tag:blogger.com,1999:blog-4384692836709903146.post3955363348780456806..comments2024-03-27T09:55:23.143-07:00Comments on Dispatch from the Digital Health Frontier: The ONC Whitepaper on ConsentJohn Halamkahttp://www.blogger.com/profile/04550236129132159307noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4384692836709903146.post-45404806146259508162010-03-31T21:37:59.999-07:002010-03-31T21:37:59.999-07:00Great summary! Thanks for putting that one togethe...Great summary! Thanks for putting that one together!<br /><br />Was just discussing this with a bunch of ED docs today who felt "Opt-In" is a BAD idea. Seems to have different opinions depending on which clinical tribe you ask. I think we need both national guidance and patient empowerment/awareness. (Perhaps a good goal for the speakflower.org team!) :)<br /><br />Again, thanks for the summary!Dirk Stanley, MD, MPHhttps://www.blogger.com/profile/09568427937893548660noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-77193657151428595092010-03-31T10:12:57.170-07:002010-03-31T10:12:57.170-07:00I've read the White Paper as well, and agree t...I've read the White Paper as well, and agree that the paper is extremely well done. particularly in its discussion of competing interests relating to individual control over disclosure of IIHI, as well as its review of practical issues relating to "granular" controls over disclosure of IIHI, based on purpose, recipient, time, nature of record, and limits on re-disclosure. Kudos to Melissa Goldstein!<br /><br />I'm a lawyer who is working with a behavioral health software vendor to try to figure out how its EHR should handle disclosures/re-disclosures of confidential information. This is particularly complicated in management of sensitive information. (For example, if a non-SA provider receives a record from a substance abuse program, can it use the SA record to populate fields in the receiver's EHR program (such as medications)? If so, is re-disclosure of the information in those fields subject to 42 CFR Part 2? What if the information is "incidental" to SA treatment, but doesn't specifically identify the consumer as a patient at a SA program?)<br /><br />Problems such as these, and conflicts among state and federal privacy laws make it very difficult to safely establish privacy policies to inform a computerized approach to consent directive management. <br /><br />I hope that ONC and the HIT Standards Committee will offer recommendations to other federal agencies and Congress about ways to handle these issues.Anonymousnoreply@blogger.com