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Re: Release of Info on "Terminally Inconvenienced" Persons



Columbia University is taking the HIPAA requirements extremely seriously
and has recently appointed an experienced lawyer as "Associate VP for
HIPAA Compliance."  Although the University does not operate the
clinical side of the Columbia-Presbyterian Medical Center (unlike say,
Hopkins or the U. of Pennsylvania where the parent university owns its
hospital), it does operate the private practice plan here and engages in
a huge amount of biomedical research employing human subjects.

I've had some email communication with our new VP that's helped me to
clarify the implications of HIPAA for records in our manuscript holdings
that contain patient information.  He's given me permission to share
this with my colleagues, so below is an extract from his messages to me
(the "PHI" in the message is shorthand for "Patient Health
Information"):

"As an initial matter, HIPAA applies with equal force to the
identifiable health records of a deceased patient as it would a living
patient and the obligation to protect such PHI would extend to the
University as long as it maintained such records.  However, to come
within HIPAA, the identifiable patient information would have to have
been transmitted by a healthcare provider in electronic form in
connection with a transaction covered by HIPAA (e.g., electronic billing
of medical claims).  So, historical records from an era when there was
no such thing as electronic billing would not likely be subject to
HIPAA.  I say likely because there are other electronic transactions
besides billing that could bring you into HIPAA but electronic billing
is the one most likely to apply to physicians."

So it would appear that HIPAA would allow you to make your Civil War
letters accessible to researchers without any excising of names. In
fact, it would seem that patient registers from the Maine State Insane
Asylum from the 1860s could be made available to researchers without
violating HIPAA -- though there are other privacy issues, not
necessarily related to any particular legal provisions, that might lead
you to restrict the use of personal names from them.

It would also appear that a private letter from the 1980s in which
someone mentions an illness would also be exempt from HIPAA, although
not necessarily from a privacy tort action (if the writer were still
alive).

For those records created after electronic billing was introduced, the
issues of access become more complicated depending on whether the
patient is alive, patient identifiers have been removed from the record,
etc.  I won't overwhelm you with all the details.

You should be aware that like most federal statutes, the implications of
HIPAA will not be entirely clear until there is a body of case law
pertaining to it. And in the meantime, as Dan mentions, any two lawyers
are likely to disagree about the finer points of the law as written.
Since the state govt. of Maine undoubtedly has a large number of patient
records in its possession (some of which have surely made it to the
archives by now) the State Archives should discuss this with your legal
counsel.
--
Stephen E. Novak
Head, Archives & Special Collections
Augustus C. Long Health Sciences Library
Columbia University
701 West 168th Street
New York, NY 10032
(212) 305-7931
FAX: (212) 305-6097
URL: http://cpmcnet.columbia.edu/library/archives/index.html


"Dostie, Arthur" wrote:
>
> Recently we have learned of the passing of the Health Information Personal
> Privacy Act (I think I got it right) also known as HIPPA.  My understanding
> of it is that information about a persons health contained in public records
> cannot be released and this also applies to people who are "nonviable" (as
> the politically correct would say), or more simply and accurately "dead".
>
> Now let me put forward the example my supervisor came up with.  While it is
> fictional ,it is surely representative of real letters found in our Civil
> War correspondence:
>
> Dere Govinner of Maine  -  I want you to git me out of this ridgerment and
> let me com home because I have the diaree and bin sick ever sinse I got
> here.  also whin I went to Worshintin on my furlow I gut me a case of the
> clap.  And Besides, the orficer says I am useless for a soljer anyways.
> Plese to take keer of this and I will remane yore
>
> ob't servint
> Pvt. Clarence Potlatch  20th Mane somewheres in Vaginier june 1 1863
>
> Can anyone chip in on how this would be handled under HIPPA?  Would a state
> Archives be exempt as it would not be an agency covered under HIPPA?  Are we
> going to have to examine every record patrons wish to see to censor health
> information on Revolutionary War pension applicants ("I am 80 yeres old and
> not well.")?  Who's ready to see the second "Lord of the Rings" movie?
>
> Would be glad to hear any opinions.
>
> Art Dostie
>
> Maine State Archives
>
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A posting from the Archives & Archivists LISTSERV List!

To subscribe or unsubscribe, send e-mail to listserv@listserv.muohio.edu
      In body of message:  SUB ARCHIVES firstname lastname
                    *or*:  UNSUB ARCHIVES
To post a message, send e-mail to archives@listserv.muohio.edu

Or to do *anything* (and enjoy doing it!), use the web interface at
     http://listserv.muohio.edu/archives/archives.html

Problems?  Send e-mail to Robert F Schmidt <rschmidt@lib.muohio.edu>