Eliminating Redundancy

Editor's Note: The importance of the Department of Health and Human Services' (HHS) announcement of changes in privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) is highlighted by this commentary from Melinda Hatton, AHA vice president and chief Washington counsel. This article was first published in AHA News on March 25, 2002.

In its new proposed HIPAA privacy rule, HHS eliminated perhaps the most frustrating example of our concerns with the existing rule - that patients sign a written consent form for routine uses of their medical information. In addition to colliding head-on with the AHA's efforts to cut the paperwork burden for hospitals and patients, this requirement gave patients no more information or privacy protection.

Patients will already be informed of their privacy rights in a notice that will typically be 10 or more pages long. Anything beyond that is duplicative and unnecessary. And consumers agree. To help guide our thinking about written consent, the AHA and national associations representing physicians groups and pharmacists hired a nationally recognized research organization to conduct consumer focus groups. Four groups of consumers spent two hours each discussing a sample medical privacy notice and written consent form that met HIPAA requirements. We learned two key lessons.

First, they confirmed our belief that consumers find mandatory written consent to be redundant and unnecessary. Consumers in the focus groups felt that asking sick patients to read and sign lengthy legal documents is an unnecessary paperwork burden. They concluded that time spent in a doctor's office or hospital should be spent on patient care and not on filling out paperwork. Second, we were surprised to learn that, instead of empowering consumers, redundant mandatory written consent requirement and the privacy notice fueled distrust of the rule. Focus group members were nearly uniform in saying the notice was unresponsive to their concerns.

Knowing that consumers agree with our position stiffens our resolve to ensure that the latest improvements to the privacy rule survive the regulatory process and any misinformation that may have followed HHS' announcement. The AHA also will continue to work to improve the privacy notice so that it better meets patients' needs and expectations. - Melinda Hatton



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