The HIPAA Act was created to introduce standards to healthcare, protecting the rights and privacy of patients. Numerous blogs and articles explore the act and its effect on healthcare organizations, but what does it look like from the patient’s perspective? What does HIPAA compliance mean for patients?
Understanding their rights under HIPAA can help patients make informed decisions about their care and treatment plans. Likewise, it can also encourage them to actively participate in their healthcare journey.
Related: HIPAA Compliant Email: The Definitive Guide
The Health Insurance Portability and Accountability Act (HIPAA) ensures that patients are granted particular rights. These rights give them control over their protected health information (PHI). PHI is data that can be used to identify someone, such as name, address, or health conditions.
HIPAA standardizes the security practices utilized to secure PHI with controls and safeguards. The HIPAA Privacy Rule establishes the national standards for protecting individuals' sensitive data. Then, the Security Rule focuses on the safeguards that covered entities should implement to secure electronic PHI (ePHI), such as electronic medical records. HIPAA’s rules and amendments work seamlessly together to keep sensitive information as protected as possible.
A HIPAA compliant organization fulfills HIPAA’s requirements by making a concerted effort to protect patients and itself from theft and/or a data breach. The idea is to protect PHI, ensure individuals have appropriate legal rights, and hold the healthcare industry accountable.
From the patient’s perspective, it means that covered entities and their business associates protect their sensitive information, keeping it confidential. It also means that patients have more control over how their PHI is used. Overall, HIPAA’s rules and amendments give patients the power to make decisions in their personal healthcare journeys.
HIPAA protects patient privacy by legally enforcing rigorous technical, administrative, and physical controls on organizations that transmit sensitive health data. Data security is crucial to prevent unauthorized access, breaches, or theft of sensitive information. There are numerous security tools to implement; the key for any organization is to find a mix of defenses that suits their needs.
Security protocols to utilize include:
These protections aren’t just about preventing unauthorized access. They are also about preserving the confidentiality and integrity of patient information. For patients, privacy protections provide peace of mind that their information won’t be seen by anyone else or used nefariously by cybercriminals.
See also: Security controls in healthcare
The Privacy Rule requires that patients give written authorization before a healthcare organization may use or disclose PHI. Organizations must obtain patient consent and let patients object to their information being released or shared. Moreover, patients have the right to revoke it at any time.
Patients can request specific restrictions, such as limiting the information shared with certain healthcare providers or prohibiting its use for marketing purposes. Covered entities must assess their ability to accommodate patients’ requests, considering the impact on healthcare as well as compliance with legal requirements. Moreover, consent is not needed in every instance. For example, covered entities do not need to obtain consent for standard treatment, healthcare operations, and patient payment plans.
For healthcare organizations, complying with consent is necessary to avoid significant fines and penalties. For patients, ensuring compliance with consent gives them control over who sees their medical records and why. Consent allows patients to control their private information.
Under HIPAA’s Right of Access, patients have the legal and enforceable right to ask to see and/or procure a copy of their health records upon request. Moreover, individuals can choose how to receive it (i.e., as a hard or electronic copy) and if they want their records sent to an alternate healthcare provider or designated individuals. The latter can include friends, family, or caregivers.
Patients may submit their request in writing or electronically, depending on the organization. The submitter would need to be verified before the request can be processed. Covered entities must then comply with patient requests to access their medical records within 30 days or explain their denial.
Providing patients access to their personal information empowers them to be in control of their health. For example, they could monitor their conditions, better implement a treatment plan, or fix any errors that could be detrimental in the future.
More info: Questions and answers about HIPAA’s access right
Under HIPAA, patients can request amendments or corrections to their health records if they believe the information is inaccurate or incomplete. A good example is if a patient and a hospital agree that the patient’s file has a wrong test result, the hospital must change it. Then, if a hospital doesn’t agree, they must explain why to the patient. Generally, a covered entity must update the files within 60 days.
Along with the explanation, the provider should also include details on how to submit a written statement of disagreement to Health and Human Services (HHS). HIPAA allows patients to file complaints if and when a patient’s PHI is misused, mis-shared, or mishandled. HHS investigates the complaints for any possible HIPAA violation. Disclosing data without the patient’s consent can result in heavy penalties.
Having transparency and access keeps patients’ healthcare providers accountable and lets patients have a say in their care. Building trust between patients and providers promotes a healthy relationship and a healthy health outlook. Making sure that patients understand how HIPAA compliance is good for them will help develop this trust.
Patients have the right to request their medical records electronically under HIPAA. According to the HHS, "The Privacy Rule generally requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information (PHI) about them in one or more ‘designated record sets’ maintained by or for the covered entity. This includes the right to inspect or obtain a copy, or both, of the PHI, as well as to direct the covered entity to transmit a copy to a designated person or entity of the individual's choice."
Patients can request restrictions on the sharing of their PHI under HIPAA. Healthcare professionals must consider and document these requests while ensuring compliance with HIPAA regulations and ensuring that restrictions do not interfere with treatment, payment, or healthcare operations.
Patients can request an accounting of disclosures of their PHI under HIPAA. Covered entities must provide patients with the requested information, including details of disclosures made, within the specified timeframe.
Healthcare professionals should give patients a notice of privacy practices (NPP) detailing how their health information is used and disclosed. This ensures transparency and compliance with HIPAA regulations, promoting trust and confidence in the healthcare system.