Transcript Confidentiality of Alcohol and Drug Abuse Patient Records

Confidentiality and Privacy:
Impact on Alcohol and Drug
Abuse Patient Records
NIDA: Narrowing the Research-Practice Divide in
Evidence-Based Medicine with Adoption of Electronic
Health Record Systems: Present and Future Directions
July 13, 2009
42 CFR Part 2
 Long standing federal confidentiality
regulation
 Combat stigma and fear of prosecution
 Relatively narrow
 Consent-driven
 Biggest challenge: not well-known in federal
and other circles
What is protected by 42 CFR Part 2?
 Information about a person who has applied
for or been given a diagnosis or treatment
for alcohol or drug abuse
 Generated by a SA treatment “program”
 Prohibition of re-disclosure
 Protection attaches to the information
 Information that can used to identify someone
as an alcohol or drug abuser
What is a SA Treatment Program?
 “Individual or entity … that “holds itself out” as
providing, and provides, alcohol or drug
abuse diagnosis, treatment or referral for
treatment
 Identified unit within a general medical facility

Medical personnel or other staff whose
primary function is SA treatment and are
identified as such
Consent with nine Exceptions
 Consent must be obtained with the following
exceptions:




medical emergencies
research
audit/evaluation
authorizing court order
 Regulations do not apply to
 communication within a program
 qualified service organizations/ with QSO agreements
(limited)
 crimes on the premises
 child abuse and neglect reporting
Personal Health Records
 Any …“electronic record of IIHI on an
individual that can be drawn from multiple
sources and that is managed, shared, and
controlled by or for the individual.” (Recovery
Act, 13400(11).
 PHR vendor is “…an entity, other than a
covered entity…that offers or maintains a
personal health record (13400(18))
Regulation
 Payer hosted: HIPAA
 Provider hosted: HIPAA: Part 2
 Private Companies: Unregulated
 Patient Hosted
More Information
Hipaa.samhsa.gov/privacy
Confidentiality of alcohol and drug abuse patient
records regulation and the HIPAA privacy rule
National Committee of Vital and Health
Statistics, transcripts, letter of
recommendation
Healthit.hhs.gov