MOVING TOWARD A
COMMON APPROACH
Electronic health records,
health information exchanges, and
electronic laboratory and disease
reporting present an important
opportunity for enhancing public
health surveillance, detecting
public health events more effectively,
and ensuring the conditions
necessary for people to be healthy.
The sharing and exchange of
data within and between jurisdictions
and public health professionals
is essential to rapidly
detecting and responding to health
events and to continuing to improve
the public’s health. We found
wide variation in the content of
state statutes related to the use
and disclosure of identifiable (or
potentially identifiable) information
held by public health agencies despite
the development of model
policies. This finding may suggest
that practices in the use and disclosure
of information also vary significantly
across the United States.
Further research is needed
on how public health officials understand
and act within the laws
of their jurisdictions, on whether
those laws inhibit or facilitate the
sharing of information needed for
public health purposes, and, if laws
are acting as a barrier, on what
factors may influence the adoption
of new privacy laws and policies
within states in the future. There is
also a need to continue the work,
begun by Lee and Gostin,17 of
identifying the essential elements
of such a framework and build
consensus within the public health
community on which future privacy
policies can be based. Advances
in information technology
and federal policies that encourage
the exchange of data via electronic
health records will require
a common, understandable, and
principled framework for ensuring
the appropriate protection, use,
and disclosure of personally identifiable
information maintained
by public health systems. Such a
framework can be developed and
its adoption encouraged by engaging
stakeholders in the development
of the framework, integrating
the framework into other
public health efforts such as the
movement to accredit state and
local health departments, and
providing state and local jurisdictions
with tools, such as a set of
sample policies, to assess their own
privacy practices and policies.