Skip to content Skip to navigation

Settlement in Rhode Island Reached to Boost HIE Transparency

May 5, 2014
by Rajiv Leventhal
| Reprints

The Rhode Island Department of Health’s (DOH) statewide health information exchange (HIE) must be more transparent and offer patients more privacy protections, according to a settlement between the DOH and the Rhode Island chapter of the American Civil Liberties Union (ACLU).

In 2010, the ACLU filed a lawsuit against the Rhode Island DOH, challenging the adequacy of rules the agency had adopted to implement a centralized database of patient healthcare records. The HIE, called CurrentCare, authorized by the General Assembly in 2008, allows medical personnel to routinely access a patient’s entire medical file, including mental health records and other sensitive medical information.

When the DOH first adopted regulations to implement the HIE, the ACLU objected that they provided virtually no details as to how the system would actually work, or how it would protect the privacy, confidentiality, and informed consent interests of patients. At the time, the DOH responded that those issues would be dealt with through internal “policies” that would not be subject to the public notice and comment requirement that agency regulations must normally undergo, according to an ACLU announcement.

The ACLU’s lawsuit, filed in R.I. Superior Court, argued that the Department’s position violated the Administrative Procedures Act (APA), “since all department policies that have general application and which implement, interpret or prescribe law” are subject to the APA’s public vetting process.  Noting the significant privacy issues raised by the HIE, the ACLU had called it crucial that regulations setting up the system be as detailed as possible, explaining, for example, the rights patients have to opt out of the system, to correct information contained in it, and to ensure appropriate confidentiality of the data.

Under the settlement agreement, the DOH agreed it would halt its practice of “adopting unofficially promulgated policies to implement” its obligations under the HIE law. In their place, the DOH has unveiled significantly revised regulations that specify how patients can, among other things, revoke their participation in the HIE, limit healthcare providers’ access to their HIE information, and correct errors in their medical records. The proposed revisions to the regulations were the subject of a public hearing, and patients remain free not to have their medical information submitted to the HIE.

Michael Fine, the director of the Rhode Island Department of Health, told Rhode Island Public Radio that he welcomed the ACLU's help in protecting patient privacy.



Phishing Attack at Baystate Health Potentially Exposes Data of 13K Patients

A phishing scam at Baystate Health in Springfield, Mass. has potentially exposed the personal data of 13,000 patients, according to a privacy statement from the patient care organization and a report from MassLive.

New Use Cases Driving Growth in Health Data Exchange through Direct

In an update, DirectTrust reported significant growth in Direct exchange of health information and the number of trusted Direct addressed enabled to share personal health information (PHI) in the third quarter of 2016.

Insurers to CBO: Consider Private Insurers’ Data in Evaluations of Telemedicine

Eleven private insurers, including Aetna, Humana and Anthem, are urging the Congressional Budget Office (CBO) to consider the experience of commercial insurers when evaluating the impact of telemedicine coverage in Medicare.

AHRQ Developing New Patient Safety Surveillance Tool

With the aim of improving patient safety monitoring, the Agency for Healthcare Research and Quality (AHRQ) within the U.S. Department of Health and Human Services (HHS) is currently developing and testing an improved patient safety surveillance system.

Gates Foundation Awards $210M to UW's Population Health Initiative

The Bill and Melinda Gates Foundation is awarding $210 million to Seattle-based University of Washington’s Population Health Initiative, with the funds going toward the construction of a new building to serve as the initiative’s hub.

AHA Offers Interoperability Standards Recommendations to ONC

The American Hospital Association (AHA) has offered feedback to the ONC on the agency’s draft Interoperability Standards Advisory (ISA) that it issued in August.