https://wiki.expertiza.ncsu.edu/api.php?action=feedcontributions&feedformat=atom&user=Nadeem 2026-05-09T23:44:13Z User contributions MediaWiki 1.41.0 https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_5,_Group_2&diff=16961 2008-08-09T03:21:01Z

<p>Nadeem: /* Advantages */</p> <hr /> <div>= Open Non-Proprietary Technology vs. Closed Proprietary Technology =<br /> <br /> The issues surrounding electronic voting have highlighted the concerns of use of open non-proprietary technology vs. closed proprietary technology. On the one side, closed proprietary technology allegedly safeguards voting security by making it impossible for outsiders to discover vulnerabilities by analyzing the code. On the other side, open technology encourages more eyes to look over the code, and may find vulnerabilities in advance, in time to correct them. What bearing does this discussion have on other types of software systems? Should other systems with high social value also have open non-proprietary licenses to increase accountability, or do the risks of open licensing outweigh the benefits? <br /> <br /> Examine how the experience with electronic voting applies to other critical software systems (e.g., software used for port security, handling medical records, or managing a payroll). What are the costs and benefits of open non-proprietary technology vs. closed proprietary technology for such applications? Are there applications where one or the other should clearly be used? Are there applications for which neither is appropriate? Please explain your answers.<br /> <br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html<br /> <br /> ==Introduction==<br /> &lt;blockquote&gt;<br /> # Thou shalt keep each voter's choices an inviolable secret.<br /> #Thou shalt allow each eligible voter to vote only once, and only for those offices for which she is authorized to cast a vote.<br /> #Thou shalt not permit tampering with thy voting system, nor the exchange of gold for votes.<br /> #Thou shalt report all votes accurately.<br /> #Thy voting system shall remain operable throughout each election.<br /> #Thou shalt keep an audit trail to detect sins against Commandments II-IV, but thy audit trail shall not violate Commandment I.<br /> &lt;/blockquote&gt;<br /> <br /> ==Proprietary Systems==<br /> ===Advantages===<br /> A leading proponent of proprietary software is Microsoft. They argue that requiring users to pay for software as a product increases funding for the research and development of software. They claim that per-copy fees maximize the profitability of software development.<br /> <br /> When it comes to market revenue, closed source software especially creates greater commercial activity over free software.<br /> <br /> ===Disadvantages===<br /> ==Open Source System==<br /> ===Advantages===<br /> An obvious benefit is that open source code, available to all, is usually free.<br /> <br /> Another convenience of open source code is that bugs are usually found faster and can be fixed by the user(s) who comes across it. Instead of waiting for a new release of the software with the bug corrected, open source code can also be redistributed to bring a corrected version to everyone immediately.<br /> <br /> Support for open source software, just as the software itself, is easily accessible. With so many people able to view the code, theoretically any number of them could offer support.<br /> <br /> Possibly the biggest advantage of open source software is the fact that everybody has the right and ability to modify and tweak the source code. This allows for implementation in other software and adaptability to a changing environment.<br /> <br /> ===Disadvantages===<br /> ==Resources==<br /> * [http://cpsr.org/prevsite/conferences/cfp93/shamos.html/ Electronic Voting - Evaluating the Threat] Michael Ian Shamos, Ph.D., J.D. March 1993.<br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html<br /> * [http://www.technewsworld.com/story/56938.html?welcome=1218234164 Open Source, Transparency and Electronic Voting] John P. Mello, Jr., ''LinuxInsider''. Apr 18, 2007.<br /> * [http://www.wired.com/politics/onlinerights/news/2003/10/61014 E-Vote Software Leaked Online] Kim Zetter, ''Wired''. Oct 29, 2003.<br /> * [http://rawstory.com/news/2005/Diebold_insider__alleges_company_plagued_1206.html Diebold insider alleges company plagued by technical woes, Diebold defends 'sterling' record] Miriam Raftery, ''Raw Story''. Dec 6, 2005.<br /> * [http://avirubin.com/vote.pdf Analysis of an Electronic Voting System (pdf)] Tadayoshi Kohno, et al. Johns Hopkins University Information Security Institute. July 23, 2003.<br /> * [http://timjimnetworktech.wikidot.com/advantages-disadvantages-of-open-source Advantages Disadvantages Of Open Source]<br /> * [http://itmanagement.earthweb.com/osrc/article.php/3758486 Datamation - Closed Source vs. Open Source in Desktop Linux] Matt Hartley, July 12, 2008.</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_5,_Group_2&diff=16951 2008-08-09T00:43:28Z

<p>Nadeem: /* Resources */</p> <hr /> <div>= Open Non-Proprietary Technology vs. Closed Proprietary Technology =<br /> <br /> The issues surrounding electronic voting have highlighted the concerns of use of open non-proprietary technology vs. closed proprietary technology. On the one side, closed proprietary technology allegedly safeguards voting security by making it impossible for outsiders to discover vulnerabilities by analyzing the code. On the other side, open technology encourages more eyes to look over the code, and may find vulnerabilities in advance, in time to correct them. What bearing does this discussion have on other types of software systems? Should other systems with high social value also have open non-proprietary licenses to increase accountability, or do the risks of open licensing outweigh the benefits? <br /> <br /> Examine how the experience with electronic voting applies to other critical software systems (e.g., software used for port security, handling medical records, or managing a payroll). What are the costs and benefits of open non-proprietary technology vs. closed proprietary technology for such applications? Are there applications where one or the other should clearly be used? Are there applications for which neither is appropriate? Please explain your answers.<br /> <br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html<br /> <br /> ==Introduction==<br /> &lt;blockquote&gt;<br /> # Thou shalt keep each voter's choices an inviolable secret.<br /> #Thou shalt allow each eligible voter to vote only once, and only for those offices for which she is authorized to cast a vote.<br /> #Thou shalt not permit tampering with thy voting system, nor the exchange of gold for votes.<br /> #Thou shalt report all votes accurately.<br /> #Thy voting system shall remain operable throughout each election.<br /> #Thou shalt keep an audit trail to detect sins against Commandments II-IV, but thy audit trail shall not violate Commandment I.<br /> &lt;/blockquote&gt;<br /> <br /> ==Proprietary Systems==<br /> ===Advantages===<br /> ===Disadvantages===<br /> ==Open Source System==<br /> ===Advantages===<br /> An obvious benefit is that open source code, available to all, is usually free.<br /> <br /> Another convenience of open source code is that bugs are usually found faster and can be fixed by the user(s) who comes across it. Instead of waiting for a new release of the software with the bug corrected, open source code can also be redistributed to bring a corrected version to everyone immediately.<br /> <br /> Support for open source software, just as the software itself, is easily accessible. With so many people able to view the code, theoretically any number of them could offer support.<br /> <br /> Possibly the biggest advantage of open source software is the fact that everybody has the right and ability to modify and tweak the source code. This allows for implementation in other software and adaptability to a changing environment.<br /> <br /> ===Disadvantages===<br /> ==Resources==<br /> * [http://cpsr.org/prevsite/conferences/cfp93/shamos.html/ Electronic Voting - Evaluating the Threat] Michael Ian Shamos, Ph.D., J.D. March 1993.<br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html<br /> * [http://www.technewsworld.com/story/56938.html?welcome=1218234164 Open Source, Transparency and Electronic Voting] John P. Mello, Jr., ''LinuxInsider''. Apr 18, 2007.<br /> * [http://www.wired.com/politics/onlinerights/news/2003/10/61014 E-Vote Software Leaked Online] Kim Zetter, ''Wired''. Oct 29, 2003.<br /> * [http://rawstory.com/news/2005/Diebold_insider__alleges_company_plagued_1206.html Diebold insider alleges company plagued by technical woes, Diebold defends 'sterling' record] Miriam Raftery, ''Raw Story''. Dec 6, 2005.<br /> * [http://avirubin.com/vote.pdf Analysis of an Electronic Voting System (pdf)] Tadayoshi Kohno, et al. Johns Hopkins University Information Security Institute. July 23, 2003.<br /> * [http://timjimnetworktech.wikidot.com/advantages-disadvantages-of-open-source Advantages Disadvantages Of Open Source]<br /> * [http://itmanagement.earthweb.com/osrc/article.php/3758486 Datamation - Closed Source vs. Open Source in Desktop Linux] Matt Hartley, July 12, 2008.</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_5,_Group_2&diff=16950 2008-08-09T00:30:11Z

