Medical privacy | NCVHS | HIPAA — The World Privacy Forum has sent a letter to Dr. Simon P. Cohn, Chairman of the National Committee on Vital and Health Statistics, supporting the Committee’s formal conclusion that all entities that create, compile, store, transmit, or use personally identifiable health information should be covered by a federal privacy law. More needs to be done about health care data that is left unprotected by HIPAA. The Forum’s letter included a discussion of two HHS programs that operate outside of HIPAA: FDA RiskMAPS, and the National Institutes of Health, which is not a covered entity under HIPAA.

We particularly note the Committee’s observation that the non-covered entities “may even sell personal health information without authorization for the purpose of marketing or other purposes that consumers may find objectionable.” The World Privacy Forum agrees with the Committee, and believes that the use of identifiable patient health care information for marketing is a disturbing possibility. New institutions are being developed and implemented to exploit gaps in HIPAA that allow use of patient data for marketing purposes. Action to close those gaps is needed urgently. The Committee’s letter is a small step in that direction.

iPledge Program | FDA — The World Privacy Forum testified before the Dermatologic and Ophthalmic Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee of the Food and Drug Administration regarding privacy issues related to iPledge, a mandatory program for patients taking the drug Accutane or isotretinoin generics. The FDA has stated that the program, which it requires four drug manufacturers to have in place, does not fall under HIPAA. The program collects substantive amounts of patient information. The Forum urged the FDA to set privacy standards for all RiskMAPs in general, and to resolve privacy issues in the iPledge program specifically. The Forum requested that all marketing provisions of the iPledge program privacy policy be removed, that patients be expressly informed the program does not fall under HIPAA, and that patients be given a printed copy of the iPledge program privacy policy, among other requests.

Our principal concern with iPledge is that the FDA has failed to set privacy standards for the iPledge program [2] or for similar programs that mandate patient tracking. As a result, the iPledge registry has privacy shortcomings that may potentially impact the individuals who take Accutane or Isotretinoin generics.

National Disaster Medical System | Privacy Act of 1974 — The World Privacy Forum has filed public comments with the Department of Health and Human Services requesting that its new National Disaster Medical System protect all patient information to at least the baseline protections that HIPAA affords, including the HIPAA security and privacy protections. Currently, the new system does not do this, even though the system is housed at HHS, the agency which promulgated the HIPAA standards. The National Disaster Medical System currently contains overbroad routine uses which could potentially result in significant privacy and even public health issues. For example, public health information will not be able to be disclosed under the National Disaster Medical System as the system is currently organized. Additionally, some of the current routine uses in the system would authorize disclosures that would be illegal under HIPAA. For example, Congressional disclosure of a HIPAA record requires a written authorization, something the new system does not require.