Although it was initiated with the idea it would be used for social security purposes only, it becomes easy to identify persons through the construction of secondary data bases. It is imperative to protect against such a development with unique health care identifiers. The secretary shall publish in the Federal Register any recommendation of the National Committee on Vital and Health Statistics regarding the adoption of a standard. The Leahy bill, which responds to some of the requirements of the Health Insurance Portability and Accountability Act of 1996, as of this writing, is very protective of patient confidentiality. It will require vigilance and hard work to maintain it in this form throughout the legislative process.
Many protections are necessary.
It is important that the physician continue to be the guardian of the patient's record. In this role, physicians have controlled access to the record, let patients know when others are seeking access, and served as advisors to patients as to the consequences of releasing the information. We are able to resist pressures that patients find difficult to resist alone. Deidentification is best accomplished in the physician's office before the release of the record. The practice of having patients sign blanket releases for insurance or other purposes should be discontinued.