<p>Nadeem: /* Advantages */</p> <hr /> <div>= Open Non-Proprietary Technology vs. Closed Proprietary Technology =<br /> <br /> The issues surrounding electronic voting have highlighted the concerns of use of open non-proprietary technology vs. closed proprietary technology. On the one side, closed proprietary technology allegedly safeguards voting security by making it impossible for outsiders to discover vulnerabilities by analyzing the code. On the other side, open technology encourages more eyes to look over the code, and may find vulnerabilities in advance, in time to correct them. What bearing does this discussion have on other types of software systems? Should other systems with high social value also have open non-proprietary licenses to increase accountability, or do the risks of open licensing outweigh the benefits? <br /> <br /> Examine how the experience with electronic voting applies to other critical software systems (e.g., software used for port security, handling medical records, or managing a payroll). What are the costs and benefits of open non-proprietary technology vs. closed proprietary technology for such applications? Are there applications where one or the other should clearly be used? Are there applications for which neither is appropriate? Please explain your answers.<br /> <br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html<br /> <br /> ==Introduction==<br /> &lt;blockquote&gt;<br /> # Thou shalt keep each voter's choices an inviolable secret.<br /> #Thou shalt allow each eligible voter to vote only once, and only for those offices for which she is authorized to cast a vote.<br /> #Thou shalt not permit tampering with thy voting system, nor the exchange of gold for votes.<br /> #Thou shalt report all votes accurately.<br /> #Thy voting system shall remain operable throughout each election.<br /> #Thou shalt keep an audit trail to detect sins against Commandments II-IV, but thy audit trail shall not violate Commandment I.<br /> &lt;/blockquote&gt;<br /> <br /> ==Proprietary Systems==<br /> ===Advantages===<br /> ===Disadvantages===<br /> ==Open Source System==<br /> ===Advantages===<br /> An obvious benefit is that open source code, available to all, is usually free.<br /> <br /> Another convenience of open source code is that bugs are usually found faster and can be fixed by the user(s) who comes across it. Instead of waiting for a new release of the software with the bug corrected, open source code can also be redistributed to bring a corrected version to everyone immediately.<br /> <br /> Support for open source software, just as the software itself, is easily accessible. With so many people able to view the code, theoretically any number of them could offer support.<br /> <br /> Possibly the biggest advantage of open source software is the fact that everybody has the right and ability to modify and tweak the source code. This allows for implementation in other software and adaptability to a changing environment.<br /> <br /> ===Disadvantages===<br /> ==Resources==<br /> * [http://cpsr.org/prevsite/conferences/cfp93/shamos.html/ Electronic Voting - Evaluating the Threat] Michael Ian Shamos, Ph.D., J.D. March 1993.<br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html<br /> * [http://www.technewsworld.com/story/56938.html?welcome=1218234164 Open Source, Transparency and Electronic Voting] John P. Mello, Jr., ''LinuxInsider''. Apr 18, 2007.<br /> * [http://www.wired.com/politics/onlinerights/news/2003/10/61014 E-Vote Software Leaked Online] Kim Zetter, ''Wired''. Oct 29, 2003.<br /> * [http://rawstory.com/news/2005/Diebold_insider__alleges_company_plagued_1206.html Diebold insider alleges company plagued by technical woes, Diebold defends 'sterling' record] Miriam Raftery, ''Raw Story''. Dec 6, 2005.<br /> * [http://avirubin.com/vote.pdf Analysis of an Electronic Voting System (pdf)] Tadayoshi Kohno, et al. Johns Hopkins University Information Security Institute. July 23, 2003.</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_5,_Group_2&diff=16899 2008-08-06T22:49:21Z

<p>Nadeem: </p> <hr /> <div>= Open Non-Proprietary Technology vs. Closed Proprietary Technology =<br /> <br /> The issues surrounding electronic voting have highlighted the concerns of use of open non-proprietary technology vs. closed proprietary technology. On the one side, closed proprietary technology allegedly safeguards voting security by making it impossible for outsiders to discover vulnerabilities by analyzing the code. On the other side, open technology encourages more eyes to look over the code, and may find vulnerabilities in advance, in time to correct them. What bearing does this discussion have on other types of software systems? Should other systems with high social value also have open non-proprietary licenses to increase accountability, or do the risks of open licensing outweigh the benefits? <br /> <br /> Examine how the experience with electronic voting applies to other critical software systems (e.g., software used for port security, handling medical records, or managing a payroll). What are the costs and benefits of open non-proprietary technology vs. closed proprietary technology for such applications? Are there applications where one or the other should clearly be used? Are there applications for which neither is appropriate? Please explain your answers.<br /> <br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html<br /> <br /> ==Introduction==<br /> <br /> ==Proprietary Systems==<br /> ===Advantages===<br /> ===Disadvantages===<br /> ==Open Source System==<br /> ===Advantages===<br /> ===Disadvantages===<br /> ==Resources==<br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_5,_Group_2&diff=16898 2008-08-06T22:47:05Z

<p>Nadeem: </p> <hr /> <div>== Open Non-Proprietary Technology vs. Closed Proprietary Technology ==<br /> <br /> The issues surrounding electronic voting have highlighted the concerns of use of open non-proprietary technology vs. closed proprietary technology. On the one side, closed proprietary technology allegedly safeguards voting security by making it impossible for outsiders to discover vulnerabilities by analyzing the code. On the other side, open technology encourages more eyes to look over the code, and may find vulnerabilities in advance, in time to correct them. What bearing does this discussion have on other types of software systems? Should other systems with high social value also have open non-proprietary licenses to increase accountability, or do the risks of open licensing outweigh the benefits? <br /> <br /> Examine how the experience with electronic voting applies to other critical software systems (e.g., software used for port security, handling medical records, or managing a payroll). What are the costs and benefits of open non-proprietary technology vs. closed proprietary technology for such applications? Are there applications where one or the other should clearly be used? Are there applications for which neither is appropriate? Please explain your answers.<br /> <br /> * http://courses.ncsu.edu/csc379/lec/001/lectures/wk14/lecture.html<br /> <br /> ==Introduction==<br /> <br /> ==Proprietary Systems==<br /> ===Advantages===<br /> ===Disadvantages===<br /> ==Open Source System==<br /> ===Advantages===<br /> ===Disadvantages===</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16870 2008-08-05T21:02:03Z

