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Interoperability Part I As a nurse or healthcare professional, it is vital to realize that Interoperability can be a significant issue in the continuum of care. Despite efforts, it’s still a long journey until Interoperability is fully achieved. Until then, Interoperability efforts may be at odds with fundamental regulations such as HIPAA privacy rules. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule permits, but does not require, covered health care entities to obtain patient consent before using or disclosing Protected Health Information (PHI) for treatment, payment, and health care operations. Entities can share PHI digitally, or by phone, fax, or mail.

Although HIPAA does not require that health care entities offer patients a choice about the sharing of their PHI, many entities and states have adopted policies or laws that require patient consent. HIPAA is designed to work in tandem with other privacy- protective policies, so in those states, the entity is required to get the patient’s basic consent preference (e.g., the entity must document if the patient wishes to opt-in or opt- out of electronic exchange). Below are a few examples of patient consent scenarios illustrating how data flows in line with the patient’s consent preference. This is not a comprehensive list of scenarios.

Patient is Not Asked for a Consent Decision - HIPAA background rules apply

When patient consent is not required, and HIPAA background rules apply, PHI can flow as shown in the graphic below.

Flow of PHI When Patient is Not Asked for a Consent Decision

Patient Declines Digital Sharing

If patient consent is required by state law (called “opt in / opt out” laws [PDF - 429 KB]) to share information electronically and a patient makes a consent decision that does not allow her health information to be shared digitally, entities can still exchange the patient’s information. However, in line with HIPAA, the entities must use phone, fax, or mail. These methods can be much slower and costlier than digital sharing. This type of scenario is shown in the graphic below.

Flow of PHI when Patient Declines Digital Sharing

Patient Allows Partial Sharing

Sensitive health information, which includes mental health records, adds another layer of complexity to the Computable Privacy environment. The graphic below shows what happens when there are specialized rules for specific clinical categories, such as mental health. In this scenario, a patient chooses to stop her health care entities from sharing her mental health records, but she allows them to share her physical health records.

Flow of PHI when Patient Does Not Consent to Mental Health Record Sharing

Evaluate the impact of patient consent in achieving full interoperability.

Include the following aspects in the assignment:

• Assess one of the patient consent scenarios listed above

• Find two recent (less than three years) scholarly articles on your chosen scenario

• Create recommendations on how Patient Consent based on your selected scenario could be integrated without constituting an obstacle to achieving Interoperability

• In your own perspective, discuss the impact of wearable technologies in achieving interoperability.

• At all times, proper sentence structure, grammar, and spelling are required. Grammarly is a free tool to assist you. All references used must be placed.