Week 5: 2/8/2016 – 2/15/2016
Historical and Contemporary role of institutions and actors: Statutory and regulatory mechanisms related to patient health information
The Role of Institutions/Actors in policy making
Public policy making in the U.S. health domain is a complex process that is highly political. It is continual and cyclical and is heavily influenced by internal and external factors (Longest, 2010). There are several players/actors inside of government involved in the process of policy making. These include the office of President, his resources and political appointees; civil servants; and Congress (Kingdon, 2011). Each of the players/actors can influence one another in decision-making, however; some have more influence than others. The President and his political appointees are critical to agenda setting, but have less control over the alternatives considered and over implementation (Kingdon, 2011). Civil servants do not have a significant role in agenda setting; however they have more impact on alternatives and implementation. Congress is central to both agenda setting and alternative specification, although the members have more impact on the agenda while the staffers concentrate on the alternatives (Kingdon, 2011).
Statutory and regulatory mechanisms related to patient health information
Current State: Statutory requirements and regulatory requirements are requirements that are mandated by law, and are non-negotiable. Failure to comply could result in a fine or other penalty for the person(s) and/or organizations for the non-compliance.
According to Longest, (2010), political problems that move forward to legislative development are those that policy makers believe are urgent and have a high public interest. There are a number of laws and regulations at both the federal and state level that govern the confidentiality of health information, including:
The privacy rule:
- Preempts state law contrary to the privacy rule (exceptions are made if certain conditions are met)
- Establishes requirements for notice and acknowledgment
- Establishes an individual’s right to opt out of the facility directory, or to request restrictions to other uses of his or her health information
- Establishes requirements for use
- Establishes administrative requirements
The Privacy Act of 1974 was designed to give citizens some control over the information collected about them by the federal government and its agencies. It grants people the following rights:
- to find out what information was collected about them
- to see and have a copy of that information
- to correct or amend that information
- to exercise limited control of the disclosure of that information to other parties
Confidentiality of Alcohol and Drug Abuse Patient Records. This rule establishes additional privacy provisions for records of the identity, diagnosis, prognosis, or treatment of patients maintained in connection with a federally assisted drug or alcohol abuse program.
The Health Insurance Portability and Accountability Act (HIPAA) – when Personal Health Information (PHI) is connected to the patient’s legal medical record it is protected under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.
Future State: President Obama has requested a thirty five percent increase in the 2017 budget for cybersecurity and has announced plans to implement a Cybersecurity National Action Plan (CNAP). The CNAP would take short term actions and develop a long-term strategy to enhance cybersecurity awareness and protections, protect privacy, maintain public safety (as well as economic and national security), and empower Americans to take better control of their digital security.
In order to implement these changes, the federal government is seeking a 2017 budget of greater than $19 billion for cybersecurity. This will enable agencies to increase their level of cybersecurity, help private sector organizations as well as individuals better protect themselves, deter adversary activity and more effectively respond to incidents.
Another variable to agenda making is the current political circumstance that surrounds the problem. According to Longest, (2010), the window of opportunity to allow a problem to move forward may depend on what society and existing political bodies currently view as actions of priority. With the increase in the number of people using personal health records to manage their health information and become more engaged in their quest for good health, along with the amount of funding being put in place to enhance the security of personal health information, this may be the “window of opportunity” to regulate and standardize the context for patient portals.
References:
Kingdon, J.W. (2011). Agendas, alternatives, and public policies (2nd ed). Boston, MA: Longman.
Longest, B.B. Jr. (2010). Health policymaking in the United States (5th ed.). Chicago, IL: Health Administration Press
Retrieved from: https://www.healthit.gov/…/personal–health–record-phr-model-privacy-n…
Retrieved from: https://www.healthit.gov/…/can-i-keep-my-own-personal–health–records–…
Retrieved from: https://patientprivacyrights.org/learn-personal–health–records/
Retrieved from: http://perspectives.ahima.org/patient-access-to-personal-health-information-regulation-vs-reality/#.VruMSZjruJA
Retrieved from: http://www.himss.org/
Patient portals 