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July 14, 2021 03:23pm
By Jill Murphy, Associate Editor
Convenient care clinics provide a health care option that complements traditional medical service providers.
Convenient care clinics (CCCs) provide a health care option that complements traditional medical service providers. CCCs deliver affordable, accessible, episodic care to consumers who may otherwise have to wait for appointments or who seek urgent or emergency care. These clinics make it easier and more convenient for patients to get the right level of care from qualified health care professionals, in the right place and at the right time.
To ensure continuity of care, clinics build relationships with traditional health care systems and share patient information appropriately. Protecting the privacy and security of health information while supporting continuity of care can be challenging, however. The rapid growth of intranet applications to transmit and share patient information, advancements in the computerization of patient medical records, and public concerns about privacy led to passage of the Health Insurance Portability and Accountability Act (HIPAA) in 1996.1HIPAA was introduced to improve coverage for workers changing employment and to raise standards of electronic health care transactions. The act has been instrumental in ensuring patient privacy is protected (Figure).
Protected Health Information
The privacy rules within HIPAA limit who can receive patient information. Individually identifiable health information includes many common identifiers (eg, name, address, birthdate, social security number). The rules apply to all forms of protected health information (PHI)—electronic, written, and oral. PHI includes the following:
Patient Rights Under the HIPAA Privacy Rule
Patients have the right to:
In terms of information use or sharing:
Strategies for Building and Maintaining a HIPAA Compliance Culture
To address the challenges of protecting the privacy and security of health information while facilitating appropriate disclosure, clinics should do the following4:
Convenient Care Collaborates and Complements
Convenient care is a patient-centric model of health care committed to high-quality, easy-access, and affordable health care, and acts as an important and integrated partner in the health care system. To support this care model, CCCs should do the following5:
Appropriate data exchange between convenient care and primary care is essential to becoming a trusted partner in the patient’s care. All clinics should ensure compliance with HIPAA disclosure requirements to ensure secure, confidential exchange of information.
Impact of Electronic Health Records on Privacy
Electronic documentation tools offer many features designed to increase the quality and use of clinical documentation, thereby enhancing communication among all health care providers. With continued advancement of EHRs comes increasing concern that a potential loss of documentation integrity could compromise patient care, care coordination, and quality reporting, and lead to fraud and abuse.
Interoperability facilitates data exchange while creating challenges if the information passed between organizations and consumers is not accurate or complete. Documentation integrity is at risk when the wrong information is documented on the wrong patient health record, such as when a lab result is imported into the wrong record. Errors in patient identification can affect clinical decision making and patient safety, impact a patient’s privacy and security, and result in duplicate testing and increased costs to patients, providers, and payers.6A clearly defined process for merging patient records or duplicates must be established to prevent consolidating clinical information from multiple patients into one patient’s EHR.
The advancement of technology has changed the practice of medicine. The provider—patient relationship has evolved from a face-to-face interaction to real-time online encounters and from e-mails to virtual appointments. Health care organizations can provide easy-to-use, self-service patient tools that enhance patient communication and engagement through patient portals and the implementation of appropriate policies and procedures.
Patient portals represent a technological advancement that is breaking down barriers in patient—provider communication by providing online access to health care information. Privacy incidents and HIPAA violations may occur, however, if incorrect data populate the patient portal. An increase in patient-reported incidents or amendments may increase as patients identify errors that might otherwise go undetected. An increased awareness and need for appropriate management of PHI flowing in and out of patient portals are critical to the confidentiality, privacy, and security of that information.7
To ensure continuity of care, clinics should build relationships with traditional health care systems and share patient information appropriately. Protecting the privacy and security of health information while supporting continuity of care can be challenging. Therefore, ongoing training and annual review of HIPAA requirements should be standard practices. The Health Information Technology for Economic and Clinical Health Act’s modifications to the privacy and security rules was the first major change since HIPAA’s privacy rule went into effect in 2003. The act strengthens privacy and security requirements, broadens patients’ rights to access their PHI, and restricts the uses and disclosures of that information. Establishing policies and procedures to protect patient privacy and ensure accurate disclosure of PHI is paramount.8The continued advancement of EHRs and patient portals has greatly improved communication between providers and patients. Through implementation of appropriate policies and procedures, care coordination can be enhanced without compromising patient privacy.
Susan Gentilli, RHIA, MBA, is the manager of healthcare quality and safety at Target Corp in Minneapolis, Minnesota. In her current role, she is responsible for monitoring the effectiveness of Target’s health care quality programs, as well as implementing improvement strategies to reduce errors, mitigate risk, and improve the health care experience for pharmacy and clinic guests. Prior to joining Target, Susan was the director of quality measurement and improvement at HealthPartners health plan in Bloomington, Minnesota.