Sharing of Health Information Progresses, but Privacy Lags

Standards and regulations on how health information can be shared have improved, but patient information still needs protection.

A year after a federal advisory committee recommended how health information could be shared, the country has moved a long way to harmonizing standards and relaxing regulations that barred hospitals from promoting health IT, but it still needs to implement measures to protect patients information.

In October 2005, a commission on systemic interoperability laid out a series of recommendations for connecting the fragmented systems that hold Americans health information.

On Oct. 31, 2006, Scott Wallace, head of the now-disbanded commission, said that the government had acted on eight of the 14 recommendations.

However, it has not yet adopted recommendations that would prevent patients from being discriminated against because of the release of the information, even if the release itself was illegal.

Of areas where progress has been made, one of the most notable is the relaxation of anti-corruption rules that prevented hospitals from donating equipment and training to community physicians to help them adopt health IT.

Other achievements are a certification process for electronic health records and selection of technology standards to allow different systems to exchange information, according to a statement released Oct. 31 by the National Alliance for Health Information Technology, which Scott Wallace has led for several years.

However, HHS (Department of Health and Human Services) has not moved to find ways to prohibit discrimination based on data gathered through the unauthorized release of patients health information.

It also has not implemented criminal sanctions for privacy violations, even though a report this June from the NCVHS (National Committee on Vital and Health Statistics), a group that advises HHS, made the same recommendation, along with the advice that HIPAA (Health Insurance Privacy and Portability Act) be enforced.

HHS did commission a study examining how variations in states privacy laws might impede interoperable health IT.

A pdf from the alliance describing the commissions recommendations and the progress made for each is available here.

/zimages/4/28571.gifClick here to read about how more communities are exchanging health information.

The commission was created in January 2005 to study how to make health information accessible across different health systems. Its members were appointed by Congress and President Bush, and the commission was set to be disbanded after making its recommendations.

While Wallace praised HHS for supporting health IT, he said progress in Congress was more limited. Several health IT bills that incorporated the Commissions recommendations have stalled.

"Congressional approval is mandatory for several key recommendations, including implementing a national standard for matching patients and their health records," he said.

Meanwhile, other measures to connect health information are moving ahead. The National Committee on Vital and Health Statistics Workgroup on National Information Infrastructure unanimously voted to approve a report outlining the basic criteria for networks that exchange health information.

In Nov. 2005, HHS awarded four contracts to develop prototypes of the NHIN (National Health Information Network), and NCVHS was charged with synthesizing the requirements identified by the contractors.

The NCVHS was not supposed to make architectural requirements, but to make sure that the networks are "wrapped in a privacy and security structure that warrants the trust of the individual whose information is exchanged."

In the end, NCVHS recommended a series of what it called "high-level requirements."

These included certification, authentication, authorization, person identification, location of health information, transport and content standards, data transactions, auditing and logging, time-sensitive data access, communications, and data storage.

For a pdf of a draft version of the report, click here.

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