'Sensitive' Health Data, State Health Information Exchanges: Dilemmas Prevail
One of these options involves granular consent policies for HIEs and EHRs. Such policies would provide consumers with the ability to decide for themselves which types of PHI would have extra access restrictions, such as “only my PCP can see my psychiatrist records, while ED physicians cannot see these unless I am unconscious and cannot provide history.”
Another option allows consumers to see what information is available for other providers to view. This, along with robust audit log reporting, might provide a greater sense of trust in the system. Both of these options would hopefully result in lower opt-out rates and a greater sense of involvement in ones own medical care.
What can you do to help bring about these changes? First, learn about the HIE policies in your region and in your state. Learn about the governance structure, read the meeting minutes, and participate in the decision-making process by writing letters or attending meetings and speaking up. Also let your legislators know that this is an important issue. Second, educate your patients about the privacy and safety issues around HIEs, and discuss their participation status with them. Third, provide clear information to your patients about your participation status with the HIE and understand what their wishes and fears are. Finally, if you have access to your state’s HIE, sit down with your patients and show them how it works and what information is available about them. You are a patient, too, so use the opportunity to understand what your rights and responsibilities are as an HIE participant.
Share your experiences with your HIE by commenting on this article below.
-- Steven R. Daviss, M.D., DFAPA
Dr. Daviss is chair of the department of psychiatry at Baltimore Washington Medical Center, chair of the APA Committee on Electronic Health Records, co-chair of the CCHIT Behavioral Health Work Group, and co-author of Shrink Rap: Three Psychiatrists Explain Their Work, published by Johns Hopkins University Press. He is available on Twitter @HITshrink and at drdaviss@gmail.com.
