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to add a new routine use to system of records 00-37-0013. "Health Resources Utilization Statistics, HHS/OASH/NCHS." This system of records is maintained in the National Center for Health Statistics (NCHS) for the purposes of collecting statistics on the utilization of health services, processing and analyzing the data, and publication of the statistical findings. NCHS is proposing to add a new routine use to permit disclosure of information to a contractor. PHS invites interested persons to submit comments on or before January 11, 1984.

Civil Rights↗

Privacy Act of 1974; report of new system--HCFA.

In accordance with the requirements of the Privacy Act of 1974, we are proposing to establish a new system of records, Evaluation of the Medicare Competition Demonstrations, HHS/HCFA/ORD No. 09-70-0029. We have provided background information about the proposed system in the "Supplementary Information" section below. HCFA invites public comments by January 23, 1984, with respect to routine uses of the system. Dates: HCFA filed a new system report with the Speaker of the House, the President of the Senate, and the Director, Office of Management and Budget (OMB) on December 16, 1983. The new system of records, including routine uses, will become effective 60 days from December 16, 1983, unless HCFA receives comments which would convince us to make a contrary determination.

Centers for Medicare and Medicaid Services, U.S.↗

Privacy Act of 1974; systems of records--PHS.

In accordance with the requirements of the Privacy Act and the Debt Collection Act of 1932 (Pub. L. 97-365), the Public Health Service (PHS) is publishing a notice of a proposal to add three routine uses and a "special disclosure" statement to four systems of records in the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA). PHS invites interested persons to submit comments on the proposed routine uses on or before February 27, 1984.

Civil Rights↗

Privacy Act of 1974; system of records--PHS. Notification of a new system of records: 09-30-0046, "Survey of alcohol use among youth and young adults".

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new system of records entitled, "Survey of Alcohol Use Among Youth and Young Adults, HHS/ADAMHA/NIAAA," to create a single comprehensive research data base so that critical issues associated with alcohol use among 16- to 27-year-olds can be analyzed. PHS invites interested persons to submit comments on the proposed routine uses on or before March 19, 1984. DATES: PHS has sent a Report of a New System to the Congress and to the Office of Management and Budget (OMB) on Februrary 8, 1984 PHS has requested that OMB grant a waiver of the usual requirement that a system of records not be put into effect until 60 days after the report is sent to OMB and Congress (If this waver is granted, PHS will publish a notice to that effect in the Federal Register.)

Adolescent↗