April 26, 2002, was the last day for the public to submit comments regarding Health and Human Services Secretary Tommy Thompson's proposed changes to the Medical Privacy Rule. The changes under review include a variety of revisions to the 1996 Health Insurance Portability and Accountability Act (HIPAA), which was designed to address the need for national standards on patient privacy. Since 1996, increased Internet use and continuing technological advances in data warehousing have created an "e-health" environment within the American health system. As a result, medical professionals and consumers alike are expressing concerns over where the boundaries should be placed on who should have access to patient information.
Under current law, a patient must provide consent before a doctor, pharmacist or other health professional involved in their care can access their medical information. A 2000 Gallup survey* indicates that the public would like to maintain this level of privacy -- 78% of respondents said that it is very important that no one have access to their medical information without their permission.
The proposed changes, while still maintaining some standards, would remove existing consent requirements and allow those involved in a patient's care, treatment and payment to review the patient's medical records without consent. The goal of this change is to open the lines of communication among family physicians, specialists, health insurance providers and pharmacies to remove barriers to patient care or treatment if patients are unable to provide consent, particularly in emergency situations. In addition, the change would allow physicians to discuss a patient's care with other physicians or nurses without fear of breaking confidentiality rules.
Respondents to the 2000 survey were opposed to allowing any health professionals to access medical records without consent. A firm majority (71%) were opposed to giving "medical doctors other than the ones you have given permission" the ability to access their records. Americans seemed to object least in the case of pharmacists although 59% still opposed allowing this group access to medical records without permission.
The public would also support a more active role on the part of the federal government in addressing privacy issues in general. In a September 2001 Gallup poll**, 53% of Internet users said that the federal government should be paying more attention to matters of Internet privacy, with 31% feeling that the amount of attention is about right. Half reported that the federal government should do more to ensure a citizen's privacy online.
*Survey results are based on a national sample of 1,000 adults, aged 18 and older, conducted by The Gallup Organization, commissioned by the Institute for Health Freedom, Aug. 11-26, 2000. For results based on this sample, one can say with 95% confidence that the margin of sampling error is ±3%.
**Results are based on telephone interviews with 573 Internet users, aged 18 and older, conducted Sept. 11-13, 2000. For results based on this sample, one can say with 95% confidence that the margin of sampling error is ±5%.