Update on patient privacy legislation.
The administrative simplification provisions of HIPAA will establish the first national standards for the electronic transmission of health care transactions with which all federal programs (DOD, Medicare, and Medicaid) and all private health plans must comply. Individuals and organizations should prepare themselves, their systems, and their processes to meet these new administrative and financial data standards and requirements. The benefits of standardized electronic transactions on achieving a single paper-free claims submission to be used by all providers and payers is of obvious benefit. Not so obvious are consequences associated with limiting the access and use of existing data repositories on a variety of clinical, administrative, and research functions. It is critically important in this age of increased accountability for fiscal restraint and improving the outcomes of entire patient populations that clinicians, managers, organizations, and researchers to use data for a variety of clinical, quality improvement/evaluation, and research purposes. Administrative simplification and protecting individual privacy should not be achieved by overly bureaucratic and restrictive responses that impede epidemiologic and health services research, quality improvement activities, and optimization strategies for improving the health of populations. While the health system understands the need for some increased regulation to ensure the privacy of individual patient privacy in the "wired" world solutions must be found and overly restrictive consequences associated with prohibiting access to data must be resolved. More than ever, the entire system requires data to inform every level and type of decision made. Legislation and bureaucratic processes that do not understand and support responsible data-driven decision-making will serve to roll-back, not advance health system improvement. As we prepare ourselves for HIPAA compliance and the expectations of the benefits it will achieve, we must wait to see what impact it will have on clinical, administrative, and research functions concerned with improvement.
Maddox
P J
PJ
Health Systems Management Program, College of Nursing and Health Science, George Mason University, Fairfax, VA, USA.
D016494:Computer Security / Q000331:legislation & jurisprudence*; D003219:Confidentiality / Q000331:legislation & jurisprudence*; D020408:Health Insurance Portability and Accountability Act / Q000458:organization & administration*; D006801:Humans; D010344:Patient Advocacy / Q000331:legislation & jurisprudence*; D018907:Privacy / Q000331:legislation & jurisprudence*; D014481:United States