<p>Nadeem: /* Purpose of Privacy Policies */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company.<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by sharing personal information with the authorities. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both ways, allowing someone with malicious intent, or simply anyone not intended access, to view personal material with less effort.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> A privacy policy for a particular web site usually includes:<br /> :*What personal information it gathers<br /> :*How personal information is used or may be used in the future<br /> :*To whom the information is disclosed<br /> :*Measures used to secure personal information<br /> :*Whether the site uses cookies or web bugs<br /> The exact content will vary form site to site, as their respective laws regulate. Some sites use existing protocols to declare their degree of confidentiality. These protocols include Platform for Privacy Preferences Project(P3P) and Internet Content Rating Association(ICRA). Browsers can automatically assess the level of privacy offered by a site using an existing protocol.<br /> <br /> ===Regulations===<br /> ====Section 5 of the FTC Act====<br /> This act is meant to enforce the promises made in a privacy policy. It also prohibits unfair or deceptive practices.<br /> ====Gramm-Leach-Bliley Act====<br /> This act is meant to regulate financial institutions involved in any of the following:<br /> :*Banking<br /> :*Securities firms<br /> :*Insurance<br /> :*Lending<br /> :*Brokering<br /> :*Transferring or safeguarding money<br /> :*Preparing individual tax returns<br /> :*Providing financial advice or credit counseling<br /> :*Providing residential real estate settlement services<br /> :*Collecting consumer debts<br /> Divided into three parts, this act inculdes:<br /> :#The Financial Privacy Rule requires financial institutions to give their customers privacy notices that explain the financial institution’s information collection and sharing practices.<br /> :#The Safeguards Rule requires financial institutions to have a security plan to protect the confidentiality and integrity of personal consumer information.<br /> :#Pretexting provisions prevents individuals and companies from obtaining personal financial information via false pretenses.<br /> ====Fair Credit Reporting Act====<br /> This act is meant to ensure accuracy in consumer reports and privacy of their content. It was recently amended by the Fair and Accurate Credit Transactions Act of 2003. Credit reporting agencies, such as the credit bureau, gather and sell personal information. This act governs such agencies.<br /> ====Children's Online Privacy Protection Act====<br /> This act is meant to allow parents to control what information is collected from their children online and how it may be used.<br /> <br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]<br /> <br /> [http://en.wikipedia.org/wiki/Internet_privacy Wikipedia: Internet privacy]<br /> <br /> [http://www.ftc.gov/privacy/privacyinitiatives/glbact.html The Gramm-Leach Bliley Act]<br /> <br /> [http://www.guardian.co.uk/world/2006/aug/28/usa.searchengines They know all about you]<br /> <br /> [http://blog.wired.com/27bstroke6/2006/09/craigslist.html?entry_id=1553329 Craigslist]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Talk:CSC_379_SUM2008:Week_4,_Group_1&diff=16869 2008-08-05T21:01:39Z

<p>Nadeem: </p> <hr /> <div>Feel free to contribute something more. - Nadeem</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16868 2008-08-05T20:02:51Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Ethical Issues===<br /> Like most privacy issues, the ethical questions posed here are controversial. These issues include:<br /> :*What information is considered private<br /> :*Who decides what information is private<br /> :*What are the rights of individuals<br /> :*What are the right of the health care industry<br /> :*Will employers and insurance companies use genetic profiling to discriminate<br /> <br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have adopted health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information-intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. <br /> <br /> The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information (PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently. However, with many systems now being developed using Microsoft's .NET Framework and Java technology, EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was passed. Since then, there have been many amendments to the act, the most notable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====Health Insurance Portability and Accountability Act (HIPAA)====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 days upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> <br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction Set<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set <br /> :*EDI Benefit Enrollment and Maintenance Set<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products<br /> :*EDI Health Care Eligibility/Benefit Inquiry<br /> :*EDI Health Care Eligibility/Benefit Response<br /> :*EDI Health Care Claim Status Request<br /> :*EDI Health Care Claim Status Notification<br /> :*EDI Health Care Service Review Information<br /> :*EDI Functional Acknowledgement Transaction Set<br /> <br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ==Bibliography==<br /> ===News===<br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> ===Laws and Regulations===<br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> ===General===<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16866 2008-08-05T04:05:45Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Ethical Issues===<br /> Like most privacy issues, the ethical questions posed here are controversial. These issues include:<br /> :*What information is considered private<br /> :*Who decides what information is private<br /> :*What are the rights of individuals<br /> :*What are the right of the health care industry<br /> :*Will employers and insurance companies use genetic profiling to discriminate<br /> <br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have adopted health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information-intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. <br /> <br /> The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information (PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently. However, with many systems now being developed using Microsoft's .NET Framework and Java technology, EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was passed. Since then, there have been many amendments to the act, the most notable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====Health Insurance Portability and Accountability Act (HIPAA)====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 days upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> <br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction Set<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set <br /> :*EDI Benefit Enrollment and Maintenance Set<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products<br /> :*EDI Health Care Eligibility/Benefit Inquiry<br /> :*EDI Health Care Eligibility/Benefit Response<br /> :*EDI Health Care Claim Status Request<br /> :*EDI Health Care Claim Status Notification<br /> :*EDI Health Care Service Review Information<br /> :*EDI Functional Acknowledgement Transaction Set<br /> <br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ==Bibliography==<br /> ===News===<br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> <br /> <br /> ===Laws and Regulations===<br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> <br /> <br /> <br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16849 2008-08-05T03:28:40Z

<p>Nadeem: /* Ethical Issues */</p> <hr /> <div>==Study Guide==<br /> ===Ethical Issues===<br /> Like most privacy issues, the ethical questions posed here are controversial. These issues include:<br /> :*What information is considered private<br /> :*Who decides what information is private<br /> :*What are the rights of individuals<br /> :*What are the right of the health care industry<br /> :*Will employers and insurance companies use genetic profiling to discriminate<br /> <br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have adopted health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information-intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. <br /> <br /> The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information (PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently. However, with many systems now being developed using Microsoft's .NET Framework and Java technology, EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was passed. Since then, there have been many amendments to the act, the most notable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====Health Insurance Portability and Accountability Act (HIPAA)====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 days upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> <br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction Set<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set <br /> :*EDI Benefit Enrollment and Maintenance Set<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products<br /> :*EDI Health Care Eligibility/Benefit Inquiry<br /> :*EDI Health Care Eligibility/Benefit Response<br /> :*EDI Health Care Claim Status Request<br /> :*EDI Health Care Claim Status Notification<br /> :*EDI Health Care Service Review Information<br /> :*EDI Functional Acknowledgement Transaction Set<br /> <br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16846 2008-08-05T03:20:18Z

<p>Nadeem: </p> <hr /> <div>==Study Guide==<br /> ===Ethical Issues===<br /> Like most privacy issues, the ethical questions posed here are controversial. Some issues include:<br /> :*What information is considered private<br /> :*Who decides what information is private<br /> :*What are the rights of individuals<br /> :*What are the right of the health care industry<br /> :*Will employers and insurance companies use genetic profiling to discriminate<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have adopted health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information-intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. <br /> <br /> The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information (PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently. However, with many systems now being developed using Microsoft's .NET Framework and Java technology, EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was passed. Since then, there have been many amendments to the act, the most notable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====Health Insurance Portability and Accountability Act (HIPAA)====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 days upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> <br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction Set<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set <br /> :*EDI Benefit Enrollment and Maintenance Set<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products<br /> :*EDI Health Care Eligibility/Benefit Inquiry<br /> :*EDI Health Care Eligibility/Benefit Response<br /> :*EDI Health Care Claim Status Request<br /> :*EDI Health Care Claim Status Notification<br /> :*EDI Health Care Service Review Information<br /> :*EDI Functional Acknowledgement Transaction Set<br /> <br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16817 2008-08-05T02:33:42Z

<p>Nadeem: /* Ethical Issues */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have adopted health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information-intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. <br /> <br /> The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information (PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently. However, with many systems now being developed using Microsoft's .NET Framework and Java technology, EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was passed. Since then, there have been many amendments to the act, the most notable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====Health Insurance Portability and Accountability Act (HIPAA)====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 days upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> <br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction Set<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set <br /> :*EDI Benefit Enrollment and Maintenance Set<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products<br /> :*EDI Health Care Eligibility/Benefit Inquiry<br /> :*EDI Health Care Eligibility/Benefit Response<br /> :*EDI Health Care Claim Status Request<br /> :*EDI Health Care Claim Status Notification<br /> :*EDI Health Care Service Review Information<br /> :*EDI Functional Acknowledgement Transaction Set<br /> <br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ==Ethical Issues==<br /> Like most privacy issues, the ethical questions posed here are controversial. Some issues include:<br /> :*What information is considered private<br /> :*Who decides what information is private<br /> :*What are the rights of individuals<br /> :*What are the right of the health care industry<br /> :*Will employers and insurance companies use genetic profiling to discriminate<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16814 2008-08-05T02:26:13Z

