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NASW Seeks Privacy Protections for Personal Health Records

For Immediate Release
January 14, 2009

Contact:
Gail Woods Waller
202-336-8236 gwaller@naswdc.org

James Finley
202-336-8315Â
jfinley@naswdc.org

Nation’s Social Workers Urge Congress to Act in Economic Recovery Plan

Washington –The National Association of Social Workers (NASW) urges Congress to include provisions in the economic recovery bill that encourage the development of a national interoperable health information infrastructure (HIT), provided it includes comprehensive statutory protections for the privacy and security of consumer health records. NASW supports privacy and security for personal health records as an essential element of HIT legislation, now being prepared for passage.

The National Association of Social Workers (NASW) is the largest professional social work organization in the world with nearly 150,000 members. NASW promotes, develops, and protects the provision of effective social work services to diverse client populations, most of whom expect confidentiality to be an important component of clinical services. Â

NASW supports the development of a national interoperable HIT network because it offers the possibility of improved care for clients and patients. However, such a network also entails a major risk to consumers, where personal records in a standardized system will be vulnerable to intentional or negligent disclosure on a massive scale. The possible loss of privacy and related problems is of grave concern.

NASW asks Congress to take a truly patient-centered approach to health IT by addressing use of a national electronic health information system in the core concept of a health professional’s ethics. Informed consent must be obtained for the disclosure of every individual’s identifiable health information.

“Social workers know from practice experience that consumers will not divulge critical and highly personal health information to health professionals unless they are assured their information will be kept private by their treating clinician. Repercussions from the unauthorized release of personal health information can have critical ramifications with family members, employers and insurance coverage,” says Jim Finley, NASW Senior Government Relations Associate.

Accordingly, NASW supports strong privacy principles that at a minimum:

  • Acknowledge a patient’s right to health information privacy and security.
  • Provide for a right of consent that protects the patient while being workable in a health care network.
  • Provide for a records process that can segregate specific information on mental health, addictions and other highly sensitive patient diagnoses and treatment histories.
  • Provide a notice to the patient when the right to privacy is breached.
  • Strengthen HIPAA Privacy and Security Rule standards to the fullest extent possible, particularly with regard to protection of psychotherapy notes and other sensitive patient information. Standards should also address the “minimum necessary requirement” and re-examine the definition of “health care operations” to determine whether such operations may be performed with de-identified patient information.
  • Allow a patient to pay privately for health care and to not have his or her records included in the network.
  • Ensure that all key health care professionals are encouraged to implement HIT into their practices through incentives provided in the legislation.
  • Preserve stronger state laws and the well-established psychotherapist-patient privilege currently recognized under federal and state law.

No comments

  1. I would like to comment on the principle that states that our nation should, “allow a patient… to not have his or her records included in the network.” Being a tech orientated person, the idea that a person’s recorders not be included on a network appears potentially problematic, a point of contention. I am thinking of matters of efficiency, of having them on hand, yet a patient should be able to have his records withdrawn from an institution. Yet having a patients data on file, within a network, facilitates the urgency on be half of cost effectiveness and patient care through the possibility of build an ethical digital infrastructure, which would reduce error. If patient room has a terminal, which is connected to the hospital, perhaps inter-hospitals, available than a doctor could input the patient order and relay them to other personal, such as nurses, the pharmacy, etc. Ordering medications in this fashion alone eliminates transcription error, barring typos, which could be safe-guarded against with programming. But for an overall information system to work it may need to be “organic.” Ideally it would be a growing record of patient’s medical history across institutions, and yet the patient should also have the right not to be included in these networks, or at least not on a permanent basis, hence the suggestion to include a patient’s right to withdraw their medical information from an institution and their record keeping affiliates. Suggestions such as having patients carry allergy and medication lists with them or even keeping a copy of their medical records, are not meant to be alternatives to the hospital holding the record, rather additions, but they could be, and this should be thought further, such that peoples might start carrying a digital copy of their medical recorder on a thumb-drive that could be uploaded onto a hospitals network. Then it would be the patient who supplies their own data, medical history, and they are the ones deciding who gets access to what and for how long. If something of this nature was implemented then the patient remains the proprietor of their information, instead of the going through the hassle many patients get to experience when “their” hospital for “their” records. Yet that is a separate, but related, issue. And finally, with the increasing interest in Linux operating systems and GNU software gaining in popularity and mainstream corporate awareness, I am hopeful that technological improvements will be implemented soon, if only because they makes economic and hence fiscal sense. Yet it is our responsibility to insure that they are considered from a patient centered bottom line. Perhaps the point of this email is just to highlight what we all know, technology is changing the way we understand management and privacy issues, if not the fabric of many of our lives, and we, as Social Workers must be proactive in these rapidly advancing times.

    Al Aguero
    Binghamton University, MSW student

  2. Al, you make some very good points.

    Send me an email sometime…

  3. Sorry I meant to leave this in the mast message: moonvoid@gmail.com

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