This cartoon depicts something that happens far too often with HIPAA — HIPAA is used as an excuse not to do something (such as make disclosures or provide access to records in ways that patients request) even though HIPAA doesn’t have such a restriction. This is often done out of a lack of knowledge about HIPAA. Healthcare providers frequently have mistaken notions of HIPAA being far more restrictive than it actually is. For example, last year, I wrote a post about how numerous healthcare providers wrongly use HIPAA as an excuse to refuse to email medical records to patients. Ironically, instead of forbidding it, HIPAA actually requires that medical records be emailed to patients if patients so request.
The biggest challenge regarding privacy notices is that hardly anyone actually reads the notice, and notices are often a chore to read.
There is a Hobson’s choice when it comes to such notices, whether under HIPAA or otherwise. As I wrote in Privacy Self-Management and the Consent Dilemma, 126 Harvard Law Review 1880 (2013): “[M]aking [notices] simple and easy to understand conflicts with fully informing people about the consequences of giving up data, which are quite complex if explained in sufficient detail to be meaningful. People need a deeper understanding and background to make informed choices.” Sadly, there’s no easy way to win on this one.
Here’s a new HIPAA cartoon. This cartoon is about protected health information (PHI). In the HIPAA regulations, the definition of PHI is quite complicated, as it is splintered into at least three separate parts that appear in HIPAA’s definitions section. Pursuant to HIPAA, 45 CFR 160.103:
Health information means any information, including genetic information, whether oral or recorded in any form or medium, that:
(1) Is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and
(2) Relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.
This cartoon depicts the potential future of the Internet of Things. As more and more devices are connected to the Internet, including ones implanted in people’s bodies, increasing thought must be given to the privacy and security implications. The speed of technological development is moving at a far greater pace than the speed of policy thinking regarding privacy and security.
How will the security of new devices be regulated? The market doesn’t seem to be adequately addressing the security of the Internet of Things. Bad security in devices has externalities beyond the users, as devices can be used as part of botnets to attack other targets.
How will privacy be designed into devices? How will notice and choice work? When privacy is “baked in” to a device, do the engineers have a comprehensive understanding of privacy? How will consumers be able to understand and respond to these design choices?
Should there be special considerations for medical devices or any device that is implantable in a person?
We still await satisfactory answers to these questions . . . but the expansion of the Internet of Things isn’t waiting.
Here’s an earlier cartoon I created regarding the Internet of Things: