Technology is a critical enabler of efforts to mobilize data and promote greater stakeholder collaboration. As healthcare organizations deploy frameworks to support meaningful data sharing and greater care coordination across the continuum, one area that must not be overlooked is the compliant protection of sensitive health information.
Federal regulations outlined in 42 CFR Part 2 (Confidentiality of Substance Use Disorder Patient Records) limit the use and disclosure of sensitive health information and identifying information. This means healthcare organizations must identify and filter data related to substance abuse to comply, but other regulations also add the need to include mental health, family planning, genetic testing, HIV, and other sexually transmitted diseases (STDs) to protect patient and member confidentiality.
A High Stakes Issue
The prevalence of mental health diagnoses continues to climb for both adults (reaching more than 44 million) and children (reaching more than 7.7 million), according to a 2019 Mental Health of America report. These trends in combination with the nation’s opioid crisis mean that the amount of sensitive information in patient records is growing. Consequently, payers and providers need methods for identifying codes related to sensitive diagnoses, and tools that ensure suppression of these codes as information is shared.
For instance, consider the challenge associated with proactive care coordination following a patient’s discharge from a psychiatric hospital. The goal for the hospital is to keep the patient from relapsing and having to be readmitted. Thus, the psychiatric provider will want to make appropriate referrals to community resources and keep communication lines open with primary care providers and other key stakeholders. Without validation of patient consent to release sensitive information, the provider must suppress it in the record. Typically, this requires manual intervention each time data is requested—a process that is not only resource-intensive but opens the door for errors and omissions.
Improving Safeguards of Sensitive Patient Information
The ability to automate the redaction of sensitive data provides payers, providers and patients piece of mind that data is only shared at the direction and explicit permission of each patient. Content that comprehensively addresses sensitivity codes is an important part of any technology infrastructure aimed at efficient and accurate identification and filtering of sensitive information.
Leveraging an automated framework can ensure:
- compliance with legal, regulatory and licensing requirements
- compliance with 42 CFR Part 2, HIPAA, and varying state laws including concealment of information of minors under 18 years of age
- sensitivity codes are always up-to-date
Health Language Sensitivity Codes helps healthcare organization ensure sensitive information is protected. Representing categories such as Mental Health, Alcohol & Substance Abuse, STD, HIV, Family Planning and Genetic Testing, the Health Language sensitive content set includes nearly 40,000 codes. Other publicly available standard sets only contain around 4,500 codes and don’t include Genetic Testing. Health Language codes come from ICD-9-CM, ICD-10-CM, ICD-10-PCS, LOINC®, SNOMED CT®, SNOMED CT US Extensions, CPT®, HCPCS, UB-04® Revenue Codes, RxNorm and NDC. Publicly available standard sets also do not include procedure codes or UB-04® Revenue Codes.
Our clients leverage the Health Language Sensitivity Codes to free up internal resources and improve accuracy. For example, healthcare organizations must address maintenance of sensitivity codes across nine coding systems—a complex initiative for resource-strapped organizations. Since the first half of the year, the Health Language clinical content team has added 10 new codes for alcohol and substance abuse, eight for family planning, four for HIV, 27 for mental health and eight for various STD’s.
Notably, an internal analysis found that Health Language sensitivity content was more comprehensive (adding more than 10,000 extra codes) and up-to-date (Health Language Sensitivity Codes updates monthly) when compared to value sets offered through the Substance Abuse and Mental Services Administration.
Unlike other industry value sets, Health Language sensitivity content includes additional codes for mental health such as: Z69.12 - Encounter for mental health services for perpetrator of spousal or partner abuse, F53.0 - Postpartum depression, F43.1 - Post-traumatic stress disorder (PTSD). In the substance abuse category, the content set includes such codes as, SNOMED 295174006 - Heroin overdose.
Several of Health Language’s analytics vendor clients are using our sensitivity codes to accurately track and identify sensitive data within longitudinal medical records. This allows their customers the confidence to not only understand this data but to make sure they are not transmitting sensitive data where not appropriate.
Wolters Kluwer is a licensed distributor for CPT, UB-04, RxNorm and hundreds of other standardized code sets, offering healthcare organizations the convenience and cost efficiencies of a single data provider. The Health Language solutions are designed to support health IT vendors, payers, health systems, HIEs, research and government organizations to improve search and documentation, support reference data management, enable semantic interoperability and data normalization, improve quality measure reporting, maximize revenue cycle management, meet Meaningful Use compliance and enhance analytics. Speak to an expert to learn more about the Health Language Sensitivity Codes.
CPT® is a registered trademark of the American Medical Association (AMA).
LOINC® is a registered trademark of Regenstrief Institute, Inc.
SNOMED CT® is a registered trademark of the International Health Terminology Standards Development Organisation (IHTSDO).
UB-04® is a registered trademark of the American Hospital Association (AHA).