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The American Association of Occupational Health Nurses (AAOHN) in Atlanta and the American College of Occupational and Environmental Medicine (ACOEM) in Arlington Heights, IL, are calling on the new Congress to address major gaps left by the recently adopted health privacy regulation. The nation’s two largest occupational health organizations urge members of Congress to support legislation that will extend health protections to cover all health information and all health care providers.
Deborah DiBenedetto, MBA, RN, COHN-S, AAOHN president, says the issue of privacy rights in occupational health were not settled with the recent release of the federal privacy rules. "AAOHN and ACOEM are pleased that the Senate Health, Education, Labor, and Pensions (HELP) Committee is providing an opportunity to continue the open dialogue about the new health privacy rules," DiBenedetto says. "The new rules issued by the Department of Health and Human Services (HHS) are a major step toward protecting all American’s health information, but still leave large amounts of information vulnerable."
Robert Goldberg, MD, FACOEM, ACOEM president, agrees. Goldberg says occupational health professionals have some special concerns that weren’t addressed adequately. Even the debate generated among most health care professionals does not address the particular concerns that occupational health physicians and nurses will encounter. "Despite what has been reported in the media, all health care information is not protected by the new rules," he adds. "In fact, most health information related to an individual’s employment is not protected and can be accessed by employers. Such information could be used to make decisions about hiring, firing, and promotions."
Both organizations commend HHS for its work on the new rules, but they recognize the statutory limitations the agency had under the 1996 Health Insurance Portability and Accountability Act (HIPAA). Individuals will visit an occupational heath care provider for many reasons associated with employment: pre-placement physical exams, health promotion activities, medical surveillance, fitness-for-duty examinations, independent medical examinations, and medical purposes associated with health and safety regulations.
Information derived from activities rarely would be transmitted electronically or meet the definition of a standard transaction, Goldberg says. And since the new rules apply only to those providers engaged in "standard transactions" as defined by HIPAA, the information collected by these providers may not be included in the protections afforded by the new rules.
Goldberg and DiBenedetto say employers do have legitimate needs to have access to certain personal health information for managing workers’ compensation, health, and disability benefits, for job accommodations, or when considering fitness for work. However, they agree that employers should not have unfettered access to an employee’s entire health record.
"Unless these large gaps are addressed by legislation, employers will continue to have relatively free access to employee health information," adds DiBenedetto. "AAOHN and ACOEM support federal legislation to close the gaps in the HHS rules and extend protections to cover all health information and health care providers — regardless of how information is transmitted and regardless of whether the information results from a HIPAA standard transaction. Otherwise, these gaps will continue to leave large amounts of personal health information unprotected."