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The us fight for terrorism involves invasion of privacy

The passage of these two acts, followed by the implementation of the HIPAA privacy rule on April 14, 2003, led to confusion for caregivers and HIM professionals as to how to respond to requests for protected health information PHI that use the phrase "homeland security" from public health departments, law enforcement agencies, federal agencies, and others.

This practice brief provides a brief analysis of the Homeland Security Act, Patriot Act, and Freedom of Information Act; background about mandatory reporting of health information; and an overview of syndromic reporting, the newest form of mandatory reporting.

In addition, this article includes practical facts to help you respond to requests for PHI. Homeland Security Act The primary mission of the Homeland Security Act is to prevent terrorist attacks within the United States, reduce the vulnerability of the United States to terrorism, and minimize damage and assist in recovery for terrorist attacks that occur in the United States.

It further states that PHI is protected from unauthorized disclosure and is to be handled and used only for the performance of official duties. The Department of Homeland Security boasts the first statutorily required privacy office within a federal agency.

The privacy office is primarily responsible for evaluating privacy's effect on the department's programs, systems, and initiatives. It is further required to mitigate any anticipated effect on privacy. The privacy office's objectives include: Evaluating the department's legislative and regulatory proposals that involve the collection, use, and disclosure of personally identifiable information Centralizing and providing program oversight and implementing all FOIA and Privacy Act operations Operating a privacy incident response program that addresses incidents involving personally identifiable information Responding to, investigating, and addressing complaints of privacy violations Providing training, the us fight for terrorism involves invasion of privacy, and outreach that build the foundation for privacy practices across the department and create transparency 5 Patriot Act The major objective of the Patriot Act is "to deter and punish terrorist acts in the United States and around the world [and] to enhance law enforcement investigatory tools" 6 by dramatically reducing restrictions pertaining to law enforcement requests to search telephone records, e-mail communication, and health records.

The Patriot Act allows for the emergency disclosure of electronic communications to protect life and broadens the definition of terrorism to include acts of domestic terrorism. Under the Foreign Intelligence Surveillance Act, the Patriot Act allows the director of the Federal Bureau of Investigation or a designee of the director to apply for an order requiring the "production of any tangible things including books, records, papers, documents, and other items for an investigation to protect against international terrorism or clandestine intelligence activities.

Each application for a production order must be made to a judge or magistrate, and the judge must demonstrate that the records concerned are sought for an authorized investigation not concerning an American or to protect against terrorism or clandestine intelligence. The Patriot Act should provide some comfort to privacy officers because it states, "A person who, in good faith, produces tangible things under an order pursuant to this section shall not be liable to any other person for such production.

Such production shall not be deemed to constitute a waiver of any privilege in any other proceeding or context. The provisions set to expire pertain to business records, roving wiretaps, and so-called "lone-wolf" investigations and continue to provide law enforcement agencies with broad discretion when gathering information.

Originally signed into law by President Lyndon B. Johnson in 1966, FOIA provides for the partial or full disclosure of unreleased information and documents controlled by the US government. It further defines all records subject to disclosure, outlines procedures, and identifies exemptions to the statute.

FOIA exemptions address sensitivity and personal rights, including: Ford's veto of the Privacy Act Amendments. The Privacy Act provides protection of records that can be retrieved by personal identifiers such as name or Social Security number. Individuals are entitled access to records and to request correction of these records.

Americans feel the tensions between privacy and security concerns

The act prohibits disclosure of these records without appropriate written consent of the individual to whom the records pertain, unless one of the 12 disclosure exceptions within the Privacy Act applies. The Privacy Act applies to federal agencies only and includes only records within the possession of those agencies. These amendments further define the rights of individuals requesting government records and strengthened privacy efforts.

From 1986 to 2001, FOIA had several amendments that provided agencies with the ability to withhold information from the public. All of these restrictions were revoked in January 2009 by President Barack Obama in an effort to encourage transparency in government records. To understand these acts and their basic intent, HIM professionals and their colleagues must recognize that the US government is permitted to access any and all information it deems necessary to protect the nation.

PHI should be released to the requesting authority without delay, provided that the appropriate identification a copy of identification, an office location, and the particular branch of government requesting the information of the government official is obtained and verified.

