It’s an important time for the Massachusetts state HIE (MassHIWay), as it numbers are growing and Beth Israel Deaconess Medical Center (BIDMC) will start sending 50,000 patient encounter records per week over the next few weeks. BIDMC will send these records to the Massachusetts eHealth Collaborative for quality assurance and the Massachusetts HIT Council discussed some legal and policy barriers around sensitive health information exchange (HIE) data during its April 8 meeting.
In a recent blog post, John Halamka, Chief Information Officer of BIDMC, detailed how MassHIWay is evolving toward “pulling” patient records with their consent. But, as HealthITSecurity.com broke down recently, funneling sensitive data through an HIE can be complicated from a policy and legal standpoint. It’s difficult to come up with umbrella policies for communicating data from areas such as substance abuse treatment or pulling HIV consent from a statewide master patient index and record locator service.
With that in mind, the Massachusetts HIT Council listed these items as HIE privacy and legal concerns: HISP to HISP trust, consent for query (targeted and untargeted), patient participation in HIway services, applicability of Chapter 224 HIE provisions, statutorily protected HIV test result, substance abuse treatment data and genetic test result data. In concert with the Privacy and Security Tiger Team’s HIE query recommendations, the group will continue to work through these issues this year:
- The Legal & Policy Advisory Group will engage expert testimony for several of these issues in order to bring perspective on how organizations are interpreting and acting upon the law in current practice.
- Many organizations have already spent time and money on developing local HIEs along with policies and procedures (e.g., Consent policy). There is a need to be mindful of the policies that are already in place and for the MassHIway phase 2 policy design to take these into account.
- Several phase 2 issues were raised in the Legal & Policy Work Group last year that should be brought forward for resolution (e.g., Permitted users of MassHIway).
- Since payers are an anticipated participant in the MassHIway there is a need to consider the concept of “minimum necessary” and how it is applied.