Privacy and Health Information Technology

The increased use of health information technology (health IT) is a common element of nearly every health reform proposal. While health IT has the potential to decrease costs, improve health outcomes, coordinate care, and improve public health,  increasing the use of health IT raises concerns about security and privacy of medical information.

This paper examines some of the gaps in privacy protections that arise out of the current federal health privacy standard, the Health Insurance Portability and Accountability (HIPAA) Privacy Rule, the main federal law which governs the use and disclosure of health information. Additionally, it puts forth a range of possible solutions, accompanied by arguments for and against each. The solutions provide some options for strengthening the current legal framework of privacy protections in order to build public trust in health IT and facilitate its use for health reform. 

The perceived “gaps” in current federal legal protections for health information can be grouped into four categories:

  1. who is covered;
  2. what is covered;
  3. state law variation; and
  4. insufficient comprehension of and compliance with privacy protections.

The solutions range from amending existing law or regulation to encouraging private action through market or other incentives.

Consensus exists that efforts to facilitate widespread adoption and use of health information technology must move forward with appropriate protections for privacy and security. Yet it continues to be a challenge to gain consensus on the details of what privacy and security measures need to be put in place. Any efforts to reform the nation’s health systems and to increase the adoption of health IT will need to address the concerns surrounding the privacy and security of personal health information.

This white paper is part of the Legal Solutions in Health Reform project. It was created by the O'Neill Institute for National and Global Health Law at Georgetown University. The project aims to identify practical, workable solutions to the legal issues that may arise in any upcoming federal health reform debate.