Researchers: HIPAA hampers QI work
A paper published in the Archives of Internal Medicine suggests an apparent conflict between protecting individual patients’ privacy and improving the quality, safety, and cost of medical care for all patients. In the paper, "Potential Impact of the HIPAA Privacy Rule on Data Collection in a Registry of Patients with Acute Coronary Syndrome," University of Michigan Cardiovascular Center (U-M CVC) researchers in Ann Arbor report how their work on heart attack care has been hampered by the national medical privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA), which took effect about two years ago.1
The changes needed to comply with HIPAA have hindered quality research efforts, they write. One problem the authors encountered was the requirement of prior consent for patients to participate in post-care surveys. The researchers note a drastic drop, from 96% in previous surveys to 34% post-HIPAA, in the percentage of heart attack survivors and chest pain patients who take part in follow-up surveys after they leave the hospital.
In addition, findings generated from these respondents may be skewed because patients who returned the HIPAA-compliant written consents were far more likely to be older, married, and white than those for whom consent could not be secured. HIPAA changes also have boosted the cost of performing the surveys dramatically, with increases noted in computing time, staff hours, office supplies, and postage, the authors say.
"We won’t solve safety, quality, and cost issues in health care unless we do quality research, and our findings show that HIPAA, as currently written, has the potential to hinder that effort," says co-author Kim Eagle, MD, clinical director of the U-M CVC. "Privacy is crucial. But quality improvement research aims to generate public benefit, and as a society, we have to be careful that we don’t find ourselves on such a far extreme on one side of privacy protection that we actually paralyze our ongoing efforts to monitor and improve care."
Reference
- Armstrong, et al. Potential impact of the HIPAA privacy rule on data collection in a registry of patients with acute coronary syndrome. Arch Intern Med 2005; 165(10):1,125-1,129.
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