Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 10 - Public Health Administration › Subchapter 10 - Registries › Part 6 - Regional Health Information Organization and Health Information Exchange › Section 216-RICR-10-10-6.2 - Definitions

Current through June 14, 2024
A. Wherever used in this Part, the following
				  terms shall be construed as follows:
1. "Act"
				  means R.I. Gen. Laws Chapter
				  5-37.7 entitled, "The Rhode Island
				  Health Information Exchange Act of 2008."
2. "Administrative review" means the
				  administrative processes contained in Practices and Procedures Before the Rhode
				  Island Department of Health (Subchapter 05 Part 4 of this Chapter), and as
				  otherwise permitted by the Administrative Procedures Act.
3. "Authorized representative" means:
a. A person empowered by the patient
				  participant to assert or to waive confidentiality, or to disclose or authorize
				  the disclosure of confidential information, as established by this Part. That
				  person is not, except by explicit authorization, empowered to waive
				  confidentiality or to disclose or consent to the disclosure of confidential
				  information; or
b. A person
				  appointed by the patient participant to make health care decisions on his or
				  her behalf through a valid durable power of attorney for health care as set
				  forth in R.I. Gen. Laws §
												23-4.10-2; or
c. A guardian or conservator, with authority
				  to make health care decisions, if the patient participant is decisionally
				  impaired; or
d. Another legally
				  appropriate medical decision maker, temporarily, if the patient participant is
				  decisionally impaired and no health care agent, guardian or conservator is
				  available; or
e. If the patient
				  participant is deceased, his or her personal representative or, in the absence
				  of that representative, his or her heirs-at-law; or
f. A parent with the authority to make health
				  care decisions for the parent's child; or
g. A person authorized by the patient
				  participant or their authorized representative to access their confidential
				  health information from the HIE, including family members or other proxies as
				  designated by the patient, to assist patient participant with the coordination
				  of their care.
4.
				  "Business associate" means a business associate as defined by HIPAA, and its
				  implementing Regulations (45
				  C.F.R. Parts 160 through
				  164).
5. "Confidential health information" means
				  all identifiable information relating to a patient participant's health care
				  history, diagnosis, condition, treatment, or evaluation.
6. "Data submitting partner" means an
				  individual, organization or entity that has entered into a business associate
				  agreement with the RHIO and submits patient participants' confidential health
				  information through the HIE.
7.
				  "Department" means the Rhode Island Department of Health.
8. "Director" means the Director of the Rhode
				  Island Department of Health or his or her designee(s).
9. "Disclosure report" means a report
				  generated by the HIE relating to the record of access to, review of and/or
				  disclosure of a patient's confidential health information received, accessed or
				  held by the HIE.
10. "Electronic
				  mobilization" means the capability to move clinical information electronically
				  between disparate health information systems while maintaining the accuracy of
				  the information being exchanged.
11. "Emergency" means the sudden onset of a
				  medical, mental, or substance use, or other condition manifesting itself by
				  acute symptoms of severity (e.g., severe pain) where the absence of medical
				  attention could reasonably be expected, by a prudent layperson, to result in
				  placing the patient's health in serious jeopardy, serious impairment to bodily
				  or mental functions, or serious dysfunction of any bodily organ or
				  part.
12. "Gender markers" means
				  the sex or gender designation recorded in a patient's medical
				  records.
13. "Health care provider"
				  means any person or entity licensed by this State to provide or lawfully
				  providing health care services, including, but not limited to, a physician,
				  hospital, intermediate care facility or other health care facility, dentist,
				  nurse, optometrist, podiatrist, physical therapist, psychiatric social worker,
				  pharmacist or psychologist, and any officer, employee, or agent of that
				  provider acting in the course and scope of his or her employment or agency
				  related to or supportive of health care services.
14. "Health care services" means acts of
				  diagnosis, treatment, medical evaluation, referral or counseling or any other
				  acts that may be permissible under the health care licensing statutes of this
				  State.
15. "Health Information
				  Exchange" or "HIE" means the technical system operated by the RHIO under State
				  authority allowing for the statewide electronic mobilization of confidential
				  health information, pursuant to the Act and this Part.
16. "Health plan" means an individual plan or
				  a group plan that provides, or pays the cost of, health care services for
				  patient participants.
17. "HIE
				  Advisory Commission" means the advisory body established by the Department in
				  order to provide community input and policy recommendations regarding the use
				  of the confidential health information of the HIE.
18. "HIPAA" means the Health Insurance
				  Portability and Accountability Act of 1996, as amended, and its implementing
				  regulations (45 C.F.R. Parts
				  160 through
				  164).
19. "HIPAA Final Omnibus Rule" means the
				  HIPAA Regulations promulgated and effective March 25, 2013.
20. "HITECH" means the Health Information
				  Technology for Economic and Clinical Health Act of 2009,
				  Pub. Law
				  111-5and its implementing Regulations.
21. "Opt-out form" means the form described
				  in §6.5.4 of this Part and by which a patient participant revokes
				  permission for the RHIO to allow provider participants access to, review of,
				  and/or disclosure of the patient participant's confidential health information
				  by electronic, written or other means.
22. "Participant" means a patient
				  participant, a patient participant's authorized representative, a provider
				  participant, a data submitting partner, the regional health information
				  organization, and the Department that has stored, submitted, accessed, and/or
				  disclosed confidential health information via the HIE in accordance with the
				  Act and this Part.
23.
				  "Participation" means a participant's authorization, submission, access and/or
				  disclosure of confidential health information in accordance with the Act and
				  this Part.
24. "Patient matching"
				  means the process of identification and linking of one (1) patient's data
				  within and across the health systems at the RHIO in order to obtain a
				  comprehensive view of that patient's health care record.
25. "Patient participant" means a person who
				  receives health care services from a provider participant and whose protected
				  health information is included in the HIE through the mechanisms established in
				  the Act and this Part.
26.
				  "Protected health information" means individually identifiable health
				  information including demographic information that is collected from an
				  individual and is created or received by a health care provider, health plan,
				  employer or health care clearinghouse that relates to the past, present, or
				  future physical or mental health or condition of an individual; the provision
				  of health care to an individual; or the past, present, or future payment for
				  the provision of health care to an individual that identifies the individual or
				  with respect to which there is a reasonable basis to believe the information
				  can be used to identify the individual.
27. "Provider participant" means a pharmacy,
				  laboratory, health care provider, or health plan that is providing health care
				  services or pays for the cost of health care services for a patient participant
				  and/or is submitting or accessing health information through the HIE and has
				  executed an electronic and/or written agreement regarding disclosure, access,
				  receipt, retention or release of confidential health information to the
				  HIE.
28. "Public Health
				  Authorities" means an agency or authority of the United States Government, a
				  State, a Territory, a Political Subdivision of a State or Territory, or an
				  Indian Tribe, that is responsible for public health matters as a part of its
				  official mandate. With regards to this Regulation, this includes: the Rhode
				  Island Department of Health (RIDOH), Executive Office of Health and Human
				  Services (EOHHS), the Department of Children, Youth and Families (DCYF), and
				  the Department of Behavioral Healthcare, Developmental Disabilities and
				  Hospitals (BHDDH).
29. "Regional
				  health information organization" or "RHIO" means the organization designated as
				  the RHIO by the State of Rhode Island to provide administrative and operational
				  support to the HIE.
30. "Security
				  incident" means a security event that results in a compromise to the
				  confidentiality, integrity, or availability of RHIO network resources,
				  including information system damage, network disruptions, or significant loss
				  of vital business assets. A security event that results in the unauthorized
				  disclosure of confidential data is also known as a security breach.
31. "Unanticipated events" means instances in
				  which the provider participant is unavailable and another health care provider
				  is providing coverage to treat the patient participant.
32. "Unsecured protected health information"
				  means protected health information that is not rendered unusable, unreadable,
				  or indecipherable to unauthorized persons through the use of a technology or
				  methodology specified by the United States Secretary of Health and Human
				  Services in guidance issued under
				  §13402(h)(2) of
				  Pub. Law
				  111-5.