Test highlights how to do EHR data sharing right

The Department Veterans Affairs  and the Substance Abuse and Mental Health Services Administration have demonstrated how to securely share sensitive health information via electronic health records  (EHRs).

The test also showed how substance abuse and other sensitive data can be tagged so that when it is sent in a summary of care record to another provider with the patient’s permission, the receiving provider will know  they need to obtain the patient’s authorization to further disclose the sensitive information with others, according to a Sept. 17 announcement by the Department of Health and Human Services. SAMHSA is an agency in HHS.

[See also: Sharing EHR data results in $2M in savings across Memphis EDs]

Privacy metadata from the SAMHSA EHR electronically explained to the VA EHR system that substance abuse treatment information within the clinical document is protected by federal confidentiality laws and can only be used for certain authorized purposes. It cannot be further disclosed without the patient’s consent.

Metadata classification tags indicate confidentiality, sensitivity, and handling instructions so that granular pieces of data can be protected from capture and disclosure. By varying the disclosure capabilities of electronic health information, providers and patients can better balance treatment and privacy.

“This project helps demonstrate that with proper standards in place existing privacy laws and policies can be implemented appropriately in an electronic environment,” said Joy Pritts, chief privacy officer in the Office of the National Coordinator for Health IT.

The demonstration was part of the Data Segmentation for Privacy (DS4P) Initiative in ONC’s Standards & Interoperability Framework.

[See also: No EHR required with new data-sharing]

The project is in response to the work of the President’s Council of Advisors on Science and Technology (PCAST), which in a 2010 report called for a universal exchange language like extensible markup language (XML) and the ability to separate health data into the smallest individual pieces that make sense to exchange.

Using standards identified in the Data Segmentation for Privacy project, SAMHSA and the VA exchanged a mock patient’s substance abuse treatment records tagged with privacy metadata from one EHR to a different EHR system after electronically verifying that the mock patient had consented to the transmission.

Many patients with behavioral health conditions are very protective of their health information, said SAMHSA Administrator Pamela Hyde. “The tools developed in this pilot will be critical for building trust and capacity in EHRs and health information exchanges, especially for patients with behavioral health problems,” she said.

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John Trader say: Nice to see a government entity taking the lead

Thanks for the article Mary. It's nice to see a government entity taking the lead on this. Not known for their innovative approach, when it comes to healthcare reform and the implementation of safe, reliable and effective HIEs to share data across networks, government departments and organizations seem to be much more proactively taking market leadership for new approaches on data sharing.

Hopefully this will resonate with other private organizations and we will see continued improvements in how patient data can be safely and securely shared across networks.

Joseph Santangelo say: Don't Rely on Just Meta Data

You may get lucky and find that reliance on Meta Data provides you with the complete picture that you need to integrate and share data across participants. An approach that you may want to consider would be to set up a data masking hub and have agents at each participant. The agents will identify sensitive data, build a common inventory across participants and then actually de-identify the data that each provider is testing with, without any PHI leaving a provider's network.