Academic journal article Generations

Health Information Privacy in a Changing Landscape

Academic journal article Generations

Health Information Privacy in a Changing Landscape

Article excerpt

Healthcare providers need to be part of the solution to consumers' privacy worries, by building trust through education.

At a time when health information is increasingly available online, and clinicians are transitioning from paper to electronic medical records, consumers remain concerned about protecting this highly sensitive personal information. They fear an unauthorized person might see their health information; they might be denied insurance, credit, or employment opportunities; and they're worried about identity theft, fraud, discrimination, and embarrassment (Dimitropoulos et al., 2011b). The technology for securely storing and sharing health information continues to evolve to allow increased data sharing and aggregation within the healthcare system. While these changes could provide many benefits by reducing costs and improving quality of care, they also present new privacy challenges.

This article provides an overview of the current framework for protecting the privacy of health information; explores technology trends that affect health information privacy; discusses the current state of privacy protection in the healthcare sector; and, describes suggested practices for healthcare professionals to be able to enhance privacy and build trust with their patients.

Health Information Privacy Basics

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instituted a national legal foundation for health information privacy. The law established broad principles and called for the Department of Health and Human Services (HHS) to issue detailed privacy and security standards if Congress did not do so within a specified time frame. HHS subsequently issued implementing regulations known as the Privacy Rule and the Security Rule. HIPAA and the Privacy Rule do not apply to every entity that maintains health information but to covered entities-health plans that provide health insurance benefits; healthcare providers such as doctors, other healthcare professionals, and, hospitals that conduct electronic transactions; and, healthcare clearinghouses that format health data.

The Privacy Rule permits the sharing of health information without patient authorization (consent) for treatment, payment, and healthcare operations, and for other specified purposes. All other sharing requires written authorization from the individual. Most disclosures are not mandatory, giving providers broad discretion in whether or not to share health information with other entities (U.S. Congress, 1996; The HIPAA Privacy Rule, 2013; Koontz, 2013). The HIPAA Security Rule is designed to ensure that health information is protected from unauthorized access and disclosure, and designates the administrative, technical, and physical controls that covered entities must put in place (U.S. Congress, 1996; The HIPAA Security Rule, 2013).

Trends in Technology

One of the most important technological trends in healthcare is the movement toward electronic health records (EHR) and health information exchange. Largely fueled by government incentive programs, healthcare providers- including physicians, other healthcare professionals, and hospitals-increasingly are storing patient records electronically. The creation of these digitized records will, in turn, enable electronic sharing among providers to show a more complete picture of an individual's health. This will be of particular benefit to older Americans, who are more likely to see a larger number of providers, and to their caregivers, care team, and family (Dimitropoulos et al., 2011a). The goal is that this information will be shared with researchers more quickly and aggregated, analyzed, and turned into actionable knowledge to improve the overall quality of healthcare in this country.

Another benefit of EHR adoption is the ability to empower individuals by using technology to make their health information more accessible to them. Providers increasingly are establishing portals or other means to enable patients to view their health information online, download the information, and transmit it to a third party-a provider, relative, caregiver, or anyone else the patient designates. …

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