When their mental health information is kept secure and confidential, mothers are more likely to be open about their feelings and any issues they're experiencing. By being more honest about their experiences, healthcare providers can offer the most effective care and support.
HIPAA and the provisions protecting maternal health information
According to the HHS guidance on the role of HIPAA in reproductive information, “The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (Privacy Rule) supports such access by giving individuals confidence that their protected health information (PHI), including information relating to abortion and other sexual and reproductive health care, will be kept private.”
The rule states that PHI can only be disclosed without the patient's explicit authorization under tightly controlled circumstances, like when required by law or for specific law enforcement purposes, as outlined in Section 164.512(f). For example, healthcare providers are prohibited from disclosing information about a patient’s abortion to law enforcement without a valid court order. These regulations foster a secure environment for individuals seeking reproductive health services.
The same protections extend to maternal health, where privacy is equally as necessary. According to Section 164.506, HIPAA ensures that all aspects of maternal health information, from prenatal to postnatal care, are kept confidential unless there is a clear, authorized reason for sharing this information.
Sections 164.502 and 164.514 strengthen these protections further, empowering women to seek and receive medical care without the threat of their private information being misused or exposed. This proactive approach helps combat stigma and discrimination in healthcare settings.
The current state of reproductive healthcare and its impact on maternal patients
The Supreme Court's decision in Dobbs v. Jackson Women’s Health Organization dramatically altered the landscape of reproductive healthcare in the United States by removing the constitutional right to abortion and transferring the power to regulate abortion to individual states. The shift has led many states to enact laws that either severely restrict or outright ban abortion, creating a patchwork of legal environments across the country. According to a journal article published in JAMIA, this post Roe v Wade world leaves “...stakeholders including patients, clinicians, informaticians, health systems, and their business associates now face challenges regarding the routine collection and use of health information.”
The uncertainty and variation that has run over into state laws complicate compliance, particularly when it comes to disclosing PHI for law enforcement purposes or as part of legal processes. Matters are now more fraught due to the potential for criminal penalties against healthcare providers who perform abortions.
These developments have an impact on maternal patients. Women seeking care in states with restrictive abortion laws may be subject to increased surveillance and potential legal risks if their PHI is not adequately protected. For instance, a woman who travels out of state for a medically necessary abortion might risk having her medical records subpoenaed or her medical history used against her upon returning home.
The impact of maternal health information on mental health
The Biden Harris Administration's new HIPAA Privacy Rule to Support Reproductive Health Care Privacy improves the protection of maternal patients' health information. By specifically prohibiting the disclosure of PHI related to lawful reproductive healthcare, the rule shields individuals from the stress and anxiety associated with the potential misuse of their sensitive medical data. HHS Secretary Xavier Becerra discussed the widespread fear among Americans that their private medical information could be shared or misused without their consent.
Fear can deter women from seeking necessary medical care, thus exacerbating stress and mental health challenges. The rule requires healthcare providers, health plans, and clearinghouses to amend their Notice of Privacy Practices to comply with this new regulation and to sign an attestation against using PHI for investigating or imposing liability on individuals seeking reproductive care. These easures reinforce patient-provider trust.
Best practices when sharing maternal health information
- Both mental health providers and maternal healthcare practitioners need to use HIPAA compliant email services that encrypt emails both in transit and at rest. Services like Paubox provide seamless encryption and ensure that emails can only be accessed by the intended recipients.
- Before sharing any health information via email or other electronic means, obtain explicit consent from patients. Consent should detail what information will be shared, with whom, and for what purpose.
- Providers should establish clear procedures for patients to revoke consent, ensuring that their decisions are respected and implemented promptly.
- Mental health providers, who often deal with various forms of mental health cases, can create specific privacy settings in electronic health records (EHR) systems that are designed for patients with reproductive concerns and maternal health information. These settings should restrict access to sensitive data to only those healthcare providers directly involved in the maternal care of the patient.
- Both forms of providers can use data masking when displaying PHI in shared environments to ensure that sensitive information is not exposed to unauthorized personnel.
See also: Top 12 HIPAA compliant email services
FAQs
What is the privacy rule?
The Privacy Rule is a part of HIPAA that sets standards for how protected health information should be handled to ensure it's kept private and secure.
Can patients access information relating to how their reproductive information is shared?
Yes, patients can access information about how their reproductive health information is shared through their healthcare provider's Notice of Privacy Practices.
What is an EHR?
An Electronic Health Record is a digital version of a patient's medical history, maintained by the healthcare provider over time, that includes all the key administrative clinical data relevant to that person's care.
Kirsten Peremore
