Heath Information Technology Commission Report - Fy2010 Appropriation Bill - Michigan Department Of Community Health Page 59
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87Most state have enacted their own privacy laws that apply, in some cases unintentionally, to the
electronic exchange of health care information. One of the impediments to interstate exchange
is reconciling differing state laws and finding reasonable ways to facilitate exchange that both
allows information to flow and meets the requirements of those differing laws.
The MiHIN Shared Services will address the following issues:
Inconsistent laws addressing the disclosure or re-disclosure of information for treatment
purposes.
Inconsistent laws addressing the disclosure of “sensitive” patient information.
Inconsistent laws addressing the disclosure of public health information (immunization
records, communicable diseases, etc.) among states.
Laws, designed for paper based HIE, which fail to address current modes of
transmission and/or storage of electronic data. (Electronic Transmission/Electronic
Signatures).
Lack of uniform consent/authorization forms and policies
4.5.8 Trust Agreements
Data sharing agreements and data use agreements have been developed and the MiHIN
Shared Services will utilize these agreements wherever reasonable. For health information
exchange to take place among health care networks, all participants must adhere to a set of
shared rules. In addition, the participants must define their relationships—community HIE to
community HIE, state to state, and local and state to national—under state and federal law.
Legal relationships are defined through data use, data sharing, or trust agreements or
memoranda of understanding (MOU). These agreements or MOUs address the privacy and
security responsibilities of the parties to the agreement.
Trust agreements or MOUs address the following (and other issues):
The policies that establish who has access to health information
What uses of information are acceptable
The extent to which patients can give or withhold access to their information
The design of privacy and security safeguards
The following intrastate and interstate agreements have been collected:
12
National : DURSA
HISPC - Review agreements developed by the Inter -Organizational Agreements
13
Collaborative
My One HIE (Southeastern Michigan based)
12 . Draft Data Use and Reciprocal Support Agreement, National Health Information Network Cooperative DURSA Workgroup.
January 23, 2009; Data Use and Reciprocal Support Agreement (DURSA )for NIHIN Limited Production Pilot Activities.
October 21, 2009.
13. Health Information Security and Privacy Collaboration (HISPC) Model Inter Organizational Agreements Public Entity Data
Sharing Agreements and User Guide; Model Inter Organizational Agreements Private Entity Sharing Agreements and User
Guide; Model Inter Organizational Agreements Health Information Exchange Agreement: Public Health Pilot. March, 2009.
MiHIN Strategic Plan
Page 53
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