Some patient information will remain public

Doctors should continue reporting suspected child abuse or neglect, and adverse events suspected from prescription drugs or medical devices.

By Joel B. Finkelstein, AMNews staff. April 7, 2003.

Give it up for the public good -- protected health information that is.

The medical records privacy rule, while protecting patient information, does not bar physicians from providing individually identifiable data to government agencies and programs for public health purposes.

Under the regulations, doctors should continue reporting suspected child abuse or neglect to social service agencies. And physicians also need to report prescription drug and medical device-related adverse events to the Food and Drug Administration, even if a link is only suspected.

These public health disclosures should be made to any FDA contacts listed on the product's label, within literature that accompanies the product, or in sources such as the Physicians' Desk Reference.

However, the rule, part of the Health Insurance Portability and Accountability Act, does forbid unauthorized disclosure of patient information to a product's manufacturer for the company's marketing efforts.

Other allowed disclosures for public health purposes include FDA post-market surveillance and product recalls, as well as local and national government efforts to detect and track infectious disease outbreaks.

Under limited circumstances, physicians can share patients' health information with employers. The physician has to be working for or on behalf of the company as part of a worker-safety program mandated by a federal agency or state law.

State laws that require physicians and other medical professionals or facilities to report cases and circumstances of certain diseases and injuries to public health officials still stand under the rule.

Physicians also should continue to report births and deaths, as well as adverse events related to food and dietary supplements.

Privacy rule pointers

The Office of Civil Rights is the division of the Dept. of Health and Human Services responsible for overseeing and enforcing the privacy regulations. Federal guidance on the HIPAA privacy rule is now available in the form of 190 frequently asked questions. Physicians may find answers to their questions with a keyword search or by browsing the FAQs accessible through the OCR Web site (www.hhs.gov/ocr/hipaa).