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MEDICAL PRIVACY
Patient and Medical Confidentiality
"If my patients fear that what
they tell me could come back to haunt them,
they'll tend to be less
forthright. I may come up with the wrong treatment
because I was chasing the wrong
clues."
Nancy Dickey, M.D., Chairman, Board of
Trustees, American Medical Association, The Nightengale News,
Sept/Oct 1996
State Data Collection Laws and Proposals
Federal Laws and Proposals
Children and Schools
Protecting Privacy
Health Care Identifiers and Data Systems
- Birth Defect Registries
- Immunization Registries
- Federal OASIS home
health care database -
CCHC publishes 10 concerns
- Health care identification
numbers - National systems
- Social Security Numbers
- Medical Records Law in Minnesota
Allows Access without Patient Consent
- Health Care Smart Cards
- Health
Passports In a public-private initiative to bring smartcards
(plastic cards with embedded computer chips) into the health care
industry, public and private funding is directed at a new
three-state initiative. The Western Governors' Association (WGA)
will pilot the Health Passport Program in three cities. (Cheyenne,
WY; Bismarck, N.D.; and Reno, NV) According to the WGA, the HPP
"is one dimension of a much broader public health strategy for the
next century...it will ensure convergence with financial and
retail industry plans for a universal transition to smart cards by
the year 2000." The intent is "[e]xpanding the population of
potential HPP card holders so that it can serve as a portable
medical record or access key for a majority of providers'
patients." The director of the Bismarck project expects the cards
to rollout in May 1999. This could be similar to the
"MNCard" defeated in 1997. More
information can be found at
Enhanced Electronic
Benefit guidelines (88 pages)
- Unique Patient Identifiers
- Master Patient Index:
- Sequoia Software Corporation working with federal
government to develop a Master Patient Index (MPI) to link all
patient medical records without use of national ID number.
- From Project Brief, last updated 2/28/98: "Develop a Master
Patient Index that combines and correlates computerized patient
records from different healthcare organizations. Such a system
could save lives by providing immediate access to summary
medical records in emergencies, increase detection of fraud in
Medicare and Medicaid programs, reduce the costly duplication
of medical tests and increase provider productivity."
- October 1997 Press release from
Sequoia Software
Corporation titled Sequoia
Software Chosen to Link U.S. Patient Records:
Sequoia Corporation has received a grant from the U.S. Commerce
Department's National Institute of Standards and Technology
(NIST) as a result of winning the Department-sponsored Advanced
Technology Program competition in the category of "Information
Infrastructure for Healthcare." The MPI will be a method to
link records by indexing to correlate and cross-reference
patient identifiers such as name, birthday and Social Security
number. Sequoia's product is Medstar, an SGML/XML-based
solution for summary patient records and health care
transaction management. The use of these national standards for
information interchange will enable the seamless flow of data
across different technology platforms throughout widely-spread
networks.
- An August 26, 1998 Sequoia press release titled Sequoia Software Partners with Johns Hopkins
Health System in Building National Master Patient
Index states that JHHS
will be the "testbed for the development of healthcare's
national Master Patient Index (MPI)" According to Sequoia, "The
MPI is key to the creation of a secure computer network
allowing an authorized doctor or healthcare provider anywhere
in the nation to quickly access a patient's medical
information."
- The amount of the grant is yet unknown. Contacts at
Sequoia: Jeff Mason, jeffm@sequoiasw.com (410-715-0206, ext.
226) or Wes Shaffer, wshaf@cstoneadv.com (410-727-2131, ext.
216)
Reports and Rulings
- GAO Reports on Privacy
Regulations, Social Security Numbers, Security of Federal Data
Systems
- 1/20/99: The Joint Commission on Accreditation of Healthcare
Organizations and the National Committee for Quality
Assurance(NCQA) in a report
called Protecting Personal Health Information: A Framework for
Meeting the Challenges in a Managed Care Environment, warn that
patients who are worried about the privacy of sensitive personal
and medical information may withhold information from health care
professionals, increasing the risk of misdiagnosis and inadequate
or inappropriate treatment.
Surveillance, Research and Links
Health Care Surveillance and Medical Research
All Kids
Count - Robert Wood Johnson Funding Program for immunization
registries
Centers for Disease Control and
Prevention - Home Page
Centers for Disease
Control - health care surveillance
Every Child By Two (ECBT) -
American Nurses Foundation initiative
G-7
Global Healthcare Applications Project.
Health Resources and
Services Adminstration - Maternal and Child Health Bureau
HHS Data
Council
"The HHS Data Council coordinates all health and non-health
data collection
and analysis activities of the Department of Health and Human
Services,
rincluding an integrated health data collection strategy,
coordination of health data standards and health information and privacy policy
activities. The Secretary
has placed the Data Council in charge of the implementation of
the
Administrative
Simplification provisions of the Health Insurance
Portability and Accountability Act of 1996."
March of Dimes - supports
registry of persons on birth defect databases without parent or
patient consent
Mayo Clinic
National Committee on
Vital and Health Statistics (home page)
National
Committee on Vital and Health Statistics (core health data
elements for collection)
National Immunization
Registry Clearinghouse - registry specifics
National Immunization
Program (home page)
National Health Information
Resource Center - Funded in part by RWJF; members only site
Office of the Assistant
Secretary for Planning and Evaluation
Robert Wood Johnson
Foundation - RWJF in Minnesota
Other Organizations
Human Genome
Organisation (HUGO)
International Biometric Industry
Association
"THE WORKFORCE ATM" - run
by the Center for Employment Security Education and Research, and
the U.S. Department of Labor. Data entered by States
World Health
Organization
Medical Information Bureau
American Health Information
Management Association
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