<p>Nadeem: </p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have adopted health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information-intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. <br /> <br /> The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information (PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently. However, with many systems now being developed using Microsoft's .NET Framework and Java technology, EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was passed. Since then, there have been many amendments to the act, the most notable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====Health Insurance Portability and Accountability Act (HIPAA)====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 days upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> <br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction Set<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set <br /> :*EDI Benefit Enrollment and Maintenance Set<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products<br /> :*EDI Health Care Eligibility/Benefit Inquiry<br /> :*EDI Health Care Eligibility/Benefit Response<br /> :*EDI Health Care Claim Status Request<br /> :*EDI Health Care Claim Status Notification<br /> :*EDI Health Care Service Review Information<br /> :*EDI Functional Acknowledgement Transaction Set<br /> <br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ==Ethical Issues==<br /> Like most privacy issues, the ethical questions posed here are controversial. Some issues include:<br /> :*What information is considered private<br /> :*who decides what information is private<br /> :*what are the rights of individuals<br /> :*what are the right of the health care industry<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16693 2008-08-02T01:13:14Z

<p>Nadeem: /* Links */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both ways, allowing someone with malicious intent, or simply anyone not intended access, to view personal material with less effort.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> A privacy policy for a particular web site usually includes:<br /> :*What personal information it gathers<br /> :*How personal information is used or may be used in the future<br /> :*To whom the information is disclosed<br /> :*Measures used to secure personal information<br /> :*Whether the site uses cookies or web bugs<br /> The exact content will vary form site to site, as their respective laws regulate. Some sites use existing protocols to declare their degree of confidentiality. These protocols include Platform for Privacy Preferences Project(P3P) and Internet Content Rating Association(ICRA). Browsers can automatically assess the level of privacy offered by a site using an existing protocol.<br /> <br /> ===Regulations===<br /> ====Section 5 of the FTC Act====<br /> This act is meant to enforce the promises made in a privacy policy. It also prohibits unfair or deceptive practices.<br /> ====Gramm-Leach-Bliley Act====<br /> This act is meant to regulate financial institutions involved in any of the following:<br /> :*Banking<br /> :*Securities firms<br /> :*Insurance<br /> :*Lending<br /> :*Brokering<br /> :*Transferring or safeguarding money<br /> :*Preparing individual tax returns<br /> :*Providing financial advice or credit counseling<br /> :*Providing residential real estate settlement services<br /> :*Collecting consumer debts<br /> Divided into three parts, this act inculdes:<br /> :#The Financial Privacy Rule requires financial institutions to give their customers privacy notices that explain the financial institution’s information collection and sharing practices.<br /> :#The Safeguards Rule requires financial institutions to have a security plan to protect the confidentiality and integrity of personal consumer information.<br /> :#Pretexting provisions prevents individuals and companies from obtaining personal financial information via false pretenses.<br /> ====Fair Credit Reporting Act====<br /> This act is meant to ensure accuracy in consumer reports and privacy of their content. It was recently amended by the Fair and Accurate Credit Transactions Act of 2003. Credit reporting agencies, such as the credit bureau, gather and sell personal information. This act governs such agencies.<br /> ====Children's Online Privacy Protection Act====<br /> This act is meant to allow parents to control what information is collected from their children online and how it may be used.<br /> <br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]<br /> <br /> [http://en.wikipedia.org/wiki/Internet_privacy Wikipedia: Internet privacy]<br /> <br /> [http://www.ftc.gov/privacy/privacyinitiatives/glbact.html The Gramm-Leach Bliley Act]<br /> <br /> [http://www.guardian.co.uk/world/2006/aug/28/usa.searchengines They know all about you]<br /> <br /> [http://blog.wired.com/27bstroke6/2006/09/craigslist.html?entry_id=1553329 Craigslist]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16691 2008-08-02T01:12:04Z

<p>Nadeem: /* Links */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both ways, allowing someone with malicious intent, or simply anyone not intended access, to view personal material with less effort.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> A privacy policy for a particular web site usually includes:<br /> :*What personal information it gathers<br /> :*How personal information is used or may be used in the future<br /> :*To whom the information is disclosed<br /> :*Measures used to secure personal information<br /> :*Whether the site uses cookies or web bugs<br /> The exact content will vary form site to site, as their respective laws regulate. Some sites use existing protocols to declare their degree of confidentiality. These protocols include Platform for Privacy Preferences Project(P3P) and Internet Content Rating Association(ICRA). Browsers can automatically assess the level of privacy offered by a site using an existing protocol.<br /> <br /> ===Regulations===<br /> ====Section 5 of the FTC Act====<br /> This act is meant to enforce the promises made in a privacy policy. It also prohibits unfair or deceptive practices.<br /> ====Gramm-Leach-Bliley Act====<br /> This act is meant to regulate financial institutions involved in any of the following:<br /> :*Banking<br /> :*Securities firms<br /> :*Insurance<br /> :*Lending<br /> :*Brokering<br /> :*Transferring or safeguarding money<br /> :*Preparing individual tax returns<br /> :*Providing financial advice or credit counseling<br /> :*Providing residential real estate settlement services<br /> :*Collecting consumer debts<br /> Divided into three parts, this act inculdes:<br /> :#The Financial Privacy Rule requires financial institutions to give their customers privacy notices that explain the financial institution’s information collection and sharing practices.<br /> :#The Safeguards Rule requires financial institutions to have a security plan to protect the confidentiality and integrity of personal consumer information.<br /> :#Pretexting provisions prevents individuals and companies from obtaining personal financial information via false pretenses.<br /> ====Fair Credit Reporting Act====<br /> This act is meant to ensure accuracy in consumer reports and privacy of their content. It was recently amended by the Fair and Accurate Credit Transactions Act of 2003. Credit reporting agencies, such as the credit bureau, gather and sell personal information. This act governs such agencies.<br /> ====Children's Online Privacy Protection Act====<br /> This act is meant to allow parents to control what information is collected from their children online and how it may be used.<br /> <br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]<br /> <br /> [http://en.wikipedia.org/wiki/Internet_privacy Wikipedia: Internet privacy]<br /> <br /> [http://www.ftc.gov/privacy/privacyinitiatives/glbact.html The Gramm-Leach Bliley Act]<br /> <br /> [http://blog.wired.com/27bstroke6/2006/09/craigslist.html?entry_id=1553329 Craigslist]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16689 2008-08-02T01:06:30Z

<p>Nadeem: /* Laws */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both ways, allowing someone with malicious intent, or simply anyone not intended access, to view personal material with less effort.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> A privacy policy for a particular web site usually includes:<br /> :*What personal information it gathers<br /> :*How personal information is used or may be used in the future<br /> :*To whom the information is disclosed<br /> :*Measures used to secure personal information<br /> :*Whether the site uses cookies or web bugs<br /> The exact content will vary form site to site, as their respective laws regulate. Some sites use existing protocols to declare their degree of confidentiality. These protocols include Platform for Privacy Preferences Project(P3P) and Internet Content Rating Association(ICRA). Browsers can automatically assess the level of privacy offered by a site using an existing protocol.<br /> <br /> ===Regulations===<br /> ====Section 5 of the FTC Act====<br /> This act is meant to enforce the promises made in a privacy policy. It also prohibits unfair or deceptive practices.<br /> ====Gramm-Leach-Bliley Act====<br /> This act is meant to regulate financial institutions involved in any of the following:<br /> :*Banking<br /> :*Securities firms<br /> :*Insurance<br /> :*Lending<br /> :*Brokering<br /> :*Transferring or safeguarding money<br /> :*Preparing individual tax returns<br /> :*Providing financial advice or credit counseling<br /> :*Providing residential real estate settlement services<br /> :*Collecting consumer debts<br /> Divided into three parts, this act inculdes:<br /> :#The Financial Privacy Rule requires financial institutions to give their customers privacy notices that explain the financial institution’s information collection and sharing practices.<br /> :#The Safeguards Rule requires financial institutions to have a security plan to protect the confidentiality and integrity of personal consumer information.<br /> :#Pretexting provisions prevents individuals and companies from obtaining personal financial information via false pretenses.<br /> ====Fair Credit Reporting Act====<br /> This act is meant to ensure accuracy in consumer reports and privacy of their content. It was recently amended by the Fair and Accurate Credit Transactions Act of 2003. Credit reporting agencies, such as the credit bureau, gather and sell personal information. This act governs such agencies.<br /> ====Children's Online Privacy Protection Act====<br /> This act is meant to allow parents to control what information is collected from their children online and how it may be used.<br /> <br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]<br /> <br /> [http://en.wikipedia.org/wiki/Internet_privacy Wikipedia: Internet privacy]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16669 2008-08-01T19:22:39Z

