NASW Seeks Privacy Protections for Personal Health Records

Jan 14, 2009

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

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.

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.

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.

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 €œminimum necessary requirement€ and re-examine the definition of €œhealth 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.