Privacy rules: They’re studied and challenged
The Chicago-based American Hospital Association (AHA) has asked the federal government to reopen some portions of the patient privacy rules adopted in the last days of the Clinton administration, hoping to delay implementation of the rules. AHA executive vice president Rick Pollack, MD, wrote in a letter to Health and Human Services (HHS) Secretary Tommy Thompson that the rules pose "overwhelming" cost and implementation challenges for the nation’s hospitals and health systems.
Real rules, real world
A study commissioned by the association says the cost to hospitals could reach $22.5 billion over five years just to comply with three key provisions of the rule. The rules also include "potentially confusing and burdensome consent requirements," Pollack’s letter says. The AHA cites potential real-world problems, such as a doctor potentially violating the rule by discussing private issues with a patient in a hospital room shared with another patient. AHA also is concerned that the government’s implementation schedule is overly aggressive.
"Hospitals are expected to be in full compliance with the new privacy rules by Feb. 26, 2003 — just a little over two years from now," Pollack wrote.
A review of the rule would allow hospitals to fully assess the impact of the rules and work with the new administration on reforming them, Pollack says. Delaying implementation of the rule also would allow hospitals to find additional sources of funding. Issued in response to a congressional request for improving patient privacy standards as part of the Health Insurance Portability and Accountability Act of 1996, the privacy rules establish national standards for how personal health information is used and distributed, and set criminal and civil penalties for breaching patient privacy.
E is for ethics
On the same subject, the Chicago-based American Medical Association (AMA) and other groups recently released a report recommending more than 30 specific measures for protecting patient privacy. The AMA’s Ethical Force, or E-Force, released the report. The E-Force Oversight Body’s members include representatives from organized medicine, health care delivery organizations, patient advocacy groups, business, and government.
The E-Force selected two areas for ethics performance assessment based on their relevance to all participants in the current health care system. They include privacy and confidentiality protections in health care and processes for designing health benefits and adjudicating coverage decisions. The document is organized into eight content areas, each of which contains a set of corresponding performance expectations. This report will be used to create additional performance measures that organizations and practices can use for self-assessment, quality assurance, and quality improvement.
Mary Jane England, MD, an E-Force member, says the group is working to develop performance standards. One goal is to make the privacy policies of institutions and organizations clearly understandable to the public, allow individuals access to view and amend their medical records, and establish local review committees to investigate denial of an individual’s request for information.
"Electronic information systems can provide tremendous opportunities to advance public health and improve patient care," England says. "But if patients withhold information, provide inaccurate information, or avoid the health care system because they fear the information they disclose might be used against them, then the most sophisticated electronic systems in the world will not be able to improve their health or the health of our communities."
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