The recommendations apply only to electronic exchange of information to meet Stage 1 meaningful use criteria. More study is needed, Tiger Team members say, in such areas as exchanging data with patients and researchers.
The team's core recommendation is that fair information practices set in law should govern all decisions of good data stewardship. The group also developed a set of four "core values" to guide ONC's work to promote health information technology:
* "The relationship between the patient and his or her health care provider is the foundation for trust in health information exchange, particularly with respect to protecting the confidentiality of personal health information."
* "As key agents of trust for patients, providers are responsible for maintaining the privacy and security of their patients' records."
* "We must consider patient needs and expectations. Patients should not be surprised about or harmed by collections, uses, or disclosures of their information."
* "Ultimately, to be successful in the use of health information exchange to improve health and health care, we need to earn the trust of both consumers and physicians."
The recommendations cover use of intermediaries or third parties in information exchange, a trust framework to enable exchange among providers for treatment purposes, the ability of technology to support more granular patient consents that exclude certain information from being exchanged, the ability of patients to consent to participation in identifiable health information exchange, and specific exchanges required under Stage 1 criteria.
For instance, a set of recommendations cover the need to make "patient consent" more meaningful. Patients should have more time, and more information on the choices and consequences, before making consent decisions. Consent should be revocable and should not be required to receive necessary treatment.
For a copy of the 19-page letter of recommendations, click here.
--Joseph Goedert
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