Understanding Health Care: Electronic Health Records and HIPPA

By Glenn Robinson

Health care is among the most heavily regulated industries in America – virtually every aspect of the health care system is subject to government oversight.

There are regulatory mechanisms to supervise the doctors and professionals who render care; the institutions in which care is provided, such as hospitals and clinics; the medications and medical devices that are the tools of care; and the insurance coverage that finances it all. These regulations are developed and implemented by all levels of government — federal, state and local — as well as private organizations.

Everyone in health care agrees that regulations and standards are necessary to ensure compliance and to provide safe health care to every patient. Policy debates, for the most part, typically focus not on whether oversight should exist, but rather on how it should be structured. Impartial, external oversight is considered necessary to protect the public interest – even by those who are especially suspicious of government bureaucracy.

American health care has flourished over the past 100 years. Rather than hindering its progress, the complex system of government regulation actually may have served to support and nurture it.

Consider, for example, the public confidence engendered in the competence of physicians through licensure requirements and in the safety and effectiveness of prescription drugs through the Food and Drug Administration’s approval process.

Another form of regulation is known as HIPAA. At some point while filling out a bevy of forms at the doctor’s office, you may have run across this term.

The Health Insurance Portability and Accountability Act, or HIPAA, was passed by Congress in 1996 and was intended to improve health care efficiency by standardizing electronic data exchange and protect the privacy of patient records.

Since 2010, as part of national health care reform, there has been increased urgency in transitioning to digital versions of patients’ paper charts called electronic health records, or EHRs.

EHRs can contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, test results and more. But they’re not just a replacement for paper charts.

Part of what makes EHRs so powerful is that they also allow doctors and other care providers to access evidence-based tools that can be used to make decisions about a patient’s care in real time.

Another key advantage of EHRs is convenience. Health information can be created and securely managed digitally by authorized providers and shared with other providers at other locations.

This helps cut down on the number of forms patients must fill out and can eliminate the need for duplicate testing, as well as promote legible, complete medical documentation for streamlined coding and billing.

With all this information available to be shared with the touch of a button, precautions must be taken to ensure the privacy of the patient. As EHRs continue to evolve, so must our regulation of them.

The HIPAA law’s privacy standards strive to give patients rights over their health information, and set boundaries on who can receive a patient’s personal health information. Those who must follow the law include healthcare providers such as hospitals, doctors and nurses, pharmacies, insurance companies, and government programs such as Medicare and Medicaid.

The law limits the use of patient information by health care providers to specific purposes. Patient information can only be shared if it is necessary to coordinate treatment, pay providers for patient care, protect public health, assist police in criminal investigations, or assist family, relatives or friends responsible for care or paying medical bills – unless the patient objects.

HIPAA also requires healthcare providers to inform patients how they may use and share their health information, and grants certain rights to patients regarding their health information,  such as receiving copies of their health records upon request and being informed if their health information is being used or shared.

If you are ever concerned that your personal health information is being improperly used or shared, you have the right to file a complaint either with the federal government or your healthcare provider.

So while regulation may be seen merely as red tape in some industries; in health care, it provides a critical public protection.

This report, and other episodes, are available at KWBU.org

Glenn Robinson is the President of Baylor Scott & White Medical Center – Hillcrest. He has over 30 years of experience in hospital and health care management, and currently serves on several Boards associated with the Texas Hospital Association and the American Hospital Association. In addition, Glenn is Past-Chair and an active member of the Greater Waco Chamber of Commerce, and serves on the Prosper Waco Board.


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