New Hampshire, in an effort to protect patient's rights and prevent unprecedented privacy violations, is considering a health information privacy bill, House Bill 1587. The bill does not seek to replace the federal Health Insurance Portability and Accountability Act (HIPAA), but does propose to extend it through tighter state laws.

Concerns have been raised around the country amongst stakeholders in the health care community over the lack of regulation for electronic health records under current HIPAA standards. Several states have engaged in study groups and participated in the Health Information Security and Privacy Collaboration (HISPC) led by RTI International. Now New Hampshire is seeking to legislatively address the transition from paper based records to electronic records.

HB1587 seeks to give patients control over who can access their medical records. This includes a provision for an "audit trail" that enables a patient to request information on who accessed their account, when and how much of it they saw. Further the bill seeks to place stricter limitations on the use of health information for research. A study committee would be created under the bill to look into a potential standard health information release form that all state health care providers could use. However, reportedly some portions of the bill are in conflict with HIPAA standards.

INPUT's Take:

• NH is at the legislative forefront of the on-going privacy and security measures to protect health information. Rhode Island is considering similar measures in the RI Health Information Act of 2008. Stakeholders may see more state legislature activity seeking to assist in developing privacy policies to balance the protection of individual rights while continuing to push for the implementation of electronic health records.
• The closer states get to providing effective and efficient governance the closer the Health IT tipping point is. The technologies for health IT exist, but the lack of governance, security and privacy standards have been a chief barrier to widespread adoption.