<p>Nadeem: /* Current Standards */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both ways, allowing someone with malicious intent, or simply anyone not intended access, to view personal material with less effort.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> A privacy policy for a particular web site usually includes:<br /> :*What personal information it gathers<br /> :*How personal information is used or may be used in the future<br /> :*To whom the information is disclosed<br /> :*Measures used to secure personal information<br /> :*Whether the site uses cookies or web bugs<br /> The exact content will vary form site to site, as their respective laws regulate. Some sites use existing protocols to declare their degree of confidentiality. These protocols include Platform for Privacy Preferences Project(P3P) and Internet Content Rating Association(ICRA). Browsers can automatically assess the level of privacy offered by a site using an existing protocol.<br /> <br /> ===Laws===<br /> <br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]<br /> <br /> [http://en.wikipedia.org/wiki/Internet_privacy Wikipedia: Internet privacy]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16668 2008-08-01T19:21:04Z

<p>Nadeem: /* Links */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both ways, allowing someone with malicious intent, or simply anyone not intended access, to view personal material with less effort.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> A privacy policy for a particular web site usually includes:<br /> :*What personal information it gathers<br /> :*How personal information is used or may be used in the future<br /> :*To whom the information is disclosed<br /> :*Measures used to secure personal information<br /> :*Whether the site uses cookies or web bugs<br /> The exact content will vary form site to site, as their respective laws regulate. Some site use existing protocols to declare their degree of confidentiality. These protocols include Platform for Privacy Preferences Project(P3P) and Internet Content Rating Association(ICRA). Browsers can automatically assess the level of privacy offered by these sites.<br /> ===Laws===<br /> <br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]<br /> <br /> [http://en.wikipedia.org/wiki/Internet_privacy Wikipedia: Internet privacy]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16667 2008-08-01T19:16:21Z

<p>Nadeem: /* Laws and Standards for Website Privacy Policy */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both ways, allowing someone with malicious intent, or simply anyone not intended access, to view personal material with less effort.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> A privacy policy for a particular web site usually includes:<br /> :*What personal information it gathers<br /> :*How personal information is used or may be used in the future<br /> :*To whom the information is disclosed<br /> :*Measures used to secure personal information<br /> :*Whether the site uses cookies or web bugs<br /> The exact content will vary form site to site, as their respective laws regulate. Some site use existing protocols to declare their degree of confidentiality. These protocols include Platform for Privacy Preferences Project(P3P) and Internet Content Rating Association(ICRA). Browsers can automatically assess the level of privacy offered by these sites.<br /> ===Laws===<br /> <br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16666 2008-08-01T18:59:11Z

<p>Nadeem: /* Ethical Issues */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both ways, allowing someone with malicious intent, or simply anyone not intended access, to view personal material with less effort.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> ===Recent Laws===<br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16665 2008-08-01T18:51:33Z

<p>Nadeem: /* Links */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both way, allowing someone with malicious intent, or simply anyone not intended access, to view personal material.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> ===Recent Laws===<br /> ==Links==<br /> [http://www.ftc.gov/privacy/ Privacy Initiatives]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16664 2008-08-01T18:49:18Z

<p>Nadeem: </p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both way, allowing someone with malicious intent, or simply anyone not intended access, to view personal material.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> ===Recent Laws===<br /> ==Links==</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16663 2008-08-01T18:45:22Z

<p>Nadeem: /* Ethical Issue */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issues===<br /> A problem that websites face is the problematic privacy policy. A lot of times, the problem is not the content, but length, location, variability, and the overall confusing nature of a policy. This leads to users who fail to read or fully understand the policy.<br /> <br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both way, allowing someone with malicious intent, or simply anyone not intended access, to view personal material.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> ===Recent Laws===</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=CSC_379_SUM2008:Week_4,_Group_1&diff=16662 2008-08-01T18:32:48Z

<p>Nadeem: /* Internet Privacy */</p> <hr /> <div>Privacy policies outline a site’s practices for data collection, retention, sharing, and use. The privacy policy has become increasingly important with the profit potential in marketing private data and more sites requiring personal information to access their services. Laws such as the “Shine the Light” law enacted in California, and the European Commission’s Directive on Data Protection have been catalysts in encouraging sites to enact and display a privacy policy. However, receipt of a privacy policy does not guarantee that it will be read; widely varied legal terminology which the policies are written in make them difficult to understand, and their length requires much time to consider fully.<br /> <br /> Examine the role of online privacy policies. What ethical considerations do confusing, difficult to locate, lengthy, frequently changing, or otherwise problem-ridden privacy polices pose? What recent changes have been made or do you suggest could be made to improve privacy policies to better address these ethical considerations?<br /> <br /> * http://epic.org/privacy/profiling/sb27.html<br /> * http://www.export.gov/safeHarbor/<br /> * http://www.ftc.gov/os/statutes/fcrajump.shtm<br /> * http://bits.blogs.nytimes.com/2008/05/27/google-fights-for-the-right-to-hide-its-privacy-policy/<br /> * http://bits.blogs.nytimes.com/2008/07/04/google-changes-home-page-adding-link-to-privacy-policy/<br /> * http://cups.cs.cmu.edu/courses/privpolawtech-fa07/<br /> <br /> ==Internet Privacy==<br /> Privacy is &quot;the quality or condition of being secluded from the presence or view of others.&quot; From a technological view, this means that a person should be able to be in full control of who can see data that refers to that person. This can be information such as personal emails, name, contact information, credit card information, health records, web surfing habits etc. As software grows more advanced and users are opening up more on the web, this leads to a higher chance of a person's private information being viewed or distributed by parties that the user does not want doing so.<br /> <br /> ===Purpose of Privacy Policies===<br /> To relieve users' fears, websites started creating privacy policies. These policies explain in great detail how a website plans to use, distribute, and store a user's information and the rights the user has to retrieve it from the company. [write more stuff]<br /> <br /> ===Ethical Issue===<br /> Recent advances in technology have benefited society by leaking personal data. Law enforcement can use information to track down criminals, banks can prevent fraud, consumers can make better-informed purchasing decisions by learning about new products or services. Some would argue that all this comes at a great cost. Each individual would be sacrificing too much if personal information was so easily accessible. Also, this ease of access works both way, allowing someone with malicious intent, or simply anyone not intended access, to view personal material.<br /> <br /> ==Laws and Standards for Website Privacy Policy==<br /> ===Current Standards===<br /> ===Recent Laws===</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16566 2008-08-01T03:22:13Z

