Lead Institution: Dartmouth

Project Leader: Denise Anthony

Research Progress

• Abstract
  This project set out to follow-up on the 2003 “The State of Health Privacy: A Survey of State Health Privacy Statutes I and II” compiled by Joy Pritts (referred to as the Pritts Report), which reviewed and documented statutes regarding health information privacy and disclosure rules in all 50 U.S. states as of 2002. We compared all state statutes from the Pritts Report to existing statutes in 2010 in all 50 states. We documented whether the statute was unchanged, or if changed, we provided the text and number of any new or revised statutes, as well as evaluated the type of change that occurred between 2002 and 2010.

• Focus of the research/Market need for this project
  The great diversity of health information disclosure rules and statutes across the 50 U.S. states complicates health information exchange among providers, and makes systematic implementation of these statutes difficult. In addition, this variation significantly complicates efforts to develop or implement information technology (IT) tools to automate secure information disclosure and exchange in ways that are compliant with state statutes. IT developers must at least be aware of the state policies, and further must understand how the policy environment impacts disclosure practices as well as technology use in order to design tools that work in the complicated health care delivery environment.

• Project Aims/Goals
  We compared all state statutes from the Pritts Report to existing statutes in 2010 in all 50 states. We documented whether the statute was unchanged, or if changed, we provided the text and number of any new or revised statutes, as well as evaluated the type of change that occurred between 2002 and 2010.

  Developers of new technologies, as well as providers who are implementing Meaningful Use objectives and other required applications for health information exchange, need to have clear information regarding the current disclosure statutes in all states. Providers must create internal institutional policies that are consistent with a dizzying array of state and federal laws, so this information is relevant to both IT users and developers, as well as to researchers interested in the health privacy legal landscape.

• Key Conclusions/Significant Findings/Milestones reached/Deliverables

  • Deliverables: Excel spreadsheet that includes: the text of the statutes, following the original Pritts Report categorization, from both 2002 and 2010 (if changed). The spreadsheet also includes the qualitative coding of the types of changes, if any, that occurred in each type of statute between 2002 and 2010. The spreadsheet includes web-links to each state’s statute website (as existed at the time of data collection in 2010-2011). The spreadsheet was made available to all SHARPS researchers, and has been posted to the SHARPS website.

    Using 2010 state statute information, Dartmouth researchers worked with NYU and Vanderbilt to further develop use-case examples that illustrated how disclosure statutes operate differently in 4 states, as well as for health information exchange between states. The use-cases are posted in the Vanderbilt PolicyForge tool.

• Materials Available for Other Investigators/interested parties

  • State Health Information Statutes 2002-2010 Excel spreadsheet available.
  • Use-cases illustrating information disclosure in 4 states and for cross-state health information exchange.

• Market entry strategies
  N/A

Bibliography
SHARPS 2010 Update of State Health Information Statutes
Denise Anthony, Dartmouth and Helen Nissenbaum, NYU
Update of 2002 Pritts Report:Part 1, Part 2 to identify any changes in statutes in each state through October 2010.