[MCOH-EH] Question Regarding vaccinations

[Fred Fung MD]

Issues surrounding separation of occ health records (a wide spectrum of practices such as vaccination, preventive health, wellness, work comp, OSHA mandatory exams, a hybrid medical practice of Employee Health and general medicine, just to name a few) from personal/private health records have gone back and forth for many years especially with the implementation of HIPAA, HITECH Act of 2009, then Meaningful Use, then ACA.

The answer to separating occ health and non occ health (private health) records depends on specific situations and circumstances, i.e. "it depends". I recall Dr. Paul Papanek did a great presentation almost 10 years ago which can be accessed in the link below. (Paul, if you are on this list, I don't mean to embarrass you but your presentation was really ahead of time and an insight to the future). With Electronic Health Records systems now almost a norm across the US, access to and from Occ Health and Private Health records could not be easier and yet still controversial.

In general (for general knowledge), there are situations where work comp related medical records are exempt from HIPAA (as part of a claim of work injury to receive benefits) and Wellness/Health promotion records under ACA that healthcare professional may access medical records in both ways (i.e. separation is unnecessary). On the other hand of the balance, Dr. Warner Hudson correctly mentioned ADA and GINA limit access to personal health records unless informed consent is given and documented. The EEOC letter is filled with qualifiers that makes the opinion almost useless for practicing occ health professionals in my view. To complicate the matter further, ERISA (a federal law) may trump state laws on health and disability benefits. Plus all the IT costs/resources of separation completely, partially or by program???

So, the issue of separating occ health and private health records is a very complicated and complex one. My recommendation is to seek legal opinion from a health law attorney for your specific situation. One situation may require separation but the other may not. Here are some additional links which may be helpful. Good luck!

Fred

PS: One trivia, if I violated HIPAA against my patient, can that patient sue me successfully? Why and why not?

http://iom.nationalacademies.org/~/media/Files/Activity%20Files/Environment/OccupationalHealthRecords/Panel%203%20Papanek.pdf

http://www.dol.gov/ebsa/faqs/faq-aca25.html

http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/workerscomp.html
Does an individual have a right under the HIPAA Privacy Rule to restrict the protected health information his or her health care provider discloses for workers' compensation purposes?
Answer:
Individuals do not have a right under the Privacy Rule at 45 CFR 164.522(a) to request that a covered entity<http://www.cms.hhs.gov/HIPAAGenInfo/06_AreYouaCoveredEntity.asp>restrict a disclosure of protected health information about them for workers’ compensation purposes when that disclosure is required by law or authorized by, and necessary to comply with, a workers’ compensation or similar law. See 45 CFR 164.522(a) and 164.512(a) and (l).

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_050145.hcsp?dDocName=bok1_050145


________________________________
From: MCOH-EH [mcoh-eh-bounces at mylist.net] on behalf of Hudson, T. Warner [TWHudson at mednet.ucla.edu]
Sent: Tuesday, August 11, 2015 3:59 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Question Regarding vaccinations

Just the standard EEOC separation of occ health and personal health records form the letter they sent ACOEM 5/31/2011 posted on their site:
http://www.eeoc.gov/eeoc/foia/letters/2011/ada_gina_confidentrequre.html  read the conclusion

Warner

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Long, Deryl
Sent: Tuesday, August 11, 2015 2:28 PM
To: MCOH/EH
Subject: [MCOH-EH] Question Regarding vaccinations

All-
Our system has recently began using EPIC for patient records.  We are looking at sharing employee vaccination data in our employees patient record in EPIC database.  Is anyone aware of any regulatory compliance issues with sharing employee vaccination records with the employees patient record?

Thank you,


Deryl Long, RN, COHN
System Director of Employee Health Services
Office:770-793-7227
Deryl.Long at WellStar.org<mailto:Deryl.Long at WellStar.org>



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