NCVHS Defines What Sensitive Info HIEs Should Sequester
Prepared by Krystyna Nowik, Esq.
The National Committee on Vital and Health Statistics (NCVHS) released an advisory letter to the Department of Health and Human Services (HHS) on November 10 addressing recommendations for the management of sensitive information in the HIE context. NCVHS, which is the statutory public advisory body for HHS, explored and identified categories of sensitive health information requiring new technologies and methods for segmenting and protecting such information in electronic health records. The advisory letter, which coordinates with Health IT Policy Committee recommendations and requirements, addresses preliminary categories of sensitive information, including:
- The new HITECH cash payments (“payment in full” and “out-of-pocket” restriction);
- Genetic information;
- Psychotherapy notes;
- Substance abuse treatment records;
- HIV information;
- Sexually transmitted disease information;
- Sexuality and reproductive health information;
- Certain health information for minors, where protected by state law;
- Mental health information; and
- Certain circumstances where the entire medical record may be deemed sensitive (e.g., domestic violence, victims of violent crime).
In addition, the NCVHS advisory letter includes five core recommendations for HHS. Among these are identifying and publishing best practices for managing categories of sensitive information, and investing in research for enhancing health information exchange and electronic health record capabilities and in pilot tests and projects for assessing feasibility, effects, efficacy and the costs and benefits of such capabilities.
The NCVHS recommendations will serve as a platform for HHS to conduct research, develop technologies and implement pilot tests and projects with an eye towards understanding the feasibility, technical standards, effects on patient care, and the costs and benefits of managing sensitive information. As NCVHS stated in the advisory letter,
[o]ur nation is committed to deploying interoperable health record to improve patient health, health care, and public health. Patient trust is critical to patient participation in this deployment, and, therefore, we must invest in technologies that will promote this trust.