205814 Legal and ethical aspects of Louisiana Public Health Information Exchange (LaPHIE)

Monday, November 9, 2009: 9:10 AM

Charles Daspit, JD , Louisiana Department of Health and Hospitals, Baton Rouge, LA
Jane Herwehe, MPH , Louisiana State University, Health Care Services Division, Baton Rouge, LA
Susan Bergson, MPH , Health Systems Development- HIV/AIDS Programs, Louisiana Public Health Institute, New Orleans, LA
M. Beth Scalco, MPA, LCSW , Louisiana Office of Public Health, HIV/AIDS Program, New Orleans, LA
Amy Zapata, MPH , Louisiana Office of Public Health, HIV/AIDS Program, New Orleans, LA
Lisa Longfellow, MPH , Office of Public Health, Louisiana Department of Health and Hospitals, New Orleans, LA
Michelle Murtaza-Rossini, MPH , Louisiana State University, Health Care Services Division, Baton Rouge, LA
Background: The Louisiana State University Health Care Services Division (LSUHCSD) and the State of Louisiana Office of Public Health (OPH) have developed a secure bidirectional public health information exchange known as the Louisiana Public Health Information Exchange (LaPHIE). Developed to facilitate linkage to care and treatment for individuals with HIV, tuberculosis, or syphilis, LaPHIE utilizes electronic messages posted in patients' electronic medical records in the LSU system to help ensure important public health follow-up activities occur. Objective/purpose: With the assistance of the Louisiana Public Health Institute, serving as a neutral convener, the partners collaboratively developed consensus on legal positions and ethical arguments in support of LaPHIE. Methods: The project team formed a Legal and Ethics workgroup tasked with a legal and ethics review. The workgroup completed an inventory and review of all related Federal and State legislation, discussed LaPHIE with national experts in confidentiality and biomedical ethics, and completed consumer interviews of acceptability. Results: Results from the legal and ethical review determined that several Federal and State laws permit collaboration of health care providers for persons with HIV, TB or syphilis. The team developed a position paper supporting LaPHIE, which provides legal analysis related to specific situations that may occur when public health information is exchanged between organizations. Discussion/conclusions: Applicable laws (State and HIPAA) and an ethics review support the mission and obligation of LSU and OPH to protect individual and population health and can facilitate electronic information sharing. Privacy and confidentiality are paramount for individuals with stigmatizing conditions. Providers are legally required and ethically obligated to protect individual privacy by assuring that all information is shared in the most confidential manner with the authorized treating entity. Fear of privacy violations should not override legitimate public health objectives or the health of an individual.

Learning Objectives:
1. Discuss the significance of defining legal and ethical questions in building a case for public health information exchanges. 2. Describe the process used to formulate legal and ethical arguments for and against public health information exchange. 3. Identify aspects of public health legislation and ethical arguments that can facilitate or prohibit public health information exchanges.

Keywords: Health Insurance Portability Act, Health Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Member of the coordination and executive committees for LaPHIE. STD Program Manager for 5 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.