HIEs: Federalism vs. States' Rights
The Department of Health and Human Services is serving as a catalyst for health information exchanges at the local, regional and state levels, hoping that, ultimately, various HIEs will be linked from coast to coast. In that way, for example, a doctor could access the records of someone involved in a traffic accident while travelling in another state.
HHS is working on a set of HIE standards called the National Health Information Network that could be used for exchanging information across state lines via the Internet. It's also using HITECH Act funds to support state efforts to build HIEs. Meanwhile, its Office for Civil Rights has issued a proposal to modify the HIPAA privacy, security and enforcement rules.
Is it even realistic to envision a virtual national network that eases access to health information, given the concerns about privacy and security?
But virtually every state has its own privacy laws as well.
In his keynote address Aug. 16 at the 2010 Legal EHR Summit, sponsored by the American Health Information Management Association, attorney Robert Hudock weighed in on the federalism vs. states' rights debate.
"In talking to state legislators, they are really concerned about the federal government stepping in and telling them how privacy and security should be treated at the state level," he said. "They see this as inherently a state activity."
Hudock, from the law firm Epstein, Becker & Green, offered a solution: "I hope we see the development of a model privacy and security law that states are encouraged to adopt, rather than the states being told what to do."
At a time when there's already a lot of anxiety about federal healthcare reform, taking steps to pre-empt state privacy laws could derail progress toward building and connecting HIEs, Hudock contended.
But what happens if some states adopt the "model" privacy and security law, while others don't? How would that affect the exchange of health data across state lines?
And is it even realistic to envision a virtual national network that eases access to health information, given the concerns about privacy and security?
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