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1 Health Information Security and Privacy Collaboration (HISPC): Calming the Waters Across State Lines Presented by Barbara L Massoudi, MPH, PhD RTI International.

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Presentation on theme: "1 Health Information Security and Privacy Collaboration (HISPC): Calming the Waters Across State Lines Presented by Barbara L Massoudi, MPH, PhD RTI International."— Presentation transcript:

1 1 Health Information Security and Privacy Collaboration (HISPC): Calming the Waters Across State Lines Presented by Barbara L Massoudi, MPH, PhD RTI International Presented at Capitol Hill Steering Committee on Telehealth & Healthcare Informatics November 18, 2008 Washington, DC 2951 Flowers Rd., Suite 119, Atlanta, GA 30341 Phone: 770-986-5062 Fax:770-234-5030 E-mail: bmassoudi@rti.org

2 2 Overview  Background on HISPC Phases 1 and 2  Phase 3: the 7 Collaborative Work Groups  Next steps

3 3 Phase 1 Timeline: June 2006 – April 2007 Participation: 33 States and 1 territory Scope: Assess variation, develop solutions and implementation plans Methods:  Community-based research model  Engage a broad range of stakeholders  Follow common methodology  Panel of experts  National direction with local control

4 4 Phase 1 Products Summary reports released  Assessment of Variation and Analysis of Solutions  Implementation Plans  Nationwide Summary Reports and presentations publicly available  RTI Project site: http://privacysecurity.rti.orghttp://privacysecurity.rti.org  AHRQ National Resource Center: http://healthit.ahrq.gov http://healthit.ahrq.gov

5 5 Key topic areas addressed by solutions  Harmonize the approach to patient permission for disclosure  Simplify the complex interplay among HIPAA privacy and security rules, other federal laws, and state laws.  Reduce variation in interpretations of HIPAA  Foster trust between providers participating in exchange and among consumers permitting their information to be exchanged

6 6 Phase 2 Timeline: May – December 2007 Participation: 42 states and 2 territories Scope:  Implement 6-month projects  Develop plans for collaboration in Phase 3 Methods:  34 Phase 1 teams implement state-specific solutions  All 44 teams contribute to collaborative proposals

7 7 Phase 2 Products RTI Products:  HISPC Toolkit  Impact Analysis report State Products:  November 2007 Conference Presentations  34 states produce a multitude of state-specific deliverables, including reports, videos, websites, model agreements, model forms and educational toolkits  42 states/territories submit proposals to participate in the Phase 3 collaborative work groups

8 8 Phase 3

9 9 Timeline: April 2008 – March 2009 Participation: 40 states and 2 territories in 7 collaboratives Scope: Execute collaborative strategies developed in Phase 2 Methods:  States work both individually and collaboratively to complete project scope  Co-chairs of each collaborative form steering committee  RTI partners with Georgetown on State and Territory Law Analysis

10 10 The 7 Collaborative Work Groups  Consent 1, Data Elements  Consent 2, Policy Options  Harmonizing State Privacy Law  Consumer Education and Engagement  Provider Education  Adoption of Standard Policies  Interorganizational Agreements

11 11 Consent 1, Data Elements 11 States participating:  IN, ME, MA, MN, NH, NY, OK, RI, UT, VT and WI Goals:  To establish a model for identifying and resolving patient consent and information disclosure requirements across states.  To develop a foundational reference guide that describes and compares the requirements mandated by state law and any known regional or local consent policies and practices in each participating state. Data Elements?  What consent information does a state need to reply to a request from another state? Signed consent form? With what information? Any restrictions? Do the answers change depending on the type or source of the information?

12 12 Consent 1 Progress: Scenarios and Template Scenarios:  Treatment – Non-Emergency  Treatment – Emergency  Public Health Template:  Intricate, detailed set of spreadsheets  A battery of general questions with follow up questions for capturing additional detail  Completed by the legal work group in each state

13 13 Impact of Consent 1  A guide to navigating cross-state variation in consent requirements  A comparative analysis that will allow individuals in different states to see areas where change might be required to better align with their neighbors to facilitate exchange

14 14 Consent 2, Policy Options 4 States participating:  CA, IL, NC and OH Goals:  Provide states with a systematic process or roadmap for addressing the consent issue  Identify and describe model approaches to consent  Provide the outcomes for different consent approaches from a variety of scenarios  Culminate in a resource that all states will be able to use to support informed decision-making strategies in the adoption of consent policies and standards for HIE  Identify and describe alternatives that allow personal health information to be exchanged appropriately between states by strategically recommending one or more legal mechanisms

15 15 Interstate Consent Subgroup Result  The collaborative will provide other states a systematic process for evaluating and selecting one of these mechanisms to align consent requirements for exchanging PHI between states that have conflicting privacy laws.

