Partners in Practice: Archivists and Researchers Collaboratively Improving Access to Health Collections

Processing Collections with Protected Information: A Comparison of HIPAA and Non-HIPAA Covered Entities

Emily R. Novak Gustainis, Head, Collections ServicesCenter for the History of Medicine, Countway Library, Harvard Medical Schoolemily_gustainis@hms.harvard.edu

Society of American Archivists Annual Meeting 2014Washington, D.C.14 August 2014

What governs access protection?

The Center: A Non-HIPAA Covered Entity

Hopkins: HIPAA-covered Entity

Health information is access-protected per institutional policy and is dependent on the risk tolerance of the institution. Records are restricted 80 years from the date of record creation.

Health information about individuals containing specific identifiers is access protected; applies to any institution that is deemed a HIPAA-covered entity or Business Associate. Records open after 50 years from the date of death of the individual.

Must adhere to state medical records laws depending on the provenance of records or whether records are on deposit

Must adhere to state medical records laws; the more restrictive law applies

Other restrictions may apply: • Institutional mandate (50 or 80 years)• FERPA (for academic institutions) • Donor/Depositor (Variable)• United States government records found

in manuscript collections (Variable)• Local policy (50 or 80 years)

• Personally identifying information that could enable identity theft or fraud

• “Like records” restrictions

Other restrictions may apply: • Institutional mandate• FERPA (for academic institutions)• Donor/Depositor• United States government records found in

manuscript collections• Local policy

So how does this affect processing practice?

FRANCIS A. COUNTWAY LIBRARY OF MEDICINE Center for the History of Medicine

Request for Access to Records Containing Protected Information

The Countway Library of Medicine is the repository for certain records of physicians and patients containing individually identifiable health information and other evaluative information, including personnel and medical files or other materials and data relating to specifically named individuals, the disclosure of which may constitute an unwarranted invasion of personal privacy. Permission to access the personal or evaluative information of living individuals for research purposes is permitted only through approval from the Privacy Board of Harvard Medical School. Collection/ Series title: Collection/ Series number: HOLLIS number: Creator: Records contain: ____ Personal or evaluative information _____ Information on decedents

________________________________________________________________________ Name [Please print] ________________________________________________________________________ Affiliation ________________________________________________________________________ Address ________________________________________________________________________ __________________________________ ________________________________ Phone E-mail

Please attach a statement addressing the following aspects of your projected use of the records containing protected information.

1. State the purpose of your research and explain your need to use records containing personal or evaluative information. 2. Provide a brief description of the personal or evaluative information and dates of records required for your research.

3. Explain how your research could not be conducted without access to and use of personal or evaluative information.

4. Explain your research methodology and the safeguards which will be employed to protect sensitive information and the privacy of individuals.

5. Describe the benefits of your research and intended final product. I am seeking access to the restricted records identified in this application for the legitimate research purpose described in the attached statement. I accept responsibility for maintaining the confidentiality of these records. I agree to hold harmless and indemnify the Francis A. Countway Library of Medicine and the Harvard Medical School and its officers against any loss of damage arising out of the use of such records.

_____________________________________________________________________________ Signature of Applicant ___________________ 2014 Date

Records may be used under the following conditions: _____ No restrictions on access and use _____ No reproduction or distribution permitted _____ Other: __________________________________________________________ Jack Eckert, Countway Library of Medicine ___________________ Date

______________________________________________________________________________ Representative of the Privacy Board of Harvard Medical School ___________________ Date

Variables

What are the “most useful” formats for archivists to identify?

1. Patient histories (91.67%)

2. Case files3. Correspondence4. Patient questionnaires5. Patient summaries6. Consultation files7. Family medical histories8. Admission/registration

record9. Diagnostic indices10.Photographs/medical

imaging11.Informed consent

records (43.75%)

12. Autopsy records (40.43%)13.Lab notebooks14.Prescription books/logs 15.Research protocols16.Hospital policies17. Graphs and charts18. Surgical logbooks19. Microscope slides/specimens20. Billing information21. Genetic testing records22. Immunization records23. Insurance records (12.5%)

Example 1: Lindemann finding aid

Example 2: Harken papers

Example 3: Polk finding aid

Center for the History of Medicine, Countway Libraryemily_gustainis@hms.harvard.edu

Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutionspletocha@jhmi.edu

Thank you!