Lise Rybowski, Consultant
As background to a meeting on how best to protect the confidentiality of health care information, this paper lays out the issues to be resolved, the perspectives of the stakeholders, and some of the options available to legislators, regulators, and the health care industry. The paper discusses five factors contributing to a call for congressional action on this issue: (a) legislative requirements under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), (b) the growth of information technologies, (c) secondary uses of personal health information, (d) the spread of managed care, and (e) international pressures. In addition, the paper attempts to dissect the controversy by laying out the spectrum of views and realm of solutions regarding the most controversial issues to be addressed by Congress in the context of health information confidentiality legislation. Among these issues are providing patients access to their information, controlling the access of others to information, segregating information, conducting research, allowing the use of information beyond the realm of health care, and preempting state laws with a federal bill.