# Presentation: 507885

## The Changing Landscape of Health Care

- What’s Changed
- From 1996 to Now?

## Changing Landscape of Health Care

- Pre-Internet Boom

- Post-Internet Boom

- Provider Centric Model

- Model Expanded to Include Consumers

- Health Insurance Portability and Accountability Act (1996)

- Covered Entities

- Non-Covered Entities

**1996**

**2007**

## Landscape Change

| 1996 | 2007 |
| --- | --- |
| Pre-Internet Boom:
Little to no use of web-based technologies
Physical vs. on-line privacy concerns
Physical data aggregation vs. on-line data aggregation
“Provider centric” model:
Health care services primarily revolve around the care provider
“Push model” of information/services to consumer
HIPAA enacted with focus on “covered entities”:
Health care providers
Health plans 
Health care clearinghouses
 | Post-Internet Boom:
Abundant use of web-based technologies
On-line vs. physical privacy concerns
On-line data aggregation vs. physical data aggregation
Consumers becoming part of the model:
Generating and managing health information (e.g., PHRs)
Push/pull models involving various parties
“Non-covered” entities entering healthcare market:
PHR providers
EHR vendors
Health Information Exchanges |

## New Landscape  New Issues/Challenges

| 2007 Changing Landscape | New Issues/Challenges in 2007 |
| --- | --- |
| Post-Internet Boom:
Abundant use of web-based technologies
On-line vs. physical privacy concerns
On-line data aggregation vs. physical data aggregation
Consumers becoming part of the model:
Generating and managing health information (e.g., PHRs)
Push/pull models involving various parties
“Non-covered” entities entering healthcare market:
PHR providers
EHR vendors
Health Information Exchanges | Post-Internet Boom:
Broader access to health information
Little standardization for on-line privacy regulations
Access to on-line data can result in access to millions of records
Consumers becoming part of the model:
Aggregate of health information held by consumers
Selling of consumer information (e.g., health care products, insurances)
“Non-covered” entities entering healthcare market:
HIPAA does not address these entities
New market with little regulation or guidance |

## New Issues/Challenges  New Risks

| New Issues in 2007 | New Risks in 2007 |
| --- | --- |
| Post-Internet Boom:
Broader access to health information
Little standardization for on-line privacy regulations
Access to on-line data can result in access to millions of records
Consumers becoming part of the model:
Aggregate of health information held by consumers
Selling of consumer information (e.g., health care products, insurances)
“Non-covered” entities entering healthcare market:
HIPAA does not address these entities
New market with little regulation or guidance | Post-Internet Boom:
Unauthorized on-line access to, and disclosure of health information
Identity Theft
Compromise of millions of records through single security breach
Consumers becoming part of the model:
Accuracy of health information (i.e., how much trust will be given to patient entered data)
Read/write control of health information
Authorized distribution of health information
“Non-covered” entities entering healthcare market:
No CPS compliance requirements for non-covered entities
Potential lack of trust, which has economic impacts |

## Does HIPAA Still Address Everything?

- Since HIPAA enacted in 1996:
- Technology has exploded
- Model for accessing and delivering health care services has evolved
- “Non-covered” entities have surfaced
- HIPAA has not changed; could mean one of two things:
- It was designed to accommodate the changes above and everything is OK
- It was defined based on the 1996 environment, and therefore issues and risks exist in 2007