Untying the privacy knot
A $17 million project is evaluating whether enough common ground exists in 50 sets of state health privacy laws to support one national health records exchange. It might be a long shot
Amid the chaos of a hospital’s emergency room, an out-of-town woman seeks medical attention for her mother, who is confused and behaving erratically. The older woman is taking a psychotropic medication prescribed by
a doctor in another state.
Can the mother’s physician transmit her electronic medical records across state lines to the emergency room’s physicians? Is the daughter authorized to review those records or to make medical decisions on behalf of her mother? What level of disclosure is allowed by states’ laws intended to protect the privacy of mental health patients? Are those laws compatible?
Depending on the jurisdictions involved, their laws, legal interpretations of
those laws and federal statutes, the compliance policies of the hospitals, and the ability of medical staff to understand conflicting legal issues, answers to those questions will vary, particularly when a determination is needed stat.
“Those are real-life scenarios we come
up with every day at the doctor’s office,
the pharmacy and in paying claims,” said
Angie Santiago, a health-care consultant
in North Carolina. “Every day we’re releasing
[medical information] incorrectly
or holding it back incorrectly. There are
situations where patients themselves ask
for information, and our medical records
people are unsure what to release.”
The example above and 17 other such
scenarios will be examined in detail in the
coming months by 33 states and the commonwealth
of Puerto Rico. A project
called the Health Information Security
and Privacy Collaboration (HISPC) will
chronicle the vagaries of public policies
and business practices that determine the
privacy and security of Americans’ electronic
medical records.
The review is a critical first step toward
realizing a national system for creating
and sharing patients’ electronic records
across state lines, proponents of such a
system say. Eager to see results, the project’s leaders are “pushing this along in a very
aggressive manner,” said Michael Purcaro,
executive director of the Public Health Foundation
of Connecticut. “We’re all for it. That’s
the kind of pressure you need to put on the