As an RN doing Masters work in Information Science and Health
Informatics, I would like to add a note of caution about patients adding
their own information.  This web-based system you describe should
undergo what is called a "Usability Study" before actually being turned
over to patients to use in a HIPAA compliant world. A usability study
actually monitors how well test "patients" actually  use this system,
and what kind of mistakes they make, what kinds of questions they have. My impression 
thus far is that the general public is not adept at
understanding their own medical "data" and would not be accurate in
dealing with data entry fields.  Just remember how difficult the
transition has been for the actual healthcare providers to do the same
thing.

Pam Fleck Oldknow, B.S.N, R.N.
Medical Analyst
Barnes & Thornburg Law Firm
11 S. Meridian Street
Indianapolis, Indiana  46204
317-231-7361


>>> <[EMAIL PROTECTED]> 09/06/02 04:26PM >>>
Pam,
I do not see a problem with patients (or their family members) entering
IIHI into the web-based system you describe, provided the CE who is
managing the system secures the data in accordance with HIPAA.  The
disclosing party in this case (the patient) is not a CE, so they can
enter the data without worrying about the transaction rule OR about
getting auth. from family members to disclose their info.

I'm not really seeing a problem with the CE (owner/manager of the data
collection system) being in possession of this data, even if he/she has
no treatment relationship with some or all of the patients who are
entering it.  The data would, after all, be obtained freely and legally
from the patient.  Again, the CE would have to safeguard that IIHI and
treat it just like his/her patient's PHI, obey all rules regarding
subsequent disclosure, etc.

Maybe I'm just being dense today, but I don't see anything "wrong"
here.

Best regards,
Chris

Christopher J. Feahr, OD
Optiserv Consulting
[For the vision care industry]
Santa Rosa, CA
707-579-4984
707-529-2268 (cell/pager)
http://VisionDataStandard.org http://Optiserv 

At 09:31 AM 9/6/2002 -0500, Lawson, Pam wrote:


>We are currently looking at a product that would allow patients to
enter >demographic, past history, insurance information, etc via a web
>form.  They would setup their own password/id and be responsible for
>updating the information.  Whenever they were treated at one of our
>facilities or a physician associated/on staff with one of our
facilities, >that information could be viewed/verified by the caregiver.
 Before >setting up the account, the patient would have to click on a "I
agree" >button attached to the privacy notice/disclaimer.  I think just
this part >of the setup is OK, but the kicker is that individuals would
be allowed to >setup information on multiple users, including spouses,
parents, etc and I >just don't think this will fly under HIPAA since
that information would be >widely available without their knowledge or
consent.  Is anyone else >allowing patients to create these
repositories?  Do you allow them to >enter information on multiple
individuals, including other adults?  And, >how are you handling the
HIPAA issues?  Thanks Pam
>
>Pamela K. Lawson, RHIA
>Information Security Coordinator
>St. John Health System
>Tulsa OK
>918-744-2316
><mailto:[EMAIL PROTECTED]>[EMAIL PROTECTED] >pager 918-643-2725
>
>
>
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