Association Urges Expanding Rules to Cover Paper and e-Records - American Health Information Management Association - Industry Trend or Event

Health Management Technology, March, 2000

The American Health Information Management Association (AHIMA) is urging that draft regulations on health information and privacy be revised to cover all health records, not just electronic records. The recommendation was the most urgent among many made by AHIMA chief executive Linda Kloss in a letter to the U.S. Department of Health and Human Services (DHHS). The agency issued the draft regulations last year, after Congress failed to develop rules by August 1999, as mandated.

Kloss acknowledged that, by design, the Health Insurance Portability and Accountability Act (HIPAA) pertains to electronic health information. However, Kloss says, "Electronic health records Should not be afforded greater privacy than those maintained on paper." She warned that establishing different standards for electronic and paper records may provide a "disincentive for entities to migrate to electronic medical records systems" or may encourage the creation of "shadow" records (files that are potentially damaging and maintained separately, often to shield the records from view by insurance companies and other external parties).

In its comments on HIPAA draft rules, AHIMA also urged embracing the concepts of "minimum necessary use" and "de-identification." The former calls for rules prohibiting the use of health information for other than stated needs and requires its destruction after the needs have been met. De-identification would require the removal of identifying characteristics from records in cases where patient identity is not required.

The AHIMA comments letter is viewable on the association's Website, www.ahima.org.