Dive Brief:
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The Department of Health and Human Services released a final rule late last week updating the Confidentiality of Alcohol and Drug Abuse Patient Records regulations.
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The rule is intended to facilitate the electronic exchange of substance misuse information for treatment and other "legitimate healthcare purposes" while addressing patients' privacy concerns.
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The existing regulations were last updated in 1987.
Dive Insight:
In the 29+ years since these guidelines were last updated, the provision of healthcare has changed drastically, and the final rule was intended to help bring the guidance up to date. In particular, the old rule seemed to be doing a poor job of balancing the need to protect patients seeking help for substance abuse with their need for coordinated care.
The Partnership to Amend 42 CFR Part 2, a coalition of healthcare organizations that had sought to better align the rule with HIPAA requirements, believes providers need access to a patient’s entire medical record, including addiction records, in order to provide and coordinate safe and effective care.
Give the current opioid abuse crisis, this sensitive question is more important than ever. In Maine, the opioid crisis has grown so severe that an average of one person per day dies from an overdose. Still, some believe while care coordination can improve safety and outcomes, the final rule stymies such coordination.
For example, the final rule "adds a requirement that, upon request, patients who have included a general designation in the “To Whom” section of their consent form must be provided a list of entities to which their information has been disclosed pursuant to the general designation." Some have found this clause troubling arguing it doesn't fit in line with the reality of how care is delivered. The American Medical Informatics Association noted the clause states this clause presumes an existing relationship between a provider and a patient (making it difficult for a future third party care deliverer to be named in a patient's disclosure list), Healthcare Informatics noted.
“The new final rule makes important updates, but more work needs to be done. We look forward to working with our partners and Congress this year to improve the confidentiality law so that it continues to offer important patient protections without impeding good care,” said Dr. Jeffrey Goldsmith, president of the American Society of Addiction Medicine, was quoted in Healthcare Informatics.