HIPAA Privacy Rule
The Health Insurance Portability and Accountability Act (HIPAA) privacy rule comes up with the federal standards fundamental when it comes to safeguarding the medical and personal health information belonging to patients. HIPAA is also applicable to healthcare plans and the manner in which electronic transactions are conducted by healthcare providers. HIPAA determines the use and disclosure of patient personal health information (PHI) by healthcare practitioners alongside addressing several patients’ rights such as that of having their health information protected. However, HIPAA has its shortcomings such as its capability of disrupting how health information flows in selected circumstances. One of these circumstances is emergency contexts where health information is often needed promptly and without delay for better patient outcomes. This paper examines the impact of HIPAA on the healthcare industry, impact of the legal and regulatory requirements of the HIPAA privacy rule on the healthcare industry, and the role of accreditation and regulatory agencies in HIPAA.
Impact of HIPAA On the Healthcare Industry
HIPAA influences both patients and the organizations covered in the entity including the health care plans, healthcare providers, and the healthcare clearinghouses. For patients, the privacy rule has enabled them to assess and evaluate how their PHI may be used and disclosed. The HIPAA privacy rule empowers patients to take control of their PHI thereby allowing them to determine when information can or cannot be disclosed. Moreover, with the privacy rule in place, patients enjoy the right to obtain and freely examine and request for corrections as far as their health records are concerned (Houser, Houser, & Shewchuk, 2007). Health plans usually cover medical costs incurred by patients in health care settings. Health plans include health insurance companies and government-funded health plans such as Medicare. The HIPAA privacy rule advocates that patients’ health plans should be effectively stored either in print or electronic manner to prevent access by unauthorized personnel. Healthcare clearinghouses always act as a link between healthcare providers and health plans. They process and transmit patients’ information in a standard format between the covered entities. The HIPAA privacy rule requires the processing and transmission of the patients’ personal health information to be done in a standard coded format to prevent easy access and understanding of the patients’ PHI by unwanted persons. Health care providers get paid to provide healthcare services to patients. Healthcare providers include nursing homes, hospitals, pharmacies, practitioners, and other entities that provide healthcare services at a cost. The HIPAA privacy rule often requires them to comply with the standard code format of print or electronic processing and transmission of the patients’ health information.
Impact of the Legal and Regulatory Requirements of HIPAA on Health Care Industry
The HIPAA privacy rule addresses the saving, accessing, and sharing of patients’ medical records and personal health information. The covered entities are required to comply with certain laws and regulations of the privacy rule. Physical safeguards are one of the requirements of the privacy rule. Covered entities and companies compliant to the HIPAA privacy rule are required to have effective policies that govern the use and access of the electronic media and workstations. These entities are required to allow only authorized access of the workstations and transfer of information from the electronic media by the use of unique user IDs. The covered entities are also required by HIPAA privacy rule to audit or track their logs to enable them to keep the records of activities both on the hardware and software useful to pinpoint the causes or source of any patients’ information and security violations. Additionally, the privacy rule requires that the compliant covered entities should put in place effective measures to ensure that any medical errors can be easily remedied, and any patients’ health information lost can be recovered. Moreover, HIPAA requires the covered entities to protect the patients’ health information against public unauthorized access (Kilbridge, 2003). Thus, they need to encrypt patients’ health information whenever it is transmitted or shared through the electronic media such as email.
Role of Accreditation and Regulatory Agencies in HIPAA
Accreditation and regulatory agencies play a major role in the healthcare industry and healthcare insurance. Accreditation agencies are charged with the mandate of certification of the quality of healthcare services in various health facilities. On the other hand, regulatory agencies are charged with the mandate of protecting the public from various kinds of health risks. These regulatory agencies are also given the responsibility to establish programs that educate the public about their health and welfare. These regulations are developed and implemented at all levels by both the government and private organizations. Thus, the major role of accreditation and regulatory agencies in relation to the HIPAA privacy rule is to ensure that healthcare organizations respect their patients’ rights to privacy of personal health information, as well as promote and provide quality care to the patients (Warburton, 2009). For example, the Agency for Healthcare Research and Quality (AHRQ) addresses the use and disclose of patients’ health information, and aims at improving the quality of health care. Various accreditation and regulatory agencies address issues concerned with patients’ safety and quality of care. These agencies have established policies such as the HIPAA privacy rule that controls the use and disclose of patients’ health information. The accreditation and regulatory agencies ensure compliance with the privacy rule, as any covered entity that violates the patients’ health information rights is held accountable according to the laws and regulations.
HIPAA establishes the federal standards that safeguard patients’ medical records and other personal health information. It applies to healthcare plans, and how healthcare providers conduct transactions electronically. It also governs how the practitioners may use and disclose their patients’ personal health information (PHI), and addresses the patients’ rights to protect their health information. As discussed above, the HIPAA has significant impacts on the health care industry. There are legal and regulatory requirements of HIPAA that affect the health care industry and its operations as well. Accreditation and regulatory agencies have roles to play as far as HIPAA is concerned.
Houser, S. H., Houser, H. W., & Shewchuk, R. M. (2007). Assessing the effects of the HIPAA privacy rule on release of patient information by healthcare facilities. Perspectives in Health Information Management/AHIMA, American Health Information Management Association, 4. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082070/
Kilbridge, P. (2003). The cost of HIPAA compliance. The New England journal of medicine, 348(15), 1423. Retrieved from https://pdfs.semanticscholar.org/3b6c/a1ac743d149eb83d5c7d25db67c42e190e73.pdf
Warburton, R. N. (2009). Accreditation and Regulation: can they help improve patient safety. Agency for Healthcare Research and Quality Morbidity and Mortality Rounds on the Web. Retrieved from https://psnet.ahrq.gov/perspectives/perspective/74/accreditation-and-regulation-can-they-help-improve-patient-safety