Confidentiality and privacy in health care is important for protecting patients, maintaining trust between doctors and patients, and for ensuring the best quality of care for patients. Patient confidentiality has been a standard of medical ethics for hundreds of years, but laws that ensure it were once patchy and incomplete.

The federal law called HIPAA was passed in 1996 to make sure that there would be one nationwide law to protect patient privacy. The law includes other provisions, including continuity of care, but for many individuals, the right to confidentiality is most important. There are certain rights that the law provides for that all people should be aware of so that they can advocate for privacy and for the best possible care.

What is HIPAA?

HIPAA is the Health Insurance Portability and Accountability Act of 1996, a law passed by Congress and signed by President Clinton. Other names for the law are the Kennedy-Kassebaum Act and the Kassebaum-Kennedy Act, for two of the leading sponsors when the law was a bill going through both houses of Congress. The law was enacted as medical records were beginning to be transferred from paper to electronic form.

The transition from analog to digital records for patients left open a window of opportunity for sensitive and very personal information to be misused. At the time that HIPAA became a federal law, medical caregivers were already bound by ethical standards to protect patient privacy, but laws were inadequate to guarantee that protection.

The law also set standards for using and handling electronic records in order to cut back on fraud and abuse and to make administration more streamlined. HIPAA is not just about security and protecting privacy, though. Another thing that the law guarantees is that individuals can continue to receive health insurance coverage when changing or losing a job or when adding a dependent. It improved upon the portability and continuity of health care coverage.

The Five Titles of HIPAA

HIPAA includes five different titles that outline the rights and regulations allowed and imposed by the law. The titles address the issues of privacy, administration, continuity of coverage, and other important factors in the law.

  • Title I. The first part of the law ensures continuity in health coverage by protecting that coverage when a worker loses or changes a job. In other words, it ensures portability of heath care coverage.
  • Title II. The second title covers the administrative simplicity enacted by the law. It established nationwide standards for electronic records health care transactions. This encouraged greater simplicity in administration of health care by encouraging use of electronic records and transactions. Title II also set minimum standards and rules for protecting patient privacy.
  • b This part of the law sets rules for medical spending accounts and provides for certain deductions in medical insurance.
  • Title IV. Title IV sets guidelines for group health insurance plans and rules about pre-existing conditions.
  • Title V. In Title V the law sets rules for life insurance and for how people who have lost U.S. citizenship can be treated.

Your Rights under HIPAA

Much of the responsibility for the law falls to medical and health care professionals, to protect personal information and to accommodate and ensure continuity in coverage of health insurance. However, it is also important for individuals to understand the law and what their rights are under the law. When you understand your health care rights, you can advocate for yourself and your loved ones. Here are some of the most important rights you have thanks to HIPAA:

  • You have a right to access and get a copy of your electronic medical record. You may have to put a request in writing and wait 30 days or less.
  • You have the right to check and request that information on your record is changed if you believe it is incorrect or that there is something missing.
  • Even if a medical institution disagrees with an error you found in your record, you have a right to have a notation made that indicates you believe there is a mistake.
  • You can send your electronic medical record to a third party, or have it sent for you.
  • There are valid and legal reasons for a doctor to share your health information, but you have a right to know when, how, and with whom it is shared.
  • You also have a right to indicate any specific information that you never want shared, even with other physicians or anonymously for public health records.
  • You can request that a doctor or other health care worker contact you at a location other than your primary residence.

The Importance of Privacy and Confidentiality

It has long been an ethical standard for physicians and other health care professionals, including medical researchers, to protect the privacy of patients and to keep interactions with patients confidential. One of the most important reasons for ensuring this privacy and confidentiality is that it is essential for a patient to trust medical professionals. Trust between a patient and doctor is important because patients put their health and their lives in the hands of their doctors. They will not get the best care if there is no trust.

Patients who trust their health care professionals will not be sharing their personal information are more likely to be willing to open up and be honest about their symptoms and health habits. Doctors and other caregivers cannot do their jobs or provide the best care if they don’t get all the information from their patients.

In some instances, a person may be unwilling to get a diagnosis and treatment because of stigma and the fear that someone may find out what illness they have, including friends or an employer. Mental illnesses and infections like HIV are particularly stigmatized, and to break down that barrier it is important that patients know their doctors will not be sharing this very personal information.

Privacy and confidentiality are so important to individuals but are also vital to public health. Guaranteed privacy supports and encourages participation in public and community health initiatives and in important medical research. Keeping data about health private also allows government and other institutions to collect and study statistical information about public health, disease, injuries, disabilities, and other medical information.

When you know what your rights are and what you are entitled to under the law called HIPAA, you are better able to advocate for yourself or for a loved one who cannot do the same because of illness or age. HIPAA protects individuals and patients and ensures that you can get good quality health care while maintaining your privacy.