HIPAA regulations currently permit these disclosures without a patient's or legal guardian's authorization and require that they be recorded in the accounting of disclosures. These types of disclosures could be listed as examples in an organization's notice of privacy practice. Public Health Surveillance The duty to report certain health information already exists in the United States and is found in various federal and state statutes.

Healthcare facilities and providers must report births and deaths, treatment of gunshot wounds, suspicion of child and elder abuse, and industrial accidents, as well as cancer cases and communicable and other diseases. This duty is referred to as "mandatory reporting. Syndromic Surveillance in Bioterrorism and Outbreak Detection Events related to bioterrorism and the sudden emergence of outbreaks of H1N1 influenza, avian flu, West Nile virus, anthrax, and severe acute respiratory syndrome have prompted health agencies to seek additional methods of disease surveillance.

The most common method used to acquire additional health information is called "syndromic surveillance. The data types used in syndromic systems include "events that might precede a clinical diagnosis e.

The collection of health data is intended to collect clusters of cases, not individual cases. Whether a fine line or an abyss exists between respecting the privacy of individual health information and protecting the public from bioterrorism depends on perspective. One fundamental challenge for many healthcare organizations is deciding the us fight for terrorism involves invasion of privacy the gap between personal privacy and national security is small or large and how it can be bridged.

  • Originally signed into law by President Lyndon B;
  • A study in the wake of the Snowden revelations showed that there was notable change in public attitudes about NSA surveillance programs when questions were modified;
  • Evaluating the department's legislative and regulatory proposals that involve the collection, use, and disclosure of personally identifiable information Centralizing and providing program oversight and implementing all FOIA and Privacy Act operations Operating a privacy incident response program that addresses incidents involving personally identifiable information Responding to, investigating, and addressing complaints of privacy violations Providing training, education, and outreach that build the foundation for privacy practices across the department and create transparency 5 Patriot Act The major objective of the Patriot Act is "to deter and punish terrorist acts in the United States and around the world [and] to enhance law enforcement investigatory tools" 6 by dramatically reducing restrictions pertaining to law enforcement requests to search telephone records, e-mail communication, and health records;
  • Homeland Security Act The primary mission of the Homeland Security Act is to prevent terrorist attacks within the United States, reduce the vulnerability of the United States to terrorism, and minimize damage and assist in recovery for terrorist attacks that occur in the United States.

Several initiatives show promise for surveillance on the national level while remaining considerate of individual privacy. Public health officials have historically leveraged surveillance systems to identify outbreaks and monitor disease activity among communities.

The challenges associated with implementing broader surveillance systems include inadequate infrastructure, data integration barriers due to lack of standards, deficient understanding of public health informatics, and funding. Many states and counties already have committed significant time and resources to developing surveillance systems that serve citizens within their boundaries.

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This independent activity has generated many impressive public health surveillance systems, albeit in a somewhat federated fashion. However, these federated surveillance systems often cannot share data because of a lack of standards. The resulting data-sharing roadblocks are found at all levels of technology and consist of incompatible hardware, software versions that do not talk to each other, and inconsistent data definitions, to name a few.

Data quality presents another challenge in implementing public health surveillance. Data inaccuracy in syndromic surveillance systems becomes an obstacle to wholesale adoption of such systems if user comfort levels with the quality of the data are not satisfactory.

Public health information systems can deliver valuable information for national security efforts without compromising patient privacy. Although the nation's capacity to respond to bioterrorism may depend on further development of surveillance systems, there are many diverse efforts trying to balance individual privacy with protection of the public health. Syndromic surveillance systems likely will evolve as obstacles are overcome, standards are created, and the public accepts and supports the cost of adopting such a system.

In addition, they should know which members of their organizations are responsible for mandatory reporting and work collaboratively to effectively identify, obtain, and release information to the appropriate authorities. No single department can work alone in this area, since the information that is obtained occurs during registration specific demographicsduring the course of treatment clustering of signs and symptoms that could potentially cause a threat to the public at largeand at the time of discharge identifying key diagnoses.

Develop a matrix demonstrating all of the various reporting requirements e. Determine whether the identified needs can be met through the HIM abstracting system. If not, contact the technology department to develop an automatic reporting method or work with the department responsible for this required reporting. Determine if this information needs to be reported through the accounting of disclosures and react accordingly.

