The Revolution in Health Care Funding and Delivery
Marcia Egan, Goldie Kadushin in Social Work Practice in Community-Based Health Care, 2012
HIPAA covers all those who provide, bill, or pay for medical care and those who process health consumer information (i.e., health care clearinghouses). A health care provider is defined as anyone who furnishes health care, bills for, or is paid for care provided; social workers are included as health providers. Health plans include all government organizations, private organizations, and individuals that provide for, process information, or pay medical costs. Last, health care clearing-houses—organizations that receive health information from providers and manage or transform that information for claims—include those that provide billing services and third party administration. Health information (i.e., protected health information or PHI) is specifically defined to include any information, whether spoken, electronic, or written, that refers to the health of an individual or to the payment for care provided and that could directly or indirectly be used to identify that individual. Individual health information (IHI) includes age, geographic information, zip code, gender, race, ethnicity, and marital status. The issue is, of course, disclosure and confidentiality. Specifically, HIPAA requires that no information be transferred through any medium unless the consumer, or his or her legally specified agent, approves in writing that transmittal, unless otherwise permitted or required by law, and that any transmittal be only the minimum necessary information.
Cloud computing for big data
Jun Deng, Lei Xing in Big Data in Radiation Oncology, 2019
The security of patient-related information is a major concern in the adoption of Cloud computing by health care providers. In the United States, protected health information (PHI) is regulated according to the Health Insurance Portability and Accountability Act (HIPAA) of 1996. This extensive set of regulations applies to covered entities (i.e., hospitals) and business associates (e.g., commercial vendors) to assure patients that their PHI is confidential and protected. Under these rules, Cloud service providers are considered business associates. A business associate is defined as an entity that requires access to PHI to provide services either to a covered entity or to another business associate. In order for a Cloud provider to process PHI, it must enter in a HIPAA-compliant business associate agreement with a covered entity. A service level agreement can be established to ensure that the Cloud provider meets HIPAA regulatory obligations. This agreement covers topics such as system availability and reliability, backup and data recovery, security, and information disclosure.
Patient Data Privacy, Protected Health Information, and Ethics of Real-World Evidence
Kelly H. Zou, Lobna A. Salem, Amrit Ray in Real-World Evidence in a Patient-Centric Digital Era, 2023
In the context of expanding utilization of and access to Real World Evidence (RWE) and Real World Data (RWD), privacy and the appropriate use of such data are of utmost importance. The United States (US) Health Insurance Portability and Accountability Act of 1996 (HIPAA 1996, Summary of HIPAA privacy rules) is a federal law enacted in August, 1996, which required the creation of national standards that would prevent the disclosure of patient sensitive health data without their prior consent or knowledge. The US Department of Health and Human Services (“HHS”) issued the HIPAA Privacy Rule, to allow for implementation of the requirements of HIPAA. Whilst ensuring the privacy and protection of individuals’ health information, HIPAA enables the appropriate flow of this information to facilitate and support high quality healthcare (HIPAA 1996). Individuals and organizations, such as healthcare providers, health plans and healthcare clearinghouses, herein referred to as “Covered Entities” subject to the Privacy Rule, are required to abide by standards which address the use and disclosure of individuals “protected health information” or (PHI). Any individually identifiable health information held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral is considered PHI (Summary of HIPAA privacy rules).
Bringing student health and Well-Being onto a health system EHR: the benefits of integration in the COVID-19 era
Published in Journal of American College Health, 2022
J. Jeffery Reeves, Christopher A. Longhurst, Stacie J. San Miguel, Reina Juarez, Joseph Behymer, Kevin M. Ramotar, Patricia Maysent, Angela L. Scioscia, Marlene Millen
Sharing protected health information (PHI) between healthcare organizations is a complex process that becomes even more challenging for the student-patient. Considered educational records, student PHI is regulated by both the Family Educational Rights and Privacy Act (FERPA) of 1974 and the Healthcare Insurance Portability and Accountability Act (HIPAA) of 1996. HIPPA privacy rules restrict allowable use and disclosure of PHI but allow sharing between healthcare providers if directly related to patient care.15 However, FERPA limits the sharing of information even between healthcare providers unless expressed written consent is obtained.16 These well intentioned and important privacy regulations unfortunately contribute to the information silo seen within CHS across the country.17 To protect privacy while enabling data-sharing, health and campus information services partnered to configure the EHR with an opt-in security class following the well-established HIPPA-compliant practices of UCSDH.
Assessing adherence and cost-benefit of colorectal cancer screening for accountable providers
Published in Baylor University Medical Center Proceedings, 2019
Trace Heavener, Frank W. McStay, Victoria Jaeger, Kristen Stephenson, Lauren Sager, James Sing
In this retrospective electronic medical record review, the initial search screened for patients aged 50 to 75 years who completed FIT between June 1, 2014, and June 1, 2016 (Figure 1). Exclusion criteria were (1) not having an assigned primary care physician, (2) having a positive FIT test or colonoscopy within the year prior to completion of the FIT test results used for this study, and (3) dying within the follow-up period. Two authors independently screened patient charts and abstracted the following data: order date for FIT in outpatient setting, electronic documentation of communicating abnormal results to the patient, the ordering of and completion of diagnostic colonoscopy, the ordering of and completion of gastroenterology clinic visit, and the time to and results of diagnostic colonoscopy. Additionally, the following demographic and protected health information data were extracted: age, gender, ethnicity, insurance status, ZIP code, and previously positive FIT. This was an exploratory investigation, so a smaller sample was used as a proof of concept. Simple random sampling was conducted and used to explore the relation between abnormal FIT tests and rate of follow-up within 1 year. Measures of central tendencies were used to describe results.
University efforts to address confidentiality issues for STI services
Published in Journal of American College Health, 2019
Kendra M. Cuffe, Melissa A. Habel, Alexandra E. Coor, Oscar Beltran, Jami S. Leichliter
It is also important to note that a majority of university SHIPs covered STI screening and testing services. Theoretically, some students that use SHIPs may avoid having EOBs sent to other parties (eg parents) because the student is the actual policyholder and any EOB generated would be sent to the local addresses (ie their address at school). Under the Health Insurance Portability and Accountability Act of 1996, patients are allowed to request that any disclosure of protected health information be limited if the disclosure would endanger the patient.32,33 Additionally, there are private insurers that state that policy-holders have the right to request any confidential communications be delivered to a different mailing address or sent electronically via email.32 However, insurers ultimately have the discretion to accommodate these requests.32–35 It is important to note that university students would have to be aware of their right to protect disclosure of private health information. Additionally, contacting insurance companies for these requests also adds an additional step that theoretically may delay receipt of STI services.36
Related Knowledge Centers
- Biometrics
- Medical Record
- Privacy For Research Participants
- Honest Broker
- Common Rule
- Personal Data