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Confidentiality and Privacy: Impact on Alcohol and Drug Abuse Patient Records NIDA: Narrowing the Research-Practice Divide in Evidence-Based Medicine with Adoption of Electronic Health Record Systems: Present and Future Directions July 13, 2009 42 CFR Part 2 Long standing federal confidentiality regulation Combat stigma and fear of prosecution Relatively narrow Consent-driven Biggest challenge: not well-known in federal and other circles What is protected by 42 CFR Part 2? Information about a person who has applied for or been given a diagnosis or treatment for alcohol or drug abuse Generated by a SA treatment “program” Prohibition of re-disclosure Protection attaches to the information Information that can used to identify someone as an alcohol or drug abuser What is a SA Treatment Program? “Individual or entity … that “holds itself out” as providing, and provides, alcohol or drug abuse diagnosis, treatment or referral for treatment Identified unit within a general medical facility Medical personnel or other staff whose primary function is SA treatment and are identified as such Consent with nine Exceptions Consent must be obtained with the following exceptions: medical emergencies research audit/evaluation authorizing court order Regulations do not apply to communication within a program qualified service organizations/ with QSO agreements (limited) crimes on the premises child abuse and neglect reporting Personal Health Records Any …“electronic record of IIHI on an individual that can be drawn from multiple sources and that is managed, shared, and controlled by or for the individual.” (Recovery Act, 13400(11). PHR vendor is “…an entity, other than a covered entity…that offers or maintains a personal health record (13400(18)) Regulation Payer hosted: HIPAA Provider hosted: HIPAA: Part 2 Private Companies: Unregulated Patient Hosted More Information Hipaa.samhsa.gov/privacy Confidentiality of alcohol and drug abuse patient records regulation and the HIPAA privacy rule National Committee of Vital and Health Statistics, transcripts, letter of recommendation Healthit.hhs.gov