دورية أكاديمية
أعرض في EDS

Interpretation and integration of the federal substance use privacy protection rule in integrated health systems: A qualitative analysis.

التفاصيل البيبلوغرافية
العنوان: Interpretation and integration of the federal substance use privacy protection rule in integrated health systems: A qualitative analysis.
المؤلفون: Campbell ANC; New York State Psychiatric Institute and Columbia University Medical Center, Department of Psychiatry, 1051 Riverside Drive, Unit 120, Room 3719, New York, NY 10032, United States of America. Electronic address: anc2002@cumc.columbia.edu., McCarty D; OHSU-PSU School of Public Health, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States of America. Electronic address: mccartyd@ohsu.edu., Rieckmann T; Greenfield Health and OHSU School of Medicine, 9450 SW Barnes Road, Suite 100, Portland, OR 97225, United States of America. Electronic address: Traci.rieckmann@greenfieldhealth.com., McNeely J; New York University School of Medicine, Department of Population Health, 550 1st Avenue, 6th Floor, New York 20016, United States of America. Electronic address: Jennifer.mcneely@nyumc.org., Rotrosen J; New York University School of Medicine, One Park Avenue, 8th floor, New York, NY 10016, United States of America. Electronic address: John.Rotrosen@nyumc.org., Wu LT; Duke University Medical Center, PO Box 3903, Durham, NC 27710, United States of America. Electronic address: litzy.wu@duke.edu., Bart G; Hennepin Healthcare, 701 Park Avenue, G5, Minneapolis, MN 55415, United States of America. Electronic address: bartx005@umn.edu.
المصدر: Journal of substance abuse treatment [J Subst Abuse Treat] 2019 Feb; Vol. 97, pp. 41-46. Date of Electronic Publication: 2018 Nov 19.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Pergamon Press Country of Publication: United States NLM ID: 8500909 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-6483 (Electronic) Linking ISSN: 07405472 NLM ISO Abbreviation: J Subst Abuse Treat Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York : Pergamon Press, c1984-
مواضيع طبية MeSH: Delivery of Health Care, Integrated*/legislation & jurisprudence , Delivery of Health Care, Integrated*/standards , Electronic Health Records*/legislation & jurisprudence , Electronic Health Records*/standards , Patient Safety*/legislation & jurisprudence , Patient Safety*/standards , Privacy*/legislation & jurisprudence, Substance-Related Disorders/*therapy, Adult ; Cross-Sectional Studies ; Humans ; Qualitative Research
مستخلص: Background: Federal regulations (42 CFR Part 2) provide special privacy protections for persons seeking treatment for substance use disorders. Primary care providers, hospitals, and health care organizations have struggled to balance best practices for medical care with adherence to 42 CFR Part 2, but little formal research has examined this issue. The aim of this study was to explore institutional variability in the interpretation and implementation of 42 CFR Part 2 regulations related to health systems data privacy practices, policies, and information technology architecture.
Methods: This was a cross-sectional qualitative study using purposive sampling to conduct interviews with privacy/legal officers (n = 17) and information technology specialists (n = 10) from 15 integrated healthcare organizations affiliated with three research nodes of the National Institute on Drug Abuse (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN). Trained staff completed a short survey and digitally recorded semi-structured qualitative interview with each participant. Interviews were transcribed and coded within Atlas.ti. Framework analysis was used to identify and organize key themes across selected codes.
Results: Participants voiced concern over balancing patient safety with 42 CFR Part 2 privacy protections. Although similar standards of protection regarding release of information outside of the health system was described, numerous workarounds were used to manage intra-institutional communication and care coordination. To align 42 CFR Part 2 restrictions with electronic health records, health systems used sensitive note designation, "break the glass" technology, limited role-based access for providers, and ad hoc solutions (e.g., provider messaging).
Conclusions: In contemporary integrated care systems, substance-related EHR records (e.g., patient visit history, medication logs) are often accessible internally without specific consent for sharing despite the intent of 42 CFR Part 2. Recent amendments to 42 CFR Part 2 have not addressed information sharing needs within integrated care settings.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: UG1 DA015815 United States DA NIDA NIH HHS; UG1 DA013035 United States DA NIDA NIH HHS; UG1 DA040316 United States DA NIDA NIH HHS; U10 DA015815 United States DA NIDA NIH HHS; UG1 DA040317 United States DA NIDA NIH HHS
فهرسة مساهمة: Keywords: Addiction; Health information technology; Integrated care; Privacy; Qualitative research
تواريخ الأحداث: Date Created: 20181223 Date Completed: 20200615 Latest Revision: 20240611
رمز التحديث: 20240611
مُعرف محوري في PubMed: PMC6310476
DOI: 10.1016/j.jsat.2018.11.005
PMID: 30577898
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-6483
DOI:10.1016/j.jsat.2018.11.005