Your health information is increasingly stored in an electronic format so providers can easily view, transmit and manipulate it with your best interests in mind. However, as with any digital data, there’s always a possibility that it will fall into the wrong hands where an identity thief or ill-intentioned person can use it against you.
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that sets rules and limits on who can look at and receive your health information. Until recently, the law hadn’t received any major updates since the Department of Health & Human Services (HHS) originally established it in 1996.
The good news is that in January, HHS released sweeping changes to the rule that not only enhance patient privacy and security protections in an ever-expanding digital age, but also provide individuals new rights to their health information and strengthen the governmen's ability to enforce the law.
CyberScout caught up with Judi Hofman, co-chairwoman for the American Health Information Management Association’s national privacy and security practice council, to discuss what these changes mean for consumers.
Q: The latest changes to HIPAA include a substantial expansion of patients’ rights. Why is this, and why now?
A: The healthcare industry has seen such a huge expansion of electronic medical records over the last decade. The federal government is working to secure patient rights to privacy as health information technology quickly evolves. The rule should empower patients to become more active participants in their healthcare, including how their personal health information is used and disclosed in an electronic environment.
Q: Patients can now ask for copies of their electronic medical record in an electronic form. Why should patients request a copy of their record, and is there any benefit to having it in a digital format?
A: HIPAA always has allowed patients to request copies of their medical records. Having a copy of your record allows you to digest the information on your own. It also helps ensure continuity of care with your other providers. The electronic format (e.g., in a PDF or on a CD) is beneficial because patients can easily import that information into a personal health record online where they can begin to build a comprehensive history of their own health. They can also share their electronic copy with loved ones who can help them make decisions about their treatment.
Q: Self-pay patients can now instruct their providers not to share information about their treatment with their health plan. Why is this important?
A: Allowing patients who pay out-of-pocket the choice to restrict information about specific health care items or services from payers is one more way in which HHS is promoting individual privacy. Some patients may want to restrict sensitive information, such as HIV or a mental health diagnosis, for example. When making this request, providers must ensure that any current or future billing doesn’t include references to the restricted information.
Q: There are also changes in terms of how information is used and disclosed for marketing and fund-raising purposes. Can you explain?
A: Many patients may not realize that not-for-profit hospitals are allowed to use personal information for fund-raising purposes, such as raising funds for a new cancer treatment center or family birthing unit, for example. This includes demographic information (e.g., name, address, other contact information, age, gender, and date of birth) as well as information about health insurance status, date and department of service, treating physician, and outcomes. Covered entities must now provide patients with the ability to easily opt out of fundraising. Although patients can’t generally opt out of marketing, the new rule limits uses and disclosures of protected health information for marketing by covered entities. These entities must obtain patients’ explicit authorization when they are marketing a product for which they could receive remuneration.
Q: Changes to HIPAA also set stricter requirements for business associates. What is a business associate, and what will stricter requirements mean for patients?
A: A business associate is a contracted entity that has access to your health information so it can perform a service on behalf of the covered entity. For example, a medical transcription company can access your physician’s dictations to transcribe information into your electronic record. The changes to HIPAA hold business associates to the same standards as any other covered entity in terms of protecting your information and notifying you in the event of a breach. This should give consumers greater confidence in the overall protection of their health information regardless of who is accessing it for a variety of purposes in a healthcare setting.
Q: Can you explain the new process for identifying breaches and what patients need to know?
A: Covered entities and business associates work diligently to prevent any breaches of protected health information. However, when breaches do occur, they now have clear criteria to identify when a disclosure of unsecured protected health information is reportable to the patient as well as the federal government. More specifically, they must consider the nature of the information involved, the unauthorized person who used the information or to whom it was disclosed, whether the information was acquired or viewed, and the extent to which the risk of the breach has been mitigated.
Q: Will patient information ultimately be more protected as a result of the recent changes to HIPAA? Could the changes help reduce incidences of identity theft?
A: As regulations become more stringent, patient information will be more protected and secured from identity thieves. The goal is to help protect the confidentiality, integrity and availability of patient data. There are consequences for not doing so.