AAFP makes the case for upholding privacy with substance abuse data

Family physicians must balance treatment of patients with chronic pain against challenges faced by patients who have substance abuse issues.

In both cases, patient privacy must be paramount to facilitate the free flow of information between patient and provider, the American Academy of Family Physicians recently told federal regulators.

In a letter to Elinore McCance-Katz, MD, who leads the Substance Abuse and Mental Health Services Administration, AAFP noted that the confidential relationship between physicians and patients is essential for the flow of information needed to achieve sound medical care.

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However, various state regulations and operational standards can make data sharing difficult and can introduce burdens to ensuring confidentiality, according to the letter.

AAFP applauds a proposed rule from SAMHSA that acknowledges the need to uphold protection of patient medical information. The rule would encourage care coordination, update definitions of what constitutes a medical record and its applicability in federally assisted substance abuse treatment. The rule also removes hurdles that could discourage substance abuse care by non-Part 2 health professionals.

At the same time, however, SAMHSA noted in the proposed rule that certain electronic health records tools affected by the rule need further development and are not ready to be required as standards.

Under the proposed rule, SAMHSA would continue to prohibit law enforcement use of Substance Use Disorder Patient records SUD in criminal prosecution against the patient, a decision with which AAFP agrees.

If the proposed rule, entitled “Confidentiality of Substance Use Disorder Patient Records,” is finalized, the rule also would continue to restrict disclosure of substance use disorder treatment records without patient consent, with exceptions for bona fide medical emergencies, or in the cause of scientific research, an audit or program evaluation, or based on a court order.

“The AAFP therefore supports this proposed rule as it properly protects patient privacy concerns, improves the intent of the law and makes it less burdensome,” the association acknowledges. “Only in a setting of trust can a patient share the private feelings and personal history that enable the physician to comprehend fully, diagnose logically and to treat properly.”

More information from the letter AAFP sent to Elinore McCance-Katz at SAMHSA is available here.

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