16 16 Intrastate Consent Subgroup Result  By systematically testing these options using the scenarios, the intrastate subgroup will:  Generate a list of issues  Describe alternative solutions available through the various models  Critically analyze the alternatives

17 17 Harmonizing State Privacy Law 7 States participating:  FL, KY, KS, MI, MO, NM and TX Goal:  To advance the ability of states and territories to analyze and reform, if appropriate, existing laws to facilitate health information exchange  Primary deliverable is a framework for legislative action

18 18 Harmonizing State Privacy Law Impact  States outside of the collaborative enter their data, identify gaps and set priorities for legislative action by determining if legislation is needed, feasible and compatible with other states.  Enables states to identify legislation that is critical for development.

19 19 Consumer Education and Engagement 8 States participating:  CO, GA, KS, MA, NY, OR, WA and WV Goal:  To develop a series of coordinated state-specific projects that focus on targeted population groups to describe the risks and benefits of health information exchange, educate consumers about privacy and security, and develop messaging to address consumer privacy and security concerns.

20 20 Consumer Engagement  States are currently working on their state-specific projects, which address priority education needs and often target specific populations  States have started to share their products with others in the collaborative  Websites are going live  Ultimately, through their collaboration they will develop products and guidelines for consumer education

21 21 Consumer Education Impact  States educate and engage their consumers, addressing the topic or target population that is most important  States share their products with the collaborative states (materials, dissemination plan, lessons learned) to facilitate adaptation for specific purposes

22 22 Provider Education 8 States Participating:  FL, KY, LA, MI, MO, MS, TN and WY Goals:  To create a toolkit to introduce electronic health information exchange to providers  To increase provider awareness of the privacy and security benefits and challenges of electronic health information exchange

23 23 Provider Education Impact  After testing core message on one provider type using one communication channel, refine approach based on lessons learned and deploy campaign to additional types/channels  Enhance awareness  Address perceived barriers  Encourage adoption and participation in private and secure exchange to improve the quality of care

24 24 Adoption of Standard Policies 10 States participating:  AZ, CO, CT, MD, NE, OH, OK, UT, VA and WA Goals:  To develop a set of basic policy requirements for authentication and audit  To define an implementation strategy to help states and territories adopt agreed-upon policies

25 25 Adoption of Standard Policies Results  All states will begin to address any authentication and audit gaps they identify  States that have less stringent policies will know where they need to strengthen them to be on par with other exchanges  States that are in the process of forming HIOs and establishing authentication and audit policies will know what requirements they’ll need to meet

26 26 Adoption of Standard Policies Result  Final report will be a guide to other states so they can understand the minimum authentication and audit policies for exchanging data.

27 27 Interorganizational Agreements 6 states participating:  AK, GU, IA, NJ, NC, and SD Goals:  To develop a standardized core set of privacy and security components to include in interorganizational agreements  To execute interorganizational agreements and exchange data through cross-state pilots wherever possible

28 28 Interorganizational Agreements Next Steps  Continue coordination with DURSA* and others  Complete signatures for both pilot agreements  Cross state electronic data sharing in pilot studies *Data Use and Reciprocal Support Agreement

29 29 Current and Future Activities  ONC continues to manage intersections between HISPC and their other initiatives  Nationwide Conference scheduled for March 2009 in Washington DC

30 30 Links http://healthit.ahrq.gov www.hhs.gov/healthit http://privacysecurity.rti.org www.rti.org Identifiable information in this report or presentation is protected by federal law, Section 924(c) of the Public Health Service Act, 42 U.S.C. 299c-3(c). Any confidential identifiable information in this report or presentation that is knowingly disclosed is disclosed solely for the purpose for which it was provided


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