<p>Nadeem: /* The Transactions and Code Sets Rule */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information(PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====Health Insurance Portability and Accountability Act (HIPAA)====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction Set<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set <br /> :*EDI Benefit Enrollment and Maintenance Set<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products<br /> :*EDI Health Care Eligibility/Benefit Inquiry<br /> :*EDI Health Care Eligibility/Benefit Response<br /> :*EDI Health Care Claim Status Request<br /> :*EDI Health Care Claim Status Notification<br /> :*EDI Health Care Service Review Information<br /> :*EDI Functional Acknowledgement Transaction Set<br /> <br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16556 2008-08-01T03:11:37Z

<p>Nadeem: /* HIPAA */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information(PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====Health Insurance Portability and Accountability Act (HIPAA)====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction set (837)<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set (835)<br /> :*EDI Benefit Enrollment and Maintenance Set (834)<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products (820)<br /> :*EDI Health Care Eligibility/Benefit Inquiry (270)<br /> :*EDI Health Care Eligibility/Benefit Response (271)<br /> :*EDI Health Care Claim Status Request (276)<br /> :*EDI Health Care Claim Status Notification (277)<br /> :*EDI Health Care Service Review Information (278)<br /> :*EDI Functional Acknowledgement Transaction Set (997)<br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16555 2008-08-01T03:10:27Z

<p>Nadeem: </p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information(PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====HIPAA====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction set (837)<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set (835)<br /> :*EDI Benefit Enrollment and Maintenance Set (834)<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products (820)<br /> :*EDI Health Care Eligibility/Benefit Inquiry (270)<br /> :*EDI Health Care Eligibility/Benefit Response (271)<br /> :*EDI Health Care Claim Status Request (276)<br /> :*EDI Health Care Claim Status Notification (277)<br /> :*EDI Health Care Service Review Information (278)<br /> :*EDI Functional Acknowledgement Transaction Set (997)<br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> Genetic mapping, also called linkage mapping, can offer firm evidence that links a disease transmitted from parent to child to one or more genes. It also provides clues about which chromosome contains the gene and precisely where it lies on that chromosome.<br /> <br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16528 2008-08-01T02:48:28Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information(PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====HIPAA====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction set (837)<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set (835)<br /> :*EDI Benefit Enrollment and Maintenance Set (834)<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products (820)<br /> :*EDI Health Care Eligibility/Benefit Inquiry (270)<br /> :*EDI Health Care Eligibility/Benefit Response (271)<br /> :*EDI Health Care Claim Status Request (276)<br /> :*EDI Health Care Claim Status Notification (277)<br /> :*EDI Health Care Service Review Information (278)<br /> :*EDI Functional Acknowledgement Transaction Set (997)<br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://www.genome.gov/10000715 ''New'' Genetic Mapping]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16513 2008-08-01T02:38:32Z

<p>Nadeem: /* HIPAA */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information(PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====HIPAA====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> =====The Privacy Rule=====<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> =====The Transactions and Code Sets Rule=====<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction set (837)<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set (835)<br /> :*EDI Benefit Enrollment and Maintenance Set (834)<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products (820)<br /> :*EDI Health Care Eligibility/Benefit Inquiry (270)<br /> :*EDI Health Care Eligibility/Benefit Response (271)<br /> :*EDI Health Care Claim Status Request (276)<br /> :*EDI Health Care Claim Status Notification (277)<br /> :*EDI Health Care Service Review Information (278)<br /> :*EDI Functional Acknowledgement Transaction Set (997)<br /> =====The Security Rule=====<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> =====The Unique Identifiers Rule (National Provider Identifier)=====<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> =====The Enforcement Rule=====<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16512 2008-08-01T02:37:07Z

<p>Nadeem: /* Laws */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information(PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> ====HIPAA====<br /> =====Title I: Health Care Access, Portability, and Renewability=====<br /> Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.<br /> =====Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform=====<br /> Title II of HIPAA creates several programs to control fraud and abuse within the health care system.<br /> ======The Privacy Rule======<br /> The Privacy Rule took effect on April 14, 2003. It establishes regulations for the use and disclosure of Protected Health Information. Those covered have 30 upon the request of the individual to disclose PHI. Also, they must disclose PHI when required by law, such as reporting suspected child abuse to state child welfare agencies. When authorized by the individual, a covered entity may disclose PHI for treatment, payment, or health care operations. However, a reasonable effort must be made to disclose only the minimum necessary information required. Individuals have the right to request that any inaccurate PHI be corrected. It also requires covered entities to take reasonable steps to ensure the confidentiality of communications with individuals. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also record 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).<br /> ======The Transactions and Code Sets Rule======<br /> The HIPAA/EDI provision was meant to take effect from October 16, 2003 with a one-year extension for certain &quot;small plans;&quot; however, due to difficulty in implementing the rule, CMS granted a one-year extension to all parties. As of October 16, 2004, full implementation was not achieved and CMS began an open-ended &quot;contingency period.&quot; No penalties for non-compliance were levied; however, all parties are expected to make a &quot;good-faith effort&quot; to come comply. CMS announced that the Medicare contingency period ended July 1, 2005. After July 1, most medical providers that file electronically will have to file their electronic claims using the HIPAA standards in order to be paid. There are exceptions for doctors that meet certain criteria.<br /> <br /> Key EDI transactions used for HIPAA compliance are:<br /> :*EDI Health Care Claim Transaction set (837)<br /> :*EDI Retail Pharmacy Claim Transaction (NCPDP Telecommunications Standard version 5.1)<br /> :*EDI Health Care Claim Payment/Advice Transaction Set (835)<br /> :*EDI Benefit Enrollment and Maintenance Set (834)<br /> :*EDI Payroll Deducted and other group Premium Payment for Insurance Products (820)<br /> :*EDI Health Care Eligibility/Benefit Inquiry (270)<br /> :*EDI Health Care Eligibility/Benefit Response (271)<br /> :*EDI Health Care Claim Status Request (276)<br /> :*EDI Health Care Claim Status Notification (277)<br /> :*EDI Health Care Service Review Information (278)<br /> :*EDI Functional Acknowledgement Transaction Set (997)<br /> ======The Security Rule======<br /> The Final Rule on Security Standards took effect on April 21, 2003 with a compliance date of April 21, 2005 for most covered entities and April 21, 2006 for &quot;small plans.&quot; It is meant to complement the Privacy Rule. The Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical.<br /> ======The Unique Identifiers Rule (National Provider Identifier)======<br /> Providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new National Provider Identifier (NPI). The NPI replaces all other identifiers used by health plans, Medicare (i.e., the UPIN), Medicaid, and other government programs. The NPI does not replace a provider's DEA number however or a provider's state license number or tax identification number. The NPI is 10 digits (may be alphanumeric), the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different &quot;subparts&quot; such as a free-standing cancer center or rehab facility.<br /> ======The Enforcement Rule======<br /> On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however its deterrent effects seems to be negligible with few prosecutions for violations.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16446 2008-08-01T00:43:15Z

<p>Nadeem: </p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information(PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Most EMR systems were developed using older programming languages such as Visual Basic and C++ until recently; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sanctions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> <br /> Responsibility for patient records is usually on the creator and custodian of the record, generally a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html ''New'' Cedars-Sinai Doctors Cling to Pen and Paper]<br /> <br /> [http://www.emrexperts.com/emr-ebook/state-of-the-industry.php ''New'' State of EMR Industry]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16423 2008-08-01T00:09:37Z

