Access and Disclosure of Personal Health Information: A Challenging Privacy Landscape in 2016-2018.

OBJECTIVES: To assess the current health data access and disclosure environment for potential privacy-protecting mechanisms that enable legitimate use of personal health information while preserving the rights of individuals. To identify the gaps and challenges between increasing requests and expanding uses of such information and the regulations, technologies, and management practices that permit appropriate access and disclosure while guarding against harmful misuse of such information. METHODS: A scoping literature review focused on (1) regulations affecting access and disclosure of personal health information, (2) the uses of health information that challenge access and disclosure boundaries, and (3) privacy management practices that may help mitigate gaps in protecting patient privacy. RESULTS: Countries and jurisdictions are developing laws, regulations, and public policies to balance the privacy rights of individuals and the unprecedented opportunities to advance health and health care through expanded uses of health data. Regulations and guidance are evolving, but they are outpaced by the increasing demand for and the challenges of managing access and disclosure. Mechanisms such as consent and authorization may not always be adequate. Mechanisms that advance principled stewardship are more important than ever. CONCLUSIONS: Access and disclosure management are important dimensions of privacy management practices. This is a volatile period in which diverging public policies may reveal how best to balance access and disclosure of personal health information by individuals and by institutional custodians of the information. Approaches to access and disclosure management, including the roles of individuals, should be a focus for research and study in the years ahead.

Storage media profiles and health record retention practice patterns in acute care hospitals.

This exploratory study examined the health record retention practices among health information management professionals in acute care general hospitals in the United States. A descriptive research design was used, and data were collected using a self-reporting survey. Respondents answered questions about the relationship between researcher-assigned storage media profiles (descriptions of the type or types of media on which facilities maintain health records); retention periods and factors affecting record retention periods; retention of secondary data; vendor usage; and continued reliance on paper in environments where electronic health records exist. Storage media profiles were found to be significantly related to facility operational and research needs and to the convenience of not purging records. These findings have implications for federal policy promoting the implementation of electronic health records by 2014.

Record retention practices among the nation's "most wired" hospitals.

This exploratory study examined health record retention practices among health information management professionals in acute care general hospitals in the United States. A descriptive research design was used, and data were collected using a self-reporting survey. Respondents answered questions about record retention policies, the responsibility of health information professionals in policy administration, record retention periods, factors that determine retention periods, and other information about health record retention practices.

Possible explanations for children's literal interpretations of homonyms.

This study was designed to examine factors associated with literal interpretations of homonyms. Participants were 212 second graders, ages 7;0-8;11, who listened to a story containing 16 key words. The key words were homonymous words ('pseudo-homonyms'), nonsense words, or familiar words used accurately. While listening to the story, children selected an illustration of each key word. Later, they were asked to recall the key words and to justify their picture selections. There was no association between interpretation and recall accuracy for nonsense words or familiar words used accurately; however, children who accurately recalled a homonymous key word were more likely to interpret the homonym 'literally,' relative to children who failed to recall the key word. Yet most of the children who correctly interpreted the pseudohomonyms also correctly interpreted these key words. Most children correctly recalled the story context regardless of key word type, but whereas correct recall of context predicted accurate interpretation of nonsense words and familiar words used accurately, it did not do so for homonyms. Children made equivalent numbers of literal and accurate interpretations of homonyms, even when correctly recalling context. Children's justifications for their word interpretations implicated the role of metacognitive skills, particularly in terms of selective attention, as a factor influencing homonym interpretation.