HIPAA & Health Information
The Federal Bureau of Investigation (“FBI”), the Department of Health and Human Services (“HHS”), and the Department of Homeland Security Cybersecurity and Infrastructure Security Agency (“CISA”) recently announced that hackers have been and will continue to target the United States hospitals and health-care providers. These attacks are cyber in nature and often lead to ransomware attacks, data left, and inevitable disruption of health care services when patient information is locked until the ransom can be paid.
Cook County General Administrative Order 18-1 pertains to the Standard HIPAA Qualified Protective Orders (QPO) that will be permitted in Cook County. These orders will only be allowed for cases that are in litigation where the Plaintiff and Plaintiff’s counsel authorize disclosure of a litigants’ protected health information (PHI). It also requires all entities who received PHI to either return the documents to the Plaintiff or destroy them at the end of the case. These changes mean that Plaintiff’s attorneys will see a change in the handling of Plaintiff’s medical records and other documents covered under the QPO containing PHI.
In March 2019, Rush University Medical Center (“Rush University”) sent out breach notification letters to approximately 45,000 patients. The letter advises patients that a privacy incident occurred that may have involved the patients’ personal information. The privacy incident was caused by an employee of a third-party financial services vendor. The employee released a file that contained patient information to an unauthorized person. According to the breach notification letter, law enforcement and regulatory officials were involved in the investigation of the privacy incident. Rush University sent the breach notification letter in compliance with the Health Insurance Portability and Accountability Act’s privacy and security rules.
Protected Health Information is seeing a surge of breaches on the cyber security front due to contractor error. It’s also impacting the most consumers in comparison to other data breaches and, in some cases, has the power to cause chaos in national infrastructure. Advances in technology and compliance measures can stem the tide and protect the most valuable information in consumers lives.
In a time when data breaches occur fairly frequently, whether it’s credit card information being stolen from department stores or a credit reporting bureau breach affecting hundreds of millions of customers, keeping personal information private seems to get harder every day. That fact may give patients pause when they are asked to sign up for an electronic health record account. A 2017 survey listed electronic health record management as one of patients top concerns. Changes in recent years have led to changes in compliance measures that make electronic health records security an added benefit to patients and ensure the continued increase of their adoption.
The EU General Data Protection Regulation (“GDPR”) is now in effect as of May 25, 2018, and has been a prominent topic of international debate across multiple sectors as companies look to adjust to new stringent regulations in data management. With a wide scope (the GDPR now applies to all organizations possessing personal data of individuals based in the EU) and steep penalties for companies that fail to comply, companies across the globe are spending millions of dollars in preparation.
It happens in every emergency department: a law enforcement officer comes into the ER at two o’clock in the morning and demands to test the blood alcohol levels of a patient brought in after an auto accident. The officer pulls an exhausted nurse to the side in the hopes that the nurse will forget his or her training, or become anxious enough to give up the information for fear of being arrested. Yet no matter the specific facts, the question remains: can a hospital give law enforcement officers a patient’s PHI without authorization from the patient? In some situations, is it even required?
There is a provision under the HIPAA Privacy Rule that allows, and in some cases, requires, entities to disclose patient’s PHI to law enforcement without the patient’s authorization. However, state law can complicate this picture with more restrictive regulations and guidance.
On September 25th, a former Okaloosa County, Florida paramedic, Christopher Wimmer, was sentenced to six months jail time and three years’ probation for taking “selfies” with incapacitated victims in ambulances last year and sending them to a co-worker. He and his co-worker, Kaylee Renee Dubois, were engaged in a “selfie war” with each other and snapped images and videos of patients in ambulances who were unconscious, sedated, intoxicated, or incapacitated. In total, 101 photos, 64 videos, and 41 patients were photographed or recorded during the so-called war, and a mere three patients consented to photographs being taken of them. Employees’ missteps with the privacy rights of patients have a negative lasting effect on their employer, their own career, and their patients.
According to data from HHS’ Office of Civil Rights (OCR), healthcare data breaches in 2017 are set to outpace those from 2016. Security experts have determined this increase is due to two factors: getting entry into a system has become easier, and organizations are now more inclined to report breaches. Yet despite the increase in data breaches and the costs of settling with HHS OCR, a majority of healthcare organizations are still only spending 1-6% of their budgets on cybersecurity measures.
Though the rain has stopped falling, Houston is still dealing with the aftermath of Hurricane Harvey, one of the largest and most destructive rainfall events on record. Healthcare providers in particular find themselves struggling to keep up with the various health problems caused by the flooding itself, on top of getting life-sustaining care to individuals with chronic or preexisting conditions. Crises like Harvey create serious problems for the delivery of care, but also for regulating it—circumstances are so uniquely devastating that standards can feel like barriers to necessary medical attention. And when family and friends are desperate to know if their loved one is out of danger, even the right of privacy seems negligible.
However, natural disasters and emergency events shouldn’t be used as an excuse to regulate away protections individuals depend on, such as the privacy and confidentiality of their personal information. Regulators must be careful when determining how to respond in a crisis—overreaching for the sake of bringing relief or under-regulating for flexibility can leave the public high and dry when the floodwaters recede.