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Posts Tagged ‘phi’

The practicality of sharing PHI

Wednesday, May 27th, 2009

There will be circumstances when it is necessary to share PHI with a patient’s family and friends.  This is permitted under the HIPAA as long as the information is needed, and pertinent to the ongoing care of the patient.

Practical examples would be if a patient’s family are waiting in an ER or outside an operating theatre and the doctor or surgeon wants to update them on the patient’s condition, treatment or medical procedure.

Or if a patient is being looked after by a friend or family member, they are going to need to know the condition and types of care needed.  For example the type of medication, or particular type of care.  Any symptoms or side affects to be aware of, or how to provide a certain treatment at home.

These kinds of things are practical to the continued care and wellbeing of the patient and are permitted to be shared with (generally designated) family and friends.  These circumstances do not necessarily need the patients consent either.  In some circumstances the patient may not be able to offer their consent, if they are incapacitated or unfit.  The medical personnel are then permitted to make a judgement call of what information to share and with whom to share it.

There are also permitted discussions and use of PHI if a family member or friend is assisting or arranging payment for the treatment.  Some sharing of the medical information is going to be necessary to justify the bill, or allow the person to involve the insurance company.  Again, a good practical reason for sharing the information allowed under HIPAA.

So although the HIPAA is fairly stringent in controlling access to PHI, it tries to add a practical approach to how it handles things.  It is designed to protect the information as much as possible while not interfering with the actual care of the patient.

HIPAA and email

Tuesday, March 17th, 2009


As discussed last time HIPAA email is regarded as anything that contains any information relating to your medical records.  They don’t have to be the records themselves, they can be anything from your address or phone number, date of birth, social security number, next of kin, insurance information administrative or otherwise and even your admission information for any medical visits or stays.

It isn’t only clinics, hospitals or doctors that are subject to this.  Your employer is too if you have a health or medical plan.  If email is becoming an increasingly popular medium for transmitting your information then it is logical that those mails are stored somewhere.  Companies who handle this kind of information have to have an information storage strategy that complies with HIPAA and many other pieces of legislation.  Many companies handle this in-house with their existing staff and infrastructure.

Some outsource this burden to companies like Archive Compliance who will take care of their secure storage for them.  Companies like this have to demonstrate that their storage and retrieval methods are secure to be able to remain in business.

This method may not be palatable to everyone as you are paying out, but own nothing.  One the other hand you are paying someone to take all the hassle out of not just HIPAA email storage but all of your email storage needs.

HIPAA and you

Thursday, March 12th, 2009


Information is a commodity increasingly in demand.  Having access to people’s health information would be like the holy grail to a criminal or even an insurance company.  With the medical profession becoming increasingly digital there is even more opportunity for your private information to go missing.

Some medical practitioners will now consult by email.  Medical records can be transferred like this too.  This can leave people with an uncomfortable feeling, knowing their innermost medical secrets are floating around the ether.  HIPAA email is regarded as anything that contains any information relating to your medical records.  They don’t have to be the records themselves, they can be anything from your address or phone number, date of birth, social security number, next of kin, insurance information administrative or otherwise and even your admission information for any medical visits or stays.

We live in a defensive society where we have to be on our guard all the time, in real life and online.  Information privacy is a big issue that gets lots of attention for good and for bad.  Imagine how much your personal medical information is worth to somebody if it fell into the wrong hands.  What mischief could they do?

All electronic communication that relates even loosely to medical records is covered under the HIPAA.  The Health Insurance Portability and Accountability Act (HIPAA) of 1996 established federal regulations that require all organizations that manage Protected Health Information (PHI) to safeguard the privacy and security of their data.

This Act isn’t restricted to clinic or healthcare businesses.  Any organization that sends or receives Personal Health Information (PHI) is subject to this compliance legislation.  Although the legislation has been in force for a while, a 2006 survey of more than 300 healthcare providers and subscribers found that only about half of them are compliant with the HIPAA Security standards.

The pertinent part of the HIPAA is the Privacy Rule.  Wikipedia says this about it;

“The Privacy Rule

The Privacy Rule took effect on April 14, 2003, with a one-year extension for certain “small plans.” The HIPAA Privacy Rule regulates the use and disclosure of certain information held by “covered entities” (generally, health care clearinghouses, employer sponsored health plans, health insurers, and medical service providers that engage in certain transactions.) It establishes regulations for the use and disclosure of Protected Health Information (PHI). PHI is any information held by a covered entity which concerns health status, provision of health care, or payment for health care that can be linked to an individual.  This is interpreted rather broadly and includes any part of an individual’s medical record or payment history.

Covered entities must disclose PHI to the individual within 30 days upon request.  They also must disclose PHI when required to do so by law, such as reporting suspected child abuse to state child welfare agencies.

A covered entity may disclose PHI to facilitate treatment, payment, or health care operations or if the covered entity has obtained authorization from the individual.  However, when a covered entity discloses any PHI, it must make a reasonable effort to disclose only the minimum necessary information required to achieve its purpose.

The Privacy Rule gives individuals the right to request that a covered entity correct any inaccurate PHI.  It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals.  For example, an individual can ask to be called at his or her work number, instead of home or cell phone number.

The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also keep track of disclosures of PHI and document privacy policies and procedures.  They must appoint a Privacy Official and a contact person responsible for receiving complaints and train all members of their workforce in procedures regarding PHI.

An individual who believes that the Privacy Rule is not being upheld can file a complaint with the Department of Health and Human Services Office for Civil Rights (OCR).  However, according to the Wall Street Journal, the OCR has a long backlog and ignores most complaints. “Complaints of privacy violations have been piling up at the Department of Health and Human Services. Between April 2003 and Nov. 30, the agency fielded 23,896 complaints related to medical-privacy rules, but it has not yet taken any enforcement actions against hospitals, doctors, insurers or anyone else for rule violations. A spokesman for the agency says it has closed three-quarters of the complaints, typically because it found no violation or after it provided informal guidance to the parties involved.”

(Wikipedia, Health Insurance Portability and Accountability Act, 2009)

So you see that there is protection and enforcement out there if your information does go missing.  However this Act doesn’t prevent your information going missing in the first place…