Transcript Wisconsin Security and Privacy Project: Solutions Workgroup

Beth DeLair, JD, RN
DeLair Consulting, LLC
Discussion Topics
 Background
 Existing WI Requirements
 State Efforts to Change Law
 Senate Bill 487
 Changes to 51.30
 Changes to 146.82
 Future Efforts
 Broader changes to 146.81-84?
 Technology changes
 HISPC Phase III
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Wisconsin Statute Chapter 51.30 Today

Informed Consent Requirement
Except as provided below, for treatment purposes treatment records created
in the course of providing services to individuals for mental illness,
developmental disabilities, or AODA at a treatment facility require consent
before disclosing


Exceptions to Informed Consent requirement

In a medical emergency

The following elements in a related health care entity:

Patient’s name

Medications

Address

Allergies

Date of birth

Other relevant demographic information

Date of service (s)

Name of mental health provider (s)

Diagnosis
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“Current” 146.82-146.83
 Requires all disclosures of patient health care records to be
documented
 146.82(2)(d)
 146.82(3)(c)
 Does not permit re-disclosures of patient health care
records received except by court order
 146.82(2)(b)
 Requires written, informed consent to disclosure patient
health care records to family and/or friends that
accompany or request information about a patient
 146.82(1)
 146.82(2)
 146.836
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State Efforts to Address Changes
 November 2, 2005—Governor Doyle signs executive order
creating the eHealth Care Quality and Patient Safety Board
 Develops Wisconsin ehealth Action Plan—a roadmap for the adoption
of electronic health records and the exchange of health information in
Wisconsin
 Wisconsin applies for and receives funding through DHHS
Office of the National Coordinator via Research Triangle
Institute (HISPC Grant) Phase I--July 2006-March 2007
 4 workgroups assigned to:
 Assess variations in organization-level business policies and state laws that
affect health information exchange
 Review and account for all relevant state and federal legal requirements
 Propose practical solutions that protect privacy and security of health
information and permit interoperable exchange
 Develop plans to implement solutions
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State Efforts to Address Changes
 HIPSC Grant Phase II-July 2007-December 2007
 Refined recommendations from Phase I
 A 51.30 workgroup was convened
 Stakeholders were approached regarding changes to 146.82 and
146.83
 Bill drafted
 January-February 2008
 Draft bill is reviewed/amended
 Draft bill is discussed and introduced into senate and
assembly
 March 17, 2008—Governeor Doyle signs bill
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Changes 51.30
 Adds to the list of elements that may be disclosed
 Diagnostic test results
 Symptoms
 Removes “within” a covered entity
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Changes to 146.82-146.83
 Deletes 146.82(2)(d) and 146.83(3)
 Deletes 146.82(2)(b) and replaces it with language that:
 Allows re-disclosure for any purpose otherwise permitted under
146.82 for covered entities
 Limits re-disclosure of health care records by non-covered entities
to those made



Pursuant to court order
Per patient written authorization
For the purpose initially received
 Creates 146.82(4), which
 Allows disclosure to :family and friends” involved in the care of the
patient” with informal permission from the patient
 If patient is not available, or is not cognitively or physically able to
give permission, clinician may use “professional judgment”
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Future Efforts
 Broader Changes to 146.81-84 to make it more aligned
with HIPAA?
 Changes in state law to accommodate technology?
 HISPC Phase III-interstate collaboration
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