Twenty Years of the Health Insurance Portability and Accountability Act Safe Harbor Provision: Unsolved Challenges and Ways Forward.
Twenty Years of the Health Insurance Portability and Accountability Act Safe Harbor Provision: Unsolved Challenges and Ways Forward.
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《健康保险流通与责任法案》安全港条款实施20年：未解决的挑战与前进方向
DOI：
10.2196/37756
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发表时间：
2022-08-03
影响因子：
3.2
通讯作者：
Manson, Steven M.
中科院分区：
文献类型：
--
作者：
Krzyzanowski, Brittany;Manson, Steven M.
关键词：
《健康保险流通与责任法案》（Health Insurance Portability and Accountability Act，HIPAA）是保护患者数据隐私的重要里程碑;然而，针对地理数据的HIPAA条款仍然模糊不清，阻碍了流行病学家和地理学家使用和共享空间健康数据的方式。空间健康的文献和选择法律的和官方的指导文件学者提出了模糊的指导方针，导致使用和传播的一个单一的HIPAA安全港规定的地理数据的多种解释。对这一标准的误解导致许多实体在过于保守的水平上共享数据，而其他实体则提供了可能使患者数据处于风险之中的安全港定义。为了促进对安全港规则的理解和遵守，本文回顾了从创建到现在的HIPAA法律，阐明了常见的误解，并为学者提供了直接的指导。我们关注的是20，000人的人口门槛和安全港的3位数邮政编码规定，这是围绕如何共享患者位置数据的混乱的核心。对这两项规定的全面审查，结合了各种专家观点和相关研究，揭示了安全港的替代方法如何为研究人员提供更好的数据和更好的数据保护。自引入安全港条款以来的20年里，情况发生了很大变化;然而，它仍然是试图共享地图的研究人员的主要指导（和挫折）来源，让许多人等待这些规则根据时代进行修订。
The Health Insurance Portability and Accountability Act (HIPAA) was an important milestone in protecting the privacy of patient data; however, the HIPAA provisions specific to geographic data remain vague and hinder the ways in which epidemiologists and geographers use and share spatial health data. The literature on spatial health and select legal and official guidance documents present scholars with ambiguous guidelines that have led to the use and propagation of multiple interpretations of a single HIPAA safe harbor provision specific to geographic data. Misinterpretation of this standard has resulted in many entities sharing data at overly conservative levels, whereas others offer definitions of safe harbors that potentially put patient data at risk. To promote understanding of, and adherence to, the safe harbor rule, this paper reviews the HIPAA law from its creation to the present day, elucidating common misconceptions and presenting straightforward guidance to scholars. We focus on the 20,000-person population threshold and the 3-digit zip code stipulation of safe harbors, which are central to the confusion surrounding how patient location data can be shared. A comprehensive examination of these 2 stipulations, which integrates various expert perspectives and relevant studies, reveals how alternative methods for safe harbors can offer researchers better data and better data protection. Much has changed in the 20 years since the introduction of the safe harbor provision; however, it continues to be the primary source of guidance (and frustration) for researchers trying to share maps, leaving many waiting for these rules to be revised in accordance with the times.
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