E-health, HIPAA, and beyond.

Abstract

De sp ite rap id and vast changes in our ability to process and share information, the encounter between patient and doctor is little different today from what it was at the dawn of the twentieth century. A bright future where health information systems can revolutionize the doctor/patient encounter on a vast scale is within our reach. However, two obstacles stand in the way: concerns over privacy and lack of uniform standards. The National Committee on Vital and Health Statistics (NCVHS), a congressionally appointed advisory body on e-health, has begun to address both of these barriers. A major step on this journey was made with the adoption on 11 August 2000 of the first set of rules that derive from a littleknown provision of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The Administrative Simplification provisions of HIPAA direct the secretary of the U.S. Department of Health and Human Services (HHS) to begin the process of establishing standards for health information, securing that information, and protecting the privacy of the individuals to whom that information refers. HIPAA also designates the NCVHS to advise the HHS secretary and Congress on these matters. The NCVHS, “the statutory public advisory body” to the HHS secretary “in the area of health data and statistics,” was created by Congress nearly fifty years ago to provide advice and assistance to the department. Its eighteen representatives come from the private sector, sixteen of whom are appointed by HHS and two by Congress. It now serves as a “forum for interaction with interested private-sector groups on a variety of key health data issues.” Its charter was revised in early 2000 to include the mandate to implement HIPAA’s Administrative Simplification provisions for U.S. health data and to cooperate with other countries in devising internationally comparable health data standards that support cross-national research.