Take the initiative to serve on the team establishing the initial policies for their facility's syndromic surveillance. Suggestions for Component State Associations Component state associations CSAs should take a strong role in shaping the development of public health systems for required reporting. These acts offer CSA leaders the opportunity to work with other associations and agencies such as a the us fight for terrorism involves invasion of privacy hospital association, department of health, or long-term care licensing agency with an interest in reviewing required reporting rules and integrating new requirements into systems as they are identified.

War on terrorism

State hospital associations may be a good place to identify rule makers within the state. In most states, the department of health is given the authority to establish mandatory reporting programs; in some instances, special commissions have been established to monitor this function. Other state agencies that are likely to be involved include departments of health and human services, state bureaus of investigation, and separate registries, if established by the state government.

The HIM professional's knowledge of data management, reporting processes, coded data, and patient privacy and confidentiality requirements provide a needed resource to state agencies.

  • Syndromic Surveillance in Bioterrorism and Outbreak Detection Events related to bioterrorism and the sudden emergence of outbreaks of H1N1 influenza, avian flu, West Nile virus, anthrax, and severe acute respiratory syndrome have prompted health agencies to seek additional methods of disease surveillance;
  • This duty is referred to as "mandatory reporting;
  • The Patriot Act should provide some comfort to privacy officers because it states, "A person who, in good faith, produces tangible things under an order pursuant to this section shall not be liable to any other person for such production;
  • Form a work group that consists of HIM professionals representing all geographic regions of the state and as many different healthcare settings as possible;
  • Apple challenged the order to try to ensure that security of other iPhones remained protected, and also to provoke a wider national conversation about how far people would like technology firms to go in protecting their privacy or cooperating with law enforcement;
  • Each application for a production order must be made to a judge or magistrate, and the judge must demonstrate that the records concerned are sought for an authorized investigation not concerning an American or to protect against terrorism or clandestine intelligence.

Even with sophisticated electronic reporting systems, information managers are needed to organize information and turn data into knowledge. HIM professionals and CSAs have an obligation to offer and apply their knowledge and abilities to this process.

Your CSA will be perceived as an important entity when other CSAs see one of your representatives in virtually every healthcare setting, not just hospitals. Methods proven to be effective in dealing with other CSAs include: Making alliance building a major initiative for your CSA.

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Form a work group that consists of HIM professionals representing all geographic regions of the state and as many different healthcare settings as possible. Identify individuals who have a working knowledge of mandatory reporting or who are willing to learn.

Learn as much as you can, individually and as a group, about the rules in your state and the challenges faced by healthcare providers who are responsible for reporting. Identify areas that need improvement and areas that overlap disciplines. Realize that once data are reported, they are available to many entities and will be analyzed for various purposes.

Contact other allied healthcare associations that are involved e.

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Offer to work together as a team to enhance the reporting process and address whatever issues arise. Offer educational opportunities for healthcare workers and law enforcement personnel.

Build an alliance with the state hospital association and the state medical association. Many physicians may be unaware of the the us fight for terrorism involves invasion of privacy requirements and of the enormous amount of information being reported. Ask if a representative if the CSA can serve as a member at least in an ex officio capacity of an oversight committee that monitors reporting processes for a state hospital association or state health department.

Stress that the members of your CSA are the information people and that their involvement is critical to the integrity of reported data. Career Opportunities with Public Health Agencies Many state health departments employ HIM professionals to manage the databases created due to required reporting and statewide registries.

As healthcare oversight, syndromic surveillance, and public and patient safety issues receive more and more national attention, these opportunities will grow. HIM competencies bring value to the work of these agencies.

In the future, competency in areas such as data integration, methods of encryption and deidentification, and data analysis tools and techniques will be necessary to compete for new roles that emerge as a result of oversight and surveillance activities.

PHI should be released to the requesting authority without delay after appropriate verification. Appropriate identification of the government official must be obtained and verified, including a copy of identification, office location, and the particular branch of government requesting the information. HIPAA regulations currently permit these disclosures. These disclosures must be recorded in the accounting of disclosures. A patient or legal guardian's authorization is not required when a request is responded to under either the Homeland Security or the Patriot Act.