Health IT to Include Privacy Standards

Thanks to efforts by social workers and other health privacy advocates, federal standards for electronic health records for each person will include strict privacy protections.

The Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law in February as part of President Obama's economic stimulus plan.

NASW Lobbyist James Finley noted the HITECH Act takes into account NASW's and other organizations' concerns to include stringent privacy protections.

"We got what we wanted, which is to make sure confidentiality standards are included in the law," he said.

The federal government is in the regulatory phase of implementing the act's lofty goal: all U.S. residents will be identified with an electronic medical record by 2014. The technology to input, store, disseminate and protect such data on a national level is still in the planning stages, Finley noted.

In the meantime, the HITECH Act will force tougher policies in the Health Insurance Portability and Accountability Act (HIPAA).

While current HIPAA laws are mostly self-regulated, under the HITECH Act, federal enforcement of HIPAA is expected to increase with possible criminal and/or financial punishment to certain health care providers that have a data breach.

Finley said social workers will have opportunities for comments while the regulatory phase inches closer to completion. "Pilot phases of the law will include opportunities for input from all medical and mental health officials," he said.

NASW Associate Counsel Sherri Morgan said NASW will make every effort to alert members of how the HITECH Act may affect their practice. NASW can educate its members through alerts, continuing education courses and other training methods.

"All practitioners will be affected by this and there will be changes for how they operate their practices," Finley said.

NASW was a coalition partner with Patient Privacy Rights and joined the organization in encouraging lawmakers to adopt strict privacy rights in any electronic health information policy.

Ashley Katz, executive director of Patient Privacy Rights and a social worker, said her organization's Website contains some of the latest news related to the act. She noted it's important that social workers and other health professions be part of the decision-making procedure.

"The regulatory process is key to making the protections won powerful or meaningless, depending on the influence of the industry and the direction of the administration,"said Katz, who was a Presidential Management Fellow at the Centers for Medicare and Medicaid Services (CMS) within the Department of Health and Human Services.

She noted that many of the consumer protections written in the HITECH Act do not go into effect for two years. In the meantime, providers need to read their contracts carefully, she said. "Providers should be careful about what kind of [patient record] systems they invest in," Katz said. "Audit trails, requiring a system to track everywhere data goes, aren't required for at least five years. But there are systems out there that already are capable of audit trails."

Katz said the goal to develop a national health information technology system that protects everyone's privacy is ideal, but it remains to be seen whether it will come to fruition anytime soon. She said government officials in the United Kingdom started a similar plan, but a major backlash from the public and doctors caused officials to create an opt-out system for patients. "You just can't recover your personal health details if they are breached," Katz said. "There is no more sensitive information out there."

However, she said she believes many health care providers will eventually make electronic health records mandatory because they will not be set up to serve patients on a paper system once they are fully convert to an electronic format.

"But whether or not we have some sort of unified system that is interoperable and wired so that the government, public health officials and others can access all that data remains to be seen," she said.

Read HITECH HIPAA for Social Workers on this Website.