<p>Nadeem: /* Electronic Medical Records/Electronic Health Records */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is the confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. The possibility of patient data interception increases with multiple access points over an open network like the Internet. Protected Health Information(PHI), as it's referred to, is addressed under many local laws, as well as the Health Insurance Portability and Accountability Act (HIPAA). In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. Those managing this information are required to ensure adequate protection is provided and that access is given only to authorized parties. Since electronic data may be physically much more difficult to secure, the growth of EHR creates new issues, as flaws in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limits in software, hardware and networking technologies has made EMR difficult to implement in small, budget conscious, multiple location healthcare organizations. Until recently most EMR systems were developed using older programming languages such as Visual Basic and C++; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Under data protection legislation and the law generally responsibility for patient records (irrespective of the form they are kept in) is always on the creator and custodian of the record, usually a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16413 2008-07-31T23:50:06Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is adequate confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. Multiple access points over an open network like the Internet increases possible patient data interception. In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws. In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. The organizations and individuals charged with the management of this information are required to ensure adequate protection is provided and that access to the information is only by authorized parties. The growth of EHR creates new issues, since electronic data may be physically much more difficult to secure, as lapses in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limitations in software, hardware and networking technologies has made EMR difficult to affordably implement in small, budget conscious, multiple location healthcare organizations. Until recently most EMR systems were developed using older programming languages such as Visual Basic and C++; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Under data protection legislation and the law generally responsibility for patient records (irrespective of the form they are kept in) is always on the creator and custodian of the record, usually a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&amp;TITLE=45&amp;PART=164&amp;SECTION=501&amp;SUBPART=&amp;TYPE=TEXTPrivacy ''New'' TITLE 45--PUBLIC WELFARE AND HUMAN SERVICES]<br /> <br /> [http://www.dataprotection.ie/viewdoc.asp ''New'' Data Protection]<br /> <br /> [http://www.cnn.com/2006/US/05/22/vets.data/index.html ''New'' FBI seeks stolen personal data on 26 million vets]<br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16410 2008-07-31T23:45:14Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is adequate confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. Multiple access points over an open network like the Internet increases possible patient data interception. In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws. In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. The organizations and individuals charged with the management of this information are required to ensure adequate protection is provided and that access to the information is only by authorized parties. The growth of EHR creates new issues, since electronic data may be physically much more difficult to secure, as lapses in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limitations in software, hardware and networking technologies has made EMR difficult to affordably implement in small, budget conscious, multiple location healthcare organizations. Until recently most EMR systems were developed using older programming languages such as Visual Basic and C++; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Under data protection legislation and the law generally responsibility for patient records (irrespective of the form they are kept in) is always on the creator and custodian of the record, usually a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> [http://articles.latimes.com/2006/jun/26/health/he-privacy26 ''New'' At risk of exposure]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16405 2008-07-31T23:29:38Z

<p>Nadeem: /* Electronic Medical Records/Electronic Health Records */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is adequate confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. Multiple access points over an open network like the Internet increases possible patient data interception. In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws. In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. The organizations and individuals charged with the management of this information are required to ensure adequate protection is provided and that access to the information is only by authorized parties. The growth of EHR creates new issues, since electronic data may be physically much more difficult to secure, as lapses in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> <br /> Limitations in software, hardware and networking technologies has made EMR difficult to affordably implement in small, budget conscious, multiple location healthcare organizations. Until recently most EMR systems were developed using older programming languages such as Visual Basic and C++; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> <br /> Under data protection legislation and the law generally responsibility for patient records (irrespective of the form they are kept in) is always on the creator and custodian of the record, usually a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16401 2008-07-31T23:19:22Z

<p>Nadeem: /* Electronic Medical Records/Electronic Health Records */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> A major concern is adequate confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. Multiple access points over an open network like the Internet increases possible patient data interception. In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws. In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. The organizations and individuals charged with the management of this information are required to ensure adequate protection is provided and that access to the information is only by authorized parties. The growth of EHR creates new issues, since electronic data may be physically much more difficult to secure, as lapses in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> =====Technology limitations=====<br /> <br /> Limitations in software, hardware and networking technologies has made EMR difficult to affordably implement in small, budget conscious, multiple location healthcare organizations. Until recently most EMR systems were developed using older programming languages such as Visual Basic and C++; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> =====Preservation=====<br /> <br /> Under data protection legislation and the law generally responsibility for patient records (irrespective of the form they are kept in) is always on the creator and custodian of the record, usually a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> =====Legal status=====<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> :* Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> :* Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16397 2008-07-31T23:14:18Z

<p>Nadeem: /* Electronic Medical Records/Electronic Health Records */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> =====Interoperability=====<br /> <br /> In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use the information that has been exchanged.<br /> <br /> In the United States, the development of standards for EMR interoperability is at the forefront of the national health care agenda. EMRs, while an important factor in interoperability, are not a critical first step to sharing data between practicing physicians, pharmacies and hospitals. Many physicians currently have computerized practice management systems that can be used in conjunction with health information exchange (HIE), allowing for first steps in sharing share patient information(lab results, public health reporting) which are necessary for timely, patient-centered and portable care. There are currently multiple competing vendors of EHR systems, each selling a software suite that in many cases is not compatible with those of their competitors. Only counting the outpatient vendors, there are more than 25 major brands currently on the market. In 2004, President Bush created the Office of the National Coordinator for Health Information Technology (ONC), originally headed by David Brailer, in order to address interoperability issues and to establish a National Health Information Network (NHIN). Under the ONC, Regional Health Information Organizations (RHIOs) have been established in many states in order to promote the sharing of health information. Congress is currently working on legislation to increase funding to these and similar programs.<br /> <br /> The Center for Information Technology Leadership described four different categories (“levels”) of data structuring at which health care data exchange can take place. While it can be achieved at any level, each has different technical requirements and offers different potential for benefits realization.<br /> <br /> The four levels are:<br /> :#Non-electronic data<br /> :#Machine transportable data<br /> :#Machine organizable data (structured messages, unstructured content)<br /> :#Machine interpretable data (structured messages, standardized content)<br /> =====Older record incorporation=====<br /> <br /> To attain the wide accessibility, efficiency, patient safety and cost savings promised by EMR, older paper medical records ideally should be incorporated into the patient's record. The digital scanning process involved in conversion of these physical records to EMR is an expensive, time-consuming process, which must be done to exacting standards to ensure exact capture of the content. Because many of these records involve extensive handwritten content, some of which may have been generated by different healthcare professionals over the life span of the patient, some of the content is illegible following conversion. The material may exist in any number of formats, sizes, media types and qualities, which further complicates accurate conversion. In addition, the destruction of original healthcare records must be done in a way that ensures that they are completely and confidentially destroyed. Results of scanned records are not always usable; medical surveys found that 22-25% of physicians are much less satisfied with the use of scanned document images than that of regular electronic data.<br /> =====Privacy=====<br /> <br /> A major concern is adequate confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. Multiple access points over an open network like the Internet increases possible patient data interception. In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws. In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. The organizations and individuals charged with the management of this information are required to ensure adequate protection is provided and that access to the information is only by authorized parties. The growth of EHR creates new issues, since electronic data may be physically much more difficult to secure, as lapses in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.<br /> =====Social and organizational barriers=====<br /> <br /> According to the Agency for Healthcare Research and Quality's National Resource Center for Health Information Technology, EMR implementations follow the 80/20 rule; that is, 80% of the work of implementation must be spent on issues of change management, while only 20% is spent on technical issues related to the technology itself. Such organizational and social issues include restructuring workflows, dealing with physicians' resistance to change (or, alternatively, software engineers' evolving research in deep modeling of the physician's knowledge and workflow domains), as well as IT personnels' resistance to design and implementation flexibility needed in the complex healthcare environment, and creating a collaborative environment that fosters communication between physicians and information technology project managers. Exemplifying this need are several highly publicized HIT implementation failures, such as one at Cedars Sinai Medical Center in Los Angeles, in which physicians revolted and forced the administration to scrap a $34 million CPOE system as well as others compiled at a collection of cases of health IT difficulties by medical informatics specialists. There are, however, several successful examples of EMR implementations in large hospitals, usually hospital systems that have had years of experience developing custom EMRs, for example the Veterans Administration hospital system and the VistA EMR.<br /> =====Technology limitations=====<br /> <br /> Limitations in software, hardware and networking technologies has made EMR difficult to affordably implement in small, budget conscious, multiple location healthcare organizations. Until recently most EMR systems were developed using older programming languages such as Visual Basic and C++; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability. Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions.<br /> =====Preservation=====<br /> <br /> Under data protection legislation and the law generally responsibility for patient records (irrespective of the form they are kept in) is always on the creator and custodian of the record, usually a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law. Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.<br /> =====Legal status=====<br /> <br /> Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.<br /> <br /> * Digital signatures Most national and international standards accept electronic signatures. According to the American Bar Association, &quot;A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer.&quot; With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.<br /> * Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16394 2008-07-31T23:09:39Z

