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32 J.L. Med. & Ethics 670 (2004)
Challenging Themes in American Health Information Privacy and the Public's Health: Historical and Modern Assessments

handle is hein.journals/medeth32 and id is 670 raw text is: SYMPOSIUM Challenging Themes in American Health Information Privacy and the Public's Health: Historical and Modern Assessments James G. Hodge, Jr. and Kieran G. Gostin rotecting the privacy of individually-identifiable health data is a dominant health policy objective in the new millennium. Technological, eco- nomic, and health-related reasons substantiate the de- velopment of a national electronic health information infrastructure.' Through this emerging infrastructure, billions of pieces of health data of varying sensitivities are exchanged annually to provide health care services and service transactions, conduct health research, and promote the public's health. These multi-purpose, rapid exchanges of electronic health data, far removed from the typical disclosure of health information through the doctor/patient relationship of yesteryear, contribute to heightened individual concerns about identifiable health data. Responding to American fears and per- ceptions of actual and potential privacy abuses, policy- makers have recently developed new, modern privacy protections through legislative and regulatory laws, as well as ethical and industry codes.2 Modern health information privacy protections are reflected in federal regulations developed by the federal Department of Health and Human Services (DHHS) pur- suant to the Health Insurance Portability and Ac- countability Act of 1996 (HIPAA).3 As a national privacy standard, the HIPAA Privacy Rule applies to identifi- able health data (e.g. protected health information, or PHI) used or disclosed by covered entities (e.g., health care providers, health plans, and health care clearing- houses), their business associates, and others perform- ing covered functions. The Rule requires covered en- tities to establish and adhere to a full and detailed range of privacy protections and fair information practices. The Privacy Rule vests individuals with what are viewed as modern, comprehensive protections. Pro- tecting health information privacy, however, is not new. Policymakers at every level of government and the pri- vate sector have sought to protect the privacy of health data for decades. Thousands of legislative and regula- tory proposals have been introduced and passed with the intent to better protect the privacy of identifiable health data in a wide array of settings. The result is a myriad of privacy laws and policies that apply to selec- tive health data at varying levels of government in spe- cific settings. As a national regulatory standard, the HIPAA Privacy Rule is submerged within this existing universe of legal and ethical privacy protections. The Rule negates laws that are inconsistent with its protec- James G. Hodge, Jr., J.D, LL.M., is an Associate Professor, Johns Hopkins Bloomberg School of Public Health; Adjunct Professor of Law, Georgetown University Law Center; and Executive Director, Center for Law and the Public's Health. Kieran G. Gostin, B.A., is a graduate of Georgetown University with concentrations in the histories of Socialist and Communist Thought and Latin America. JOURNAL OF LAW, MEDICINE & ETHICS

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