Overview of Protected Health Information (PHI)
Protected health information (PHI) refers to any individually identifiable information that is collected from a person in connection with their physical or mental health. This includes information related to past, present, or future medical conditions, treatments, and services. PHI is considered confidential and must be kept secure under applicable federal regulations.
Definition of PHI
According to the U.S. Department of Health and Human Services (HHS), PHI is defined as “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. This includes demographic information such as name, address, date of birth, social security number, and other information related to a person’s physical or mental health.
The importance of protecting PHI
Protecting PHI is important for a variety of reasons. First, it ensures the privacy and confidentiality of individuals’ sensitive health information. Second, it helps to ensure that individuals have access to appropriate medical care and treatment. Finally, it helps to protect against potential identity theft and fraud. As HHS notes, “When PHI is not properly protected, individuals may not seek needed medical care because they fear others may learn of their condition or treatment.”
Examples of PHI and What is Not Considered PHI
Types of information that are considered PHI
Examples of PHI include:
- Names
- Addresses
- Phone numbers
- Email addresses
- Social security numbers
- Medical records
- Billing information
- Insurance information
- Diagnoses
- Treatments
- Prescriptions
Types of information that are not considered PHI
Information that is not considered PHI includes:
- Demographic information, such as age and gender
- Employment information
- Financial information, such as bank account numbers
- Educational information
- Criminal history information
Federal Regulations Governing PHI
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), covered entities and business associates must comply with certain federal regulations to protect the privacy and security of PHI. These regulations include the following:
HIPAA Privacy Rule
The HIPAA Privacy Rule establishes national standards for the protection of PHI. It requires covered entities to develop policies and procedures for the collection, use, and disclosure of PHI. It also sets limits on the uses and disclosures of PHI and gives individuals certain rights with respect to their PHI.
HIPAA Security Rule
The HIPAA Security Rule sets forth administrative, physical, and technical safeguards for the protection of PHI. These safeguards are designed to ensure that PHI is secure and accessible only to authorized individuals.
HITECH Act
The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted in 2009 to promote the adoption of health information technology. It requires covered entities and business associates to provide notification in the event of a breach of unsecured PHI.
How PHI is Collected, Used, and Disclosed
Collection of PHI
PHI can be collected directly from an individual or indirectly from another source. In either case, the individual must provide written authorization before PHI can be collected. PHI may only be collected for approved purposes, such as treatment, payment, or health care operations.
Use of PHI
Once PHI is collected, it can be used for a variety of purposes. For example, it can be used to provide diagnosis and treatment to individuals, to bill for services, or to conduct research. Under the HIPAA Privacy Rule, covered entities must obtain written authorization from individuals before using their PHI for any purpose other than treatment, payment, or health care operations.
Disclosure of PHI
PHI can be disclosed to other individuals or entities for various reasons. For example, PHI may be disclosed to family members or friends if the individual provides written authorization. PHI may also be disclosed to other health care providers for treatment or payment purposes. Additionally, PHI may be disclosed to law enforcement or other government agencies when required by law.
Safeguarding PHI in the Workplace
In order to protect the privacy and security of PHI, employers must implement safeguards in the workplace. These safeguards include administrative, physical, and technical measures.
Administrative Safeguards
Administrative safeguards are policies and procedures that are put in place to ensure the proper handling and use of PHI. These safeguards include employee training, incident reporting, and data security policies.
Physical Safeguards
Physical safeguards are measures that are taken to protect the physical security of PHI. These safeguards include restricted access to PHI, locked cabinets and filing systems, and secure disposal of PHI.
Technical Safeguards
Technical safeguards are measures that are taken to protect the electronic transmission and storage of PHI. These safeguards include encryption, firewalls, and authentication systems.
Breach Notification Requirements for PHI
Under the HITECH Act, covered entities and business associates must provide notification in the event of a breach of unsecured PHI. The notification must be provided without unreasonable delay and no later than 60 days following the discovery of the breach.
When a breach must be reported
A breach must be reported when there is a reasonable belief that unsecured PHI has been accessed, acquired, used, or disclosed in an unauthorized manner.
Who must be notified
The notification must be provided to the affected individual, the HHS Office for Civil Rights, and, in some cases, the media.
What must be included in the notification
The notification must include the nature and extent of the breach, the types of PHI that were involved, the steps taken to mitigate the breach, and the steps taken to protect against further breaches.
HIPAA Compliance Best Practices
In order to ensure compliance with HIPAA regulations, employers should implement best practices. These best practices include:
Establishing a culture of compliance
Creating a culture of compliance starts with upper management. Employers should ensure that leadership sets the example by adhering to all applicable laws and regulations.
Training and education
All employees who handle PHI should receive regular training on HIPAA regulations and best practices for protecting PHI. Training should be provided when new regulations are introduced or when new employees join the organization.
Regular audits and risk assessments
Periodic audits and risk assessments should be conducted to identify areas where PHI may be vulnerable. This will help employers identify any weaknesses in their security measures and take corrective action.
Protecting PHI is essential to ensuring the privacy and security of individuals’ sensitive health information. By understanding the definition of PHI, the federal regulations governing PHI, how PHI is collected, used, and disclosed, safeguarding PHI in the workplace, breach notification requirements for PHI, and HIPAA compliance best practices, employers can ensure that they are compliant with all applicable laws and regulations.
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