<p>Nadeem: /* Electronic Medical Records/Electronic Health Records */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> =====Interoperability=====<br /> <br /> In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use the information that has been exchanged.<br /> <br /> In the United States, the development of standards for EMR interoperability is at the forefront of the national health care agenda. EMRs, while an important factor in interoperability, are not a critical first step to sharing data between practicing physicians, pharmacies and hospitals. Many physicians currently have computerized practice management systems that can be used in conjunction with health information exchange (HIE), allowing for first steps in sharing share patient information(lab results, public health reporting) which are necessary for timely, patient-centered and portable care. There are currently multiple competing vendors of EHR systems, each selling a software suite that in many cases is not compatible with those of their competitors. Only counting the outpatient vendors, there are more than 25 major brands currently on the market. In 2004, President Bush created the Office of the National Coordinator for Health Information Technology (ONC), originally headed by David Brailer, in order to address interoperability issues and to establish a National Health Information Network (NHIN). Under the ONC, Regional Health Information Organizations (RHIOs) have been established in many states in order to promote the sharing of health information. Congress is currently working on legislation to increase funding to these and similar programs.<br /> <br /> The Center for Information Technology Leadership described four different categories (“levels”) of data structuring at which health care data exchange can take place. While it can be achieved at any level, each has different technical requirements and offers different potential for benefits realization.<br /> <br /> The four levels are[7]:<br /> :#Non-electronic data<br /> :#Machine transportable data<br /> :#Machine organizable data (structured messages, unstructured content)<br /> :#Machine interpretable data (structured messages, standardized content)<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16393 2008-07-31T23:05:02Z

<p>Nadeem: /* Electronic Medical Records/Electronic Health Records */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.<br /> <br /> Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16383 2008-07-31T22:54:01Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> [http://en.wikipedia.org/wiki/Electronic_medical_record ''New'' Electronic medical record]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16382 2008-07-31T22:52:00Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> [http://www.healthcareitnews.com/story.cms?id=9327 ''New'' Medical records security at risk]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16379 2008-07-31T22:40:52Z

<p>Nadeem: /* =Electronic Medical Records/Electronic Health Records */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records====<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16378 2008-07-31T22:40:24Z

<p>Nadeem: /* Catalyst */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ====Electronic Medical Records/Electronic Health Records===<br /> <br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16364 2008-07-31T21:48:49Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 ''New'' Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act ''New'' Health Insurance Portability and Accountability Act.]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16363 2008-07-31T21:47:38Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 Tech Firms Eye Medical Privacy Market]<br /> <br /> [http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act Health Insurance Portability and Accountability Act.<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16361 2008-07-31T21:46:06Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/Grandpa.html Does Government Need to Know if Grandpa Curses?]<br /> <br /> [http://news.zdnet.co.uk/emergingtech/0,1000000183,2083041,00.htm Hospital Hacked - records stolen]<br /> <br /> [http://www.os.dhhs.gov/news/press/2000pres/00fsprivacy.html PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION]<br /> <br /> [http://www.hhs.gov/news/press/2000pres/20001220.html HHS ANNOUNCES FINAL REGULATION ESTABLISHING FIRST-EVER NATIONAL STANDARDS TO PROTECT PATIENTS' PERSONAL MEDICAL RECORDS]<br /> <br /> [http://thomas.loc.gov/cgi-bin/bdquery/z?d106:h.r.00354: To amend title 17]<br /> <br /> [http://www.cdt.org/privacy/medical/ Medical Records Privacy]<br /> <br /> [http://www.whitehouse.gov/news/releases/2001/04/20010412-1.html President's Statement on Medical Privacy Information]<br /> <br /> [http://www.ama-assn.org/ama/pub/category/1905.html Guidelines for medical and health information sites on the Internet]<br /> <br /> [http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Guidelines for the Clinical Use of Electronic Mail with Patients]<br /> <br /> [http://www.healthprivacy.org/newsletter-url2306/newsletter-url_list.htm?section=HPP%20Resources HPP Resources]<br /> <br /> [http://www.os.dhhs.gov/ocr/hipaa/ Office for Civil Rights - HIPAA]<br /> <br /> [http://www.netreach.net/~wmanning/otadig.htm Protecting Privacy In Computerized Medical Information (Office of Technology Assessment): Digest]<br /> <br /> [http://www.eagleforum.org/column/1999/mar99/99-03-24.html Who Controls Your Medical Records?]<br /> <br /> [http://leahy.senate.gov/press/199711/s1368.html The Medical Information Privacy and Security Act (MIPSA)]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/HHSPrivacy.html Institute for Health Freedom]<br /> <br /> [http://www.zdnetasia.com/news/security/0,39044215,11052851,00.htm Medical Net privacy? It's unhealthy]<br /> <br /> [http://health.usnews.com/usnews/health/articles/010305/archive_004867.htm Guard Your Genetic Data from Those Prying Eyes]<br /> <br /> [http://forhealthfreedom.org/Publications/Privacy/CommunityRule.html Should Community Rights Override Individual Rights to Privacy?]<br /> <br /> [http://www.nomanagedcare.org/privacyelements.htm Key Elements Needed to Protect Medical Information Privacy]<br /> <br /> <br /> <br /> <br /> [http://epic.org/privacy/medical/ ''New'' Electronic Privacy Information Center]<br /> <br /> [http://whitepapers.zdnet.com/abstract.aspx?docid=353882 ''New'' Develop a HIPAA Privacy Policy]<br /> <br /> [http://www.computerworld.com/action/article.do?command=viewArticleBasic&amp;articleId=9100258 ''New'' U.S. Privacy Act outdated, hasn't kept up with technology, experts say]<br /> <br /> [http://abcnews.go.com/Business/story?id=87899&amp;page=1 Tech Firms Eye Medical Privacy Market]<br /> <br /> <br /> [http://pg-server.csc.ncsu.edu/mediawiki/index.php/CSC_379_SUM2008:Topics#Privacy_of_Medical_Information Topic Description]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16353 2008-07-31T20:42:40Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://www.healthprivacy.org/usr_doc/Privacystories.pdf Health Privacy Stories]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16306 2008-07-31T17:48:30Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://www.privacyrights.org/fs/fs8-med.htm#C How Private Is My Medical Information]<br /> <br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16305 2008-07-31T17:47:07Z

<p>Nadeem: /* Bibliography */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==<br /> [http://ethics.csc.ncsu.edu/privacy/medical/study.php Original Page]</div>

Nadeem https://wiki.expertiza.ncsu.edu/index.php?title=Privacy_of_Medical_Records&diff=16296 2008-07-31T17:38:21Z

<p>Nadeem: /* Study Guide */</p> <hr /> <div>==Study Guide==<br /> ===Catalyst===<br /> Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.<br /> ====Content of Medical Records====<br /> Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.<br /> ====Accessibility====<br /> Medical records are shared by people both in and out of the health care industry. These include:<br /> :*Insurance companies<br /> :*Government agencies<br /> :*Medical Information Bureau(MIB)<br /> :*Employers<br /> :*Subpoenaed for court<br /> Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:<br /> :*Health care operations, or the evaluations of hospitals or individual physicians<br /> :*Public health agencies for health research<br /> :*Direct marketers when you participate in informal health screenings<br /> ===Laws===<br /> Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.<br /> ===Genetic Mapping===<br /> More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.<br /> ===Technology===<br /> <br /> ==Bibliography==</div>

Nadeem