Strong state privacy laws continue to complicate health information exchanges' efforts to ease health-data sharing, a senior federal health technology official said Monday. And a key to overcoming such obstacles may be greater use of meta tags.
Joy Pritts, chief privacy officer in the Office of the National Coordinator for Health Information Technology, told a Washington health policy gathering that some health information exchanges are not accepting electronic health records containing mental health or substance-abuse data. Their refusal stems from concerns that certain state medical privacy laws that are more strict than federal law and require individual patient agreement before their data is shared preclude exchanges' use of the information.
“We're working on a number of different fronts on how to tackle this issue because we recognize, and the administration recognizes, how important it is to have substance and abuse and mental health really integrated into primary care,” Pritts said.
One response to those legal obstacles is the effort by ONCHIT to develop standards over the last year for meta-data tagging the types of medical information that is subject to strong state protections, she said.
Such tags would aim to provide a technological solution to the problem, she said, by embedding the highly-protected patient data within an electronic health record and requiring patient permissions to open it.
“The challenge is that the rules were written at a time that was very much a paper world. So, although the policy may not have changed, the implementation of that policy into an electronic environment has proven to be somewhat tentative,” Pritts said.
Such meta-data tagging was urged in 2010 by the President's Council of Advisors on Science and Technology in a report criticizing HHS for not pushing harder to promote health information exchange
. Meta-data tagging applied to discrete data elements in a patient's medical record could improve search capabilities for care and medical research while allowing patients to track and control the movement of their sensitive medical information, according to the PCAST report.
Additionally, federal officials are discussing the interpretations of those privacy laws with state officials to “come up with some common solutions and approaches to some of these issues,” she said.