Understanding Use is Defined Under HIPAA Regulations

Use is defined under HIPAA regulations as any disclosure or access of protected health information (PHI) by a covered entity or its business associate.

A covered entity is defined as a healthcare provider, health plan, or healthcare clearinghouse.

According to HIPAA, use is a key distinction from disclosure, which involves sharing PHI with an outside party.

The HIPAA regulations outline specific examples of use, including the use of PHI for treatment, payment, and healthcare operations.

Under HIPAA, a covered entity is permitted to use protected health information for certain purposes or situations without an individual's authorization.

A covered entity is permitted to use and disclose protected health information, without an individual’s authorization, for the following purposes or situations. This includes appointment registers with only a patient's name, telephone, or address.

However, appointment registers will become protected health information and cannot be shared under HIPAA if a covered entity adds an identifier, like a date of birth, to the record.

Not all healthcare records are classified as protected health information, and understanding how sensitive information is stored and used will help you identify when data is considered PHI or not.

Under the HIPAA Privacy Rule, there are specific situations where a covered entity is permitted to use and disclose protected health information (PHI) without an individual's authorization. This includes situations where the use or disclosure is incident to an otherwise permitted use or disclosure.

A covered entity may use or disclose PHI as a result of an otherwise permitted use or disclosure, as long as they have adopted reasonable safeguards and the information being shared is limited to the minimum necessary.

In some cases, a covered entity may be permitted to disclose PHI to the individual who is the subject of the information, unless it's required for access or accounting of disclosures.

A covered entity may also use or disclose PHI for treatment, payment, and healthcare operations, which includes activities such as providing healthcare services, obtaining payment, and managing healthcare operations.

Here are some specific examples of permitted uses and disclosures:

In some cases, a covered entity may obtain informal permission from an individual to use or disclose their PHI. This can be done by asking the individual outright or by circumstances that clearly give the individual the opportunity to agree, acquiesce, or object.

Under HIPAA, there are certain exceptions to permitted uses of protected health information (PHI). For example, disclosure of PHI is allowed to avert a serious threat to health or safety.

In situations where a patient is unable to provide consent, PHI can be disclosed to a family member or personal representative. This is often the case when a patient is incapacitated or deceased.

However, even in these situations, the disclosure must be limited to the minimum necessary to achieve the intended purpose.

Public Interest Activities are an important exception to the permitted uses of protected health information. This exception allows for the disclosure of PHI without individual authorization for certain public interest purposes and benefit activity purposes.

Covered entities may use and disclose PHI as required by law, including by statute, regulation, or court orders. This can include things like reporting a disease outbreak to public health officials.

Public health activities are another area where PHI can be disclosed without individual authorization. This includes documentation that an alteration or waiver of individuals' authorization for research purposes has been approved by an Institutional Review Board or Privacy Board.

Representations from a researcher that the use or disclosure of PHI is solely to prepare a research protocol or for similar purpose preparatory to research can also be a valid reason for disclosure. The researcher must promise not to remove any PHI from the covered entity and that the information sought is necessary for the research.

Covered entities may also disclose PHI to prevent or lessen a serious and imminent threat to a person or the public. This can include disclosing PHI to law enforcement if the information is needed to identify or apprehend an escapee or violent criminal.

The following are some examples of public interest activities where PHI can be disclosed without individual authorization:

An appointment register can become protected health information (PHI) if it includes an identifier like a date of birth.

Adding a date of birth to an appointment register makes it PHI and subject to HIPAA regulations.

If an appointment register only includes a patient's name, telephone number, or address, it's not considered PHI and can be shared freely.

Regulations play a crucial role in defining how protected health information (PHI) is used under HIPAA.

The Health Insurance Portability and Accountability Act (HIPAA) sets forth specific regulations that govern the use of PHI. HIPAA defines PHI as individually identifiable health information.

HIPAA-covered entities must comply with these regulations to protect PHI from unauthorized use or disclosure. HIPAA-covered entities include healthcare providers, health plans, and healthcare clearinghouses.

These regulations require HIPAA-covered entities to implement administrative, technical, and physical safeguards to protect PHI. HIPAA-covered entities must also obtain patient authorization before using or disclosing PHI for certain purposes.