The "tiger team" formed to help HHS sort through some of the trickiest issues related to privacy and security of electronic health information is taking on perhaps its toughest task to date, namely patient control over extra-sensitive parts of their medical records such as treatment for substance abuse, mental health and sexually transmitted diseases.

"We want to honor patient preferences from the policy perspective and determine if technology supports it," tiger team chair Deven McGraw, director of the Health Privacy Project at the Washington-based Center for Democracy and Technology, said at a meeting last week, Government Health IT reports.

Co-chair Paul Egerman noted that technologies exist to help patients wall off parts of their medical records before releasing information to providers, but they aren't perfect. Though a healthcare provider can withhold release of certain codes that indicate that the patient has an STD when exchanging a standard Continuity of Care Document, codes for certain tests or medications can spill the beans. Egerman called current controls "leaky."

Dr. David McCallie, vice president for medical informatics at Cerner, said that a PHR the company gives individuals "the ability to do additional filtering and express additional constraints." However, he added that that Cerner would build in more granular filtering capabilities "if the technology were available," McCallie reportedly said.

The tiger team said that the Office of the National Coordinator for Health Information Technology should create models and run pilot programs to test whether patients could be given more control over the consent process.

The team's recommendations are meant to inform the Health IT Policy Committee, which will vote in September on a series of policies related to consumer choice.

For more information:
- see this Government Health IT story

Related Articles:
Privacy, security 'tiger team' split on when patients must consent for HIE
HHS says providers, HIEs must get consent to share substance abuse record electronically
CCHIT finds new